EM · Teaching, supervision and feedback

Teaching, supervision and feedback in the emergency department

Also known as Bedside teaching · One-minute preceptor · Microskills model of teaching · SNAPPS · Peyton four-stage approach · Pendleton’s rules · R2C2 feedback model · Feedback sandwich · Workplace-based assessment · Mini-CEX · DOPS · Case-based discussion · Entrustable professional activities · Graded supervision · Direct observation

Teaching, supervision and feedback in the emergency department — the clinical teacher’s core toolkit and the Fellowship Scholar domain. Bedside teaching models: the one-minute preceptor and Neher’s five microskills (get a commitment, probe the evidence, teach a general rule, reinforce what was right, correct errors), SNAPPS (Summarise, Narrow the differential, Analyse, Probe, Plan, Select — Wolpaw), and Peyton’s four-stage approach to teaching a practical skill. Feedback: the principles of specific, actionable, timely, behaviour-focused feedback (Ende); Pendleton’s rules; the R2C2 facilitated reflective model (Relationship, Reactions, Content, Coach — Sargeant, Lockyer); the feedback sandwich and why it is deprecated; and the meta-analytic evidence that feedback is among the most powerful influences on performance (Wisniewski, d = 0.48). Supervision: graded autonomy, direct versus indirect observation, and entrustment through entrustable professional activities (ten Cate, Gingerich). Assessment: the workplace-based assessment tools — mini-CEX (Norcini), DOPS, and case-based discussion (Lörwald). The differential of good versus poor teaching, and the pitfalls that erode learning and safety. ACEM-primary, globally tagged.