FAIRness and clinical teaching

Abstract

Reflection on my long experience in medical student education has led me to conclude that the standard model of the clinical placement is not fit for purpose. The encounters between teacher and student are generally brief, superficial, and teacher-centred. Assessment of student progress is a particular problem. The model has come under pressure from increasing numbers of medical students on each placement and shorter placements.

I have proposed a new model of the clinical placement, emphasising generic skills over specialist knowledge, based on Harden's principles of Feedback, Activity, Relevance and Individualisation (FAIRness). The model's cardinal feature is review of students’ own work to accurately assess their progress and to give meaningful and regular feedback. Every student receives individual feedback, as well as exploring common problems in whole class sessions, where students can compare their standard to others’ work. This model emphasises improvement over time, rather than snapshots of student ability.