Clinical Teaching as Tutoring: Theory-Driven Clinical Education

Abstract

Research on effective teaching in the clinical years of medical school lacks robust educational theory. The medical education literature contains a variety of models to guide clinical teachers in their practice, however these models are step-wise prescriptions that do not assist educators in understanding how they should teach or why their teaching might be effective. The One-Minute Preceptor (OMP) model is a well-known teaching prescription that serves as a starting point for making student thinking and clinical reasoning visible. By combining multiple microskills of the OMP model, a teaching session with a clinical faculty member looks similar to that of a tutoring episode. Re-conceptualizing the teaching of medical learners in the clinical setting as that of a tutoring relationship affords a strong theoretical lens to understand learning and instruction and allows for the application of empiric science on tutoring. The assessment of student competency in this arrangement also becomes easier for faculty to accomplish. By understanding the concept of scaffolding as well as the findings in human tutoring of student-construction and collaborative problem solving, clinical teachers can promote deeper learning through a more dynamic teaching process. Using analogical encoding through the technique of contrasting cases provides clinical educators a way of focusing learners’ attention on the most important facets of clinical problems and facilitates transfer for future use. Medical educators should work on translating what is known in the learning sciences into practice in their role as teachers of medicine.