AMEE Guide no. 34: teaching in the clinical environment

Abstract

Teaching in the clinical environment is a demanding, complex and often frustrating task, a task many clinicians assume without adequate preparation or orientation. Twelve roles have previously been described for medical teachers, grouped into six major tasks: (1) the information provider; (2) the role model; (3) the facilitator; (4) the assessor; (5) the curriculum and course planner; and (6) the resource material creator (Harden & Crosby 2000).

It is clear that many of these roles require a teacher to be more than a medical expert. In a pure educational setting, teachers may have limited roles, but the clinical teacher often plays many roles simultaneously, switching from one role to another during the same encounter. The large majority of clinical teachers around the world have received rigorous training in medical knowledge and skills but little to none in teaching. As physicians become ever busier in their own clinical practice, being effective teachers becomes more challenging in the context of expanding clinical responsibilities and shrinking time for teaching (Prideaux et al. ). Clinicians on the frontline are often unaware of educational mandates from licensing and accreditation bodies as well as medical schools and postgraduate training programmes and this has major implications for staff training. Institutions need to provide necessary orientation and training for their clinical teachers. This Guide looks at the many challenges for teachers in the clinical environment, application of relevant educational theories to the clinical context and practical teaching tips for clinical teachers. This guide will concentrate on the hospital setting as teaching within the community is the subject of another AMEE guide.

Additional information

Notes on contributors

Subha Ramani

DR. SUBHA RAMANI, MD, MMEd, MPH is a general internist and medical educator. She completed Internal Medicine residencies in India and the United States. She has undergone extensive training in medical education including the Stanford Faculty Development Programme, the Dundee Discovery Courses in Medical Education and the Harvard Macy Programme for Physician Educators and completed a Masters in Medical Education from the University of Dundee in 2005. Her major areas of interest are clinical teaching methods, bedside teaching and teaching and assessment of clinical skills. She is the Director of Clinical Skills development for the Internal Medicine Residency Programme and Associate Professor of Medicine at the Boston University School of Medicine.

Sam Leinster

PROFESSOR SAM LEINSTER FRCS (Ed), FRCS (Eng) MD is presently the Dean of the School of Medicine, Health Policy and Practice, East Anglia Medical School, and Non-Executive Director and General Surgeon of Norfolk and Norwich Hospital Trust. He was previously Director of Medical Studies and Professor of Surgery at the University of Liverpool where he designed and implemented an acclaimed new curriculum for undergraduate medicine and he has also established the Breast Unit at the Royal Liverpool University Hospital. He is involved internationally in many aspects of medical education and an active member of the Association for the Study of Medical Education (ASME).