UCSF Teaching Skills for Residents
Resident Teaching
Development Program
[Specialty]
[Name]
[Date of the workshop]
Updated May 10, 2017
Contact us for more information about the Resident Teaching Development Program
http://tinyurl.com/ResTeach
UCSF Teaching Skills for Residents
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Table of Contents
Goals for the Four-Session Workshop Series ............................................................................ 4
MODULE 1: Learning Climate ................................................................................................... 5
Objectives .............................................................................................................................. 5
Strategies for Creating a Positive Learning Climate ............................................................... 6
Practice Using Four Strategies for Creating a Positive Learning Climate ............................... 7
Personal Goals for Establishing a Positive and Welcoming Learning Climate ........................ 8
Workshop Evaluation ............................................................................................................. 8
MODULE 2: Setting Goals and Expectations ............................................................................ 9
Objectives .............................................................................................................................. 9
Steps for Setting Goals and Expectations ............................................................................ 10
Practice Setting Third-Year Clerkship Goals ........................................................................ 11
Personal Goals for Setting and Communicating Goals and Expectations ............................ 12
Workshop Resources and Evaluation .................................................................................. 12
MODULE 3: Clinical Teaching Skills Model-The One-Minute Preceptor .................................. 13
Objectives ............................................................................................................................ 13
Five Microskills for Clinical Teaching ................................................................................... 14
Practice Using Clinical Teaching Skills ................................................................................ 17
Personal Goals for Clinical Teaching Skills .......................................................................... 18
Workshop Evaluation ........................................................................................................... 18
MODULE 4: Giving Feedback ................................................................................................. 19
Objectives ............................................................................................................................ 19
Definition of Feedback ......................................................................................................... 20
Practice Giving Feedback - Feedback Observation Form .................................................... 21
Personal Goals for Giving Feedback ................................................................................... 22
Workshop Evaluation ........................................................................................................... 22
Evaluation ............................................................................................................................... 23
References.............................................................................................................................. 23
UCSF Teaching Skills for Residents
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Goals for the Four-Session Workshop Series
1. Assist you in creating a supportive and challenging learning
environment for your teams.
2. Clarify expectations for medical student learning and for you as a
teacher.
3. Expand your repertoire of practical teaching techniques appropriate for
clinical settings.
4. Improve your confidence as a clinical teacher and team leader of
medical students and interns.
At the end of the session you will be asked to complete an on-line evaluation
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MODULE 1: Learning Climate
The purpose of this session is to offer guiding principles for creating an
engaging, supportive and challenging learning environment in clinical
settings.
Objectives
By the end of the session, residents will be able to:
 Discuss four strategies for creating an engaging, supportive and
challenging learning environment.
1.
2.
3.
4.
Exhibit enthusiasm for teaching and patient care.
Welcome learners and respect diversity.
Model humility in inquiry and coaching.
Balance support and challenge.
 Describe how each strategy can be used to maximize learning for a
diverse group of students and interns.
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Strategies for Creating a Positive Learning Climate
Resident-teachers create an engaging, supportive and challenging
learning environment to enhance clinical learning when they:
1. Exhibit enthusiasm for teaching and patient care.
Learning is enhanced when learners encounter enthusiastic role models.

Introduce yourself and describe why you are excited and passionate about
learning and patient care.

Learn and use student and intern names.

Embody a positive and optimistic attitude toward the team and learning.
2. Welcome learners and respect diversity.
Learning is strengthened when role models demonstrate respect for others, create
welcoming relationships and value diversity.

Invite learners’ insights, thoughts and opinions.

Create a welcoming, warm and supportive learning/working climate for all
learners.

Consider cultural or other differences that might affect participation in the
learning environment.

Communicate clear goals and expectations.
3. Model humility in inquiry and coaching.
Learning is enhanced when role models acknowledge their limits and mistakes.

Admit your own limitations, errors, and concerns.

Encourage questions and independent thinking.

Think aloud and invite learners to do the same.

Acknowledge learner insecurities, fear of harming patients, and desire to know
when and how to ask for help.
4. Balance support and challenge.
The learning environment should balance support and challenge.

Provide support for uncertainties, problems and deaths.

Challenge learners to advance their understanding and make new connections.

Provide appropriate practice with feedback and reflection.
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Practice Using Four Strategies for Creating a Positive
Learning Climate
Scenario: Welcome team on first day using these strategies. Work in trios
(attending/preceptor, team member, observer). Capture scripts.
Strategies of Learning
Scripts to use
1. Exhibit enthusiasm for
teaching and patient care.
2. Welcome learners and
respect diversity.
3. Model humility in inquiry
and coaching.
4. Balance support and
challenge.
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Personal Goals for Establishing a Positive and Welcoming
Learning Climate
I would like to try….
1. ____________________________________________________
2. _____________________________________________________
Workshop Evaluation
Evaluation Form: http://tinyurl.com/EvalResTeach
UCSF Teaching Skills for Residents
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MODULE 2: Setting Goals and Expectations
The purpose of this session is to learn how to identify and communicate
learning goals and expectations to medical students in clinical settings.
Objectives
By the end of the session, residents will be able to:
 Describe the rationale for identifying and communicating clear goals
and expectations.
 Write goals and expectations for your learners.
 Demonstrate how goals can be communicated and revisited.
 Consider cultural or other differences that could affect goal-setting for
individual learners.
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Steps for Setting Goals and Expectations
1. DEFINE educational goals and functional goals
 Write 3 educational goals for your learners - what you want them
to learn (knowledge, skills or attitudes).
 Set 3 functional goals and expectations for your learners – what
you want them to be able to do.
 Separate into educational and functional. Be specific and clear
(concrete).
 Describe the relevance and importance of the goals.
 Review clerkship goals and objectives to help with this process.
2. SOLICIT AND NEGOTIATE learner goals
 Check learner acceptance of your goals.
 Ask for learner goals and negotiate agreed upon goals.
 Consider cultural or other barriers to defining goals.
3. COMMUNICATE goals to your learners
 Practice communicating goals. “My goals for you are….”
 Tell them the relevance and importance of the goals – why they
should learn them.
4. REVISIT goals over time
 Halfway through the rotation revisit goals
 “Let’s see how we are doing…”
Adapted from the Stanford Faculty Development Program, Leland Stanford University, 1998
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Practice Setting Third-Year Clerkship Goals
Exercise 1: Creating Goals
Educational Goals
Functional Goals
(Knowledge, skills and attitudes)
(Expectations for functioning on
the team)
Exercise 2: Communicating Goals
1. Write what you would say to explain goals and objectives to your
learners:
2. Practice saying this to a partner.
3. Revise and practice again:
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Personal Goals for Setting and Communicating Goals and
Expectations
I would like to try….
1. ____________________________________________________
2. _____________________________________________________
Workshop Resources and Evaluation
Clerkship Objectives: http://tinyurl.com/ResTeach
Evaluation Form: http://tinyurl.com/EvalResTeach
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MODULE 3: Clinical Teaching Skills Model-The
One-Minute Preceptor
The purpose of this session is to offer a practical clinical teaching strategy
for use when time is limited.
Objectives
By the end of the session, residents will be able to:
 Describe the five microskills of the One-Minute Preceptor model.
 Apply the model to cases in their own specialty, avoiding biases that
could affect clinical judgment.
Materials in this section were adapted from Neher JO, Gordon CC, Meyer B, Stevens N. A Five-Step
"Microskills" Model of Clinical Teaching. Journal of the American Board of Family Practice. 1992 and from
handouts by David M. Irby, PhD.
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Five Microskills for Clinical Teaching
This practical teaching technique is composed of five consecutive “microskills” or steps,
which facilitate learning in fast-paced clinical settings where time is limited. It is also
called the One Minute Preceptor model.
1. Get a commitment – What do you think is going on?
2. Probe for supporting evidence – What led you to that conclusion?
3. Teach general rules – When this happens, do this…
4. Reinforce what was right – Specifically, you did an excellent job of…
5. Correct mistakes – Next time this happens, try this…
Case Presentation
Diagnose Learner
1. Get a commitment
2. Probe for supporting
evidence (reasoning)
Teach
1. Teach general
rules
2. Reinforce what
was right
3. Correct
mistakes
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Microskill 1: Get a Commitment
To diagnose your learner and target teaching to what the learner needs to know, first identify
learner uncertainty. This step often arises after the learner presents the case to you and pauses
for further guidance. Instead of asking more questions or giving an answer, first ask the learner
what they are thinking about the case.
Examples of questions likely to get a commitment:

What do you think is going on with this patient?

What would explain patient non-compliance?

What do you want to do next?

What do you want to accomplish during this hospitalization, procedure or test?
Examples of questions not likely to get a commitment:

Sounds like pneumonia, don’t you think?

Anything else?

Did you find out which symptoms came first?
Microskill 2: Probe for Supporting Evidence
Once the learner has stated an opinion, avoid your instinct to tell them whether you agree or
not. Instead, ask questions to find out their underlying reasoning. Their knowledge and
uncertainty will not be evident yet. You are taking the opportunity to evaluate them for teaching
purposes while allowing them to think through the case.
Helpful Approaches

What are the major findings that led to your conclusions?

What else did you consider?

What did you rule? Why?
Unhelpful Approaches

I disagree. Do you have any other ideas?

This seems like a classic case of….

What were her vital signs?
Microskill 3: Teach General Rules
Steps 1 & 2 are designed to provide clarity about what to teach and at what depth. Use this
opportunity to provide the learner with some general concepts or principles related to the case.
The learner can then apply these concepts to other patients in the future.
Helpful Approaches
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
If the patient has cellulitis, incision and drainage are not possible. You have to wait until
the area becomes fluctuant to drain it.

Patients with UTI usually experience pain with urination, increased frequency and
urgency, and they may have hematuria. The urinalysis should show bacteria and wbcs.
It may also show some rbcs.
Unhelpful Approaches

This patient has heart failure and needs diuresis. Don’t start the beta blocker now.

I’m convinced that to diagnose cellulitis you need an aspiration for a culture.
Microskill 4: Reinforce What They Did Right
Your learner may or may not know what aspect of their reasoning/management plan/diagnostic
strategy/presentation style was effective. Let the learner know specifically what was correct and
effective.
Helpful Approaches

You did a very thorough job of evaluating the patient’s abdominal complaints. Identifying
the combination of anemia and blood in the stool was critical to making the diagnosis of
colon cancer.

You considered the patient’s finances in your selection of drugs. Your sensitivity to cost
will likely contribute to his compliance.
Unhelpful Approaches

You are right. That was a good decision.

Nice presentation.
Microskill 5: Correct Mistakes
If the learner has made a mistake or needs improvement, it is crucial to their learning that you
address it. Let the learner do a self-critique first then offer your specific observations and ideas
for improvement. Focus on the future and how performance can be improved with your
suggestion.
Helpful Approaches

I agree that the patient is probably drug seeking, but we still need to do a careful history
and physical exam before we make any recommendations.
Unhelpful Approaches

You did what? What were you thinking?
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Practice Using Clinical Teaching Skills
Use for notes.
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Personal Goals for Clinical Teaching Skills
I would like to try….
1. ____________________________________________________
2. _____________________________________________________
Workshop Evaluation
Evaluation Form: http://tinyurl.com/EvalResTeach
UCSF Teaching Skills for Residents
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MODULE 4: Giving Feedback
The purpose of this session is to develop skills in giving effective feedback
to students in clinical settings.
Objectives
By the end of the session, residents will be able to:
 Define evaluation and feedback, and recognize the utility of both.
 Recognize common barriers and biases that prevent effective
feedback.
 Use effective techniques to provide positive and constructive
feedback to their learners.
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Definition of Feedback
“Specific information about the comparison between a learner’s observed
performance and a standard, given with the intent to improve the learner’s
performance.”
van der Ridder, Stokking, McGaghie, ten Cate. What is feedback in clinical education?
Medical Education, 2008:42;189-197
ASK-TELL-ASK Model of Feeback
Feedback Steps
Ask
Ask the learner’s opinion about what was effective and what
they should keep doing
Ask the learner what was ineffective
Listen actively
Respond to the content and emotion of the learner’s
reflections
Tell
Tell the learner about any additional observations, focusing
on specific observations of behavior
Ask the learner for reactions to these observations, and
respond (if applicable)
Keep the amount of feedback in correspondence with the
learner’s readiness
Ask
Ask the learner about plans for the next step. Ask for ideas
about what to stop doing
Listen actively
Ask the learner’s opinion of what they should start doing
Listen actively
Respond to the content and emotion of the learner’s
reflections
Summarize key points (or ask learner to summarize)
Agree on a plan
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Practice Giving Feedback - Feedback Observation Form
Teacher: _______________________Date:_____________ Session:___________________________
Feedback Steps
Comments/Notes
Ask
Asked the learner what s/he thought was effective
or should keep doing
Asked the learner what s/he thought was ineffective
Listened actively
Responded to the content and emotion of the
learner’s reflections
Tell
Told the learner additional observations (if any),
focusing on specific observations of behavior
Asked the learner for reactions to these
observations, and responded (if applicable)
Kept the amount of feedback in correspondence
with the learner’s readiness
Ask
Asked the learner what s//he plans to do. Prompt
with what does she want to stop doing
Listened actively
Asked the learner what s/he thought s/he should
start doing
Listened actively
Responded to the content and emotion of the
learner’s reflections
Summarized key points (or asked learner to
summarize key points)
Agree on a plan
STRENGTHS
RECOMMENDATIONS
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Personal Goals for Giving Feedback
I would like to try….
1. ____________________________________________________
2. _____________________________________________________
Workshop Evaluation
Evaluation Form: http://tinyurl.com/EvalResTeach
UCSF Teaching Skills for Residents
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Evaluation
Please remember to complete the evaluation for this program on the paper evaluation form
provided by the instructor, or at: http://tinyurl.com/ResTeach
References
A list of useful references and resources can be found on-line at: http://tinyurl.com/ResTeach
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