3. Teaching Strategies in the OR

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affective preceptor series teaching
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strategies in the operating room setting
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ads obstetrics and gynaecology educators
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the operating room or ORS an important
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clinical setting for teaching students
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in the loire get to explore the
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environment develop technical skills
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enhance their clinical knowledge and
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gain insight into its culture and
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function when given the proper guidance
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students can negotiate the o.r
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environment and become an active member
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of the care team
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however the LR can be a challenging
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place to learn several barriers exist
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such as concerns about patient safety
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the push for greater efficiency
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inadequate visualization separation from
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learning during minimally invasive
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surgery and the care teams attitude
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toward the student
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in addition the educational focus of the
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o.r is often the resident or fellows
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technical performance and not the
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medical student
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the good news is that educators on the
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o.r have several opportunities to make
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the experience more positive beneficial
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and ultimately fun for the student
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in this video we are going to focus on
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six attributes that students find
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valuable in an ort Chur an end with a
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teaching model made specifically for the
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o.r setting
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one setting expectations review and
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communicate the students learning
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objectives and his or her role in the OU
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art before the case starts what does a
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student want to get out of case what
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should they expect from the case and
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don’t forget introduce the student to
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all members of the OU our team including
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the nurses residents fellows and
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anesthesiologists as this sends a strong
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message that you recognize the student
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as part of the team
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to sensitivity to learning needs
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familiarize yourself with the student
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learning objectives formal our specific
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objectives may be available for the
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clerkship in which the student is
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enrolled in addition feel free to create
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your own learning objectives for your
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student you should also familiarize
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yourself with the student’s level of
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experience for example will this be one
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of the first experiences in the OU are
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for your student or is he or she
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comfortable with the or are they
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familiar with scrubbing and sterile
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technique
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if you have time prior to the case it
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may be helpful to review Anatomy or
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discuss resources such as books videos
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and other online materials
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reviewing the patient’s preoperative
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workup including the history physical
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exam laboratory studies and radiological
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images can also be helpful 3 communicate
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be sure to talk and teach throughout the
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case focus on pertinent questions that
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are appropriate for the level of your
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student try recruiting other teachers
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during a case as this can be very
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effective for example you can have an
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upper level learner such as a resident
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describe what they are doing and why
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they are doing it this utilization of
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upper level learners as teachers is an
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educational multiplier it allows you to
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do multi-level teaching while still
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addressing each learner at their own
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level lastly be sure to position the
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student so that they could see the
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operative field at all times
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for allow for active participation there
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are many key points in a case which
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could promote the students active
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participation students can easily help
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with positioning prepping and draping
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have an upper level learner such as a
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resident take the student throughout
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these steps with careful guidance
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students can also take part in Foley
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catheter insertions and simple suturing
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students can also be given the
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opportunity to hold the laparoscope or
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cystoscope
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if performing a hysterectomy allow the
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student to open and examine the uterus
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for pathological findings this can be
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done on a back table and provides the
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student the ability to handle surgical
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instruments
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additionally the student can then suture
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the uterus to reclose it five remain
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calm and courteous maximizing the
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student experience in the ELL art can be
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easy and fun don’t forget how important
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your attitude is during teaching
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especially in the lr it is essential to
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model professionalism teamwork and
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respect in the LR
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you set the tone in the o.r encourage
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residents and fellows and all members of
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the team to be courteous and have a
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teaching role acknowledging student
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learners and making them feel a part of
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the team can go a long way to improving
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the experience for the student six
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feedback communicating with your student
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including debriefing and providing
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feedback after a case is another prime
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teaching moment
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this is the time to review objectives
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that were met and those that need work
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the B ID model briefing intraoperative
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teaching and debriefing by following
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this quick and easy to remember model
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both the educator and the student can be
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focused on similar objectives for the
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case
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briefing this is the basic needs
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assessment and it can happen at the
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scrub sink
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conversation with the student and ask
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about his or her own past experience and
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goals for the current case
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to operative teaching
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this teaching should focus on the
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learning objective set during the
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briefing session
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debriefing this consists of four
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elements
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the student should be asked to reflect
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on their performance the educator should
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then reinforce what the student did well
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and correct any mistakes that were made
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finally the student should come away
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from the encounter with a rule to guide
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future of our experiences making your LR
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a positive environment for the student
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is rewarding and fun remember that a
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positive attitude and a welcoming
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demeanor can set the tone for an hour
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use simple models like the ID to guide
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your teaching and finally don’t forget
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that active learning can be easy to
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incorporate to your o R and is very
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exciting and fun for the student
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[Music]
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[Music]
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you