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Neher: Get a Commitment

Resist the temptation to fill the silence with your own ideas; instead, ask the learner what they think about the issue.

  • Allowing the learner to interpret information is the first step in diagnosing their learning needs.
  • Mistakes in problem formulation identify teaching opportunities.
  • Without adequate information about the learner's knowledge, teaching might be misdirected and unhelpful.
  • The learner assumes greater responsibility for their learning (and patient care) while creating a collaborative role in problem solving.
  • This method helps the learner to create a "conceptual scaffold" by forcing the recall of previously learned materials and setting up the targeted exchange of information between teacher and learner. 

Example Questions

  • What do you think is going on with this patient?
  • What would you like to accomplish with this visit/interaction?
  • The commitment can be as tentative as a hunch or best guess:  "Let's start with your gut feeling..."

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The Five-Step Microskills of Clinical Teaching

Neher J, Stevens, N G (2003). The one-minute preceptor: Shaping the teaching conversation. Family Medicine, 36 (6); 391-393.