Teaching the Novice Learner

Novice learners are one of the most common types of learners. Whether this learner is still a student, an early resident, an APP, or a part of the support staff, it is our duty to learn how to properly teach them while on shift. This module will cover teaching techniques geared toward the novice learner, including two minute observation, Aunt Minnie, SPIT, and activated demonstrations.

Key Takeaways

Novice learners are at the "Reporter" and "Interpreter" stages on the RIME framework. They should be able to:

• Ask the right questions to collect data from patients (most of the time).
• Develop a preliminary list of differential diagnoses based on the data collected.
• Prioritize a list of most likely to least likely diagnoses with guidance.

They are developing the ability to:

• Apply knowledge from the classroom and textbook.
• Learn practical knowledge from experts in the field.
• Build pattern recognition and inventory of experiences.

Two Minute Observation

In this technique, the preceptor observes the first two minutes of learner's oral presentation, then debriefs in a private setting later. This technique is good for review of fundamentals of history taking. Make sure to explain the process to the learner and patient and avoid interruptions. This technique should not be used if you do not have time to debrief.

Aunt Minnie

In this technique, the learner sees the patient and presents only the chief complaint and their diagnosis, then the preceptor sees the patient alone. Afterwards, they discuss the differential and plan. This technique is good for lower volume days and helps learners build pattern recognition skills. Avoid this technique in rare or complex presentations.

SPIT

In this technique, the learner sees the patient and develops a differential list based on the acronym Serious, Probable, Interesting, Treatable. This approach helps students expand on narrow differentials and build their ability to develop broader lists. Do not use this technique if you do not have time to discuss the list.

Activated Demonstrations

In this technique, the educator introduces a skill to be observed. The learner then observes the educator perform the skill, and they discuss afterward together. This approach can be used for clinical skills (taking history, performing exam) or procedures (central line, cardiac arrest). It is useful when there isn't much time or you have a particularly junior learner, but make sure you have some time after observation for discussion.