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By A. Stewart Truswell

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One-minute preceptor” model Teaching in the clinic Although teaching during consultations is organisationally appealing and minimally disruptive, it is limited in what it can achieve if students remain passive observers. With relatively little impact on the running of a clinic, students can participate more actively. For example, they can be Teaching during consultations has been much criticised for not actively involving learners 27 ABC of Learning and Teaching in Medicine asked to make specific observations, write down thoughts about differential diagnosis or further tests, or note any questions—for discussion between patients.

For individual patients, it supplies a basis for deciding which doctor to see. For doctors, it offers reassurance that their assessment is tailored to their unique practice and based on real work performance. Despite the fact that an assessment of outcomes is highly desirable, at least four substantial problems remain. These are attribution, complexity, case mix, and numbers. Firstly, for a good judgment to be made about a doctor’s performance, the patients’ outcomes must be attributable solely to that doctor’s actions.

Buckingham: Open University Press, 1999. x Forster F, Hounsell D, Thompson S. Tutoring and demonstrating—a handbook. Sheffield: Universities’ and Colleges’ Staff Development Agency, 1995. x Habeshaw T, Habeshaw S, Gibbs G. 53 interesting things to do in your seminars and tutorials. Bristol: Technical and Educational Services, 1992. x Jaques D. Learning in groups. 3rd ed. London: Kogan Page, 2000. x Tiberius R. Small group teaching: a trouble-shooting guide. London: Kogan Page, 1999. 21 7 One to one teaching and feedback Jill Gordon “My method (is) to lead my students by hand to the practice of medicine, taking them every day to see patients in the public hospital, that they may hear the patients’ symptoms and see their physical findings.

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