April 22, 2020, by mszrm4

Medical Education in the time of Covid-19

If you are interested in joining us on these modules, on the Medical Education course here at University of Nottingham:  Click here for details on how to apply to start in September 2020.

I don’t think any of us realised how relevant our Med Ed module “Learning in uncertain and complex environments” would become over the course of this year. Dr Nicola Cooper is currently teaching on the LCE module, whilst also working as an Acute Medicine Consultant in a local hospital, and continuing to educate, not just medical trainees but also any hospital staff who need to understand the risks of Covid-19 to themselves, patients and visitors. In her last blog, “Teaching and learning in the workplace“, Dr Cooper reminds us: “teaching and learning are not the same thing”.

This was on my mind as I returned to general practice (8 weeks after emergency abdominal surgery), into a very different world to the one I left in February. Due to risk of Covid-19, all our initial contacts with patients are currently by phone and we – including our GP trainees – are trying to manage as many as possible remotely.

For medical postgraduate trainees around the country, all formal teaching sessions have been cancelled, training targets have been changed, and they have been asked to work extra clinical time instead. But – I figured – just because “teaching” is cancelled that doesn’t mean that we can’t continue learning…

The “one-minute preceptor” (Neher et. al. 1992) is a useful model to use with trainees when most teaching opportunities are “on the job”, discussing real patients in real time. So, since I’ve been back, I have been offering brief learning moments to trainees. Whenever they come to ask advice about managing a patient, I make them do the thinking!

Neher et. al. (1992) describe 5 “Microskills”:
1. Get a commitment (make the trainee give you some differential diagnoses)
2. Probe for supporting evidence (what supports or refutes the diagnoses)
3. Teach general rules
4. Reinforce what was done right
5. Correct mistakes

In my job at the University of Nottingham, I am currently leading on the module “Coaching, Mentoring and Supervision”. John Launer describes supervision as being – in it’s widest sense – any one-to-one encounter, whether for teaching purposes, formal educational supervision or peer support (Launer 2019). In this busy and stressful time for many in the NHS we, as medical educators, can continue to use our supervision skills. Whether supporting trainees with case discussions or supporting colleagues** who need to debrief an emotionally draining day, they will be appreciated.

The Covid-19 pandemic has also affected how we deliver teaching in the University. Dr Stevie Agius is leading on another of our ongoing modules; “Principles and practice of curriculum design and the educational environment” (or PCD). In our next blog, Dr Agius will tell us about how he has worked to move all face-to-face teaching online for the module this year.

Dr Rebecca McConnell is a GP in Derbyshire, GP Trainer, GP Appraiser & Clinical Associate Professor in Medical Education, University of Nottingham. @DrRebeccaMcConn

**If you or any of your colleagues need mental health support beyond basic peer supervision, please ask for professional help. See your GP or details here for: 

NHS Practitioner Health   &    BMA Wellbeing support


Launer, J., 2019. Supervision, mentoring and coaching. Understanding medical education. Evidence, theory and practice. Third edition. Oxford: Wiley Blackwell/ASME, pp.179-190

Neher, J.O., Gordon, K.C., Meyer, B. and Stevens, N., 1992. A five-step “microskills” model of clinical teaching. The Journal of the American Board of Family Practice, 5(4), pp.419-424.

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