Student Faculty Rounds

At the beginning of each outpatient rotation, you will receive a schedule indicating the date for your student-faculty round. Identify a patient early in your rotation who you and your preceptor believe will be suitable for this exercise. Well before your session, identify a topic related to ambulatory internal medicine care. Topics in disease diagnosis, pahtophysiology, management and prognosis are the most successful. The most important feature of a topic is that it interests you.

In preparing your seminar, please keep in mind that small group teaching is usually most fun and successful when the group is asked to solve a problem. Make every effort to encourage participation by your colleagues. If you have never done this sort of thing before, you may want to read about small group teaching (Ch. 3 in reference by Newble). You may want to bring visual aids or assign specific reading to individuals in your group who can become "consultants." Be creative. If your session is loud, fun, and informative, you will have succeeded.

You will turn in to the clerkship coordinator a copy of your written objectives for your seminar and a copy of any handouts or Powerpoint slides for your file.

Objectives

  1. To broaden the exposure all students have to common conditions in Ambulatory Internal Medicine Care.
  2. To help students develop skills in small-group instruction.

Guidelines for your presentation

  1. Select a patient from your ambulatory experience who illustrates a challenge in diagnosis, prognosis, or disease management.
  2. Design a 30-minute teaching exercise based on this patient or the challenge he/she presents.
  3. Develop and communicate a set of written learning objectives on a behavioral paradigm. In this paradigm, objectives are written in a manner that implies an assessment strategy. For example, instead of writing “describe the shoulder examination”, try “by the end of the session, students will be able to demonstrate an effective examination of the shoulder”.
  4. Keep your exercise narrowly focused. Avoid overviews or large topics. For example, rather than talking about the treatment of pneumonia, talk about risk stratification for patients with pneumonia.
  5. Problem-solving exercises are more effective than lectures for most teaching. For example, for a session on physical examination of the ankle, ask students to examine each other or themselves (rather than lecture on how to examine the ankle). For a session on diagnosis of headache, give a brief lecture on the topic (10 minutes), and then have students work through several cases.
  6. Use stimulus materials (e.g.: cases, a quiz, photographs, data to interpret).
  7. An enthusiastic teacher will create interest in his/her topic more effectively than a teacher who is uninspired. Interest improves motivation to learn.
  8. See "Tips For a Successful Student-Faculty Rounds" for further guidance.

Past SFR formats that have succeeded

  1. Round Robin Problem Solving 
    Following a mini-lecture (5 minutes), presenter poses a series of problems that students take turns solving. This format has been used successfully, for example, in helping students diagnose different types of nevi, recognize malignant skin lesions, understand the predictive value of physical examination findings, and interpret ECGs. For the session on recognizing malignant skin lesions, the student projected skin photographs and asked each student in turn to describe them, identify ABCD characteristics ( Asymmetry, Border irregularity, Color variation, Diameter) and recommend for or against biopsy. For the session on predictive value, the student defined the likelihood ratio and demonstrated how it is used to calculate post-test probability. He then presented a series of physical examination maneuvers and administered multiple-choice questions regarding their absolute or comparative likelihood ratios. Many myths were debunked.
  2. Physical Diagnosis 
    Following a mini-lecture on the pertinent anatomy or physical examination components, students examine each other. This format has been used successfully to teach the Ottawa Ankle rules and the shoulder exam.
  3. Traditional Lecture
    This is a riskier strategy, but it can succeed when the topic is very circumscribed and the presenter is well-organized. In one successful example, a student projected a list of complications from an undisclosed disease. The complications included gastric perforation, osteoporosis, and sudden death. NO ONE identified the disease (eating disorder). Now motivated, students paid attention to the lecture that followed.
  4. Traditional Case Conference
    In this format, the presenter hands out (or projects) the description of a patient. Members of the audience are asked questions. At points, the presenter fills in the group's knowledge gaps with mini-lectures. Sometimes a case is used to lead-in to a longer lecture. This format was used successfully by a student who talked about drug interactions of selected herbal remedies.
  5. Quiz Bowls
    In this format, the student presenter introduces his or her topic and then divides the audience into teams. Questions are posed to one team and then the other. This format fails when the questions test factual recall rather than problem solving skill.