Spiral Approach Used to Teach Clinical Skills Across Years

Tufts University School of Dentistry has piloted a course for fourth-year students “that now involves a team of students from each year and a real-time student response tool that plants the seeds of community in previously anonymous auditorium classes,” according to a new Educause article.

The course teamed “each fourth-year student with a third-year student, a second-year student, and a first-year student so they could work together on the fourth-year student’s case. This is a new pedagogical approach called ‘Student-driven Pedagogy of Integrated, Reinforced Active Learning (SPIRAL),’ modified from a program designed by Mark Wolff and Andrew Spielman from New York University College of Dentistry (see figure 2).


According to course developers, “Each student has particular responsibilities to align with their progress through the program.

  • First-year students are responsible for presenting information pertinent to the case that has to do with the patient but represents ‘Normal’ (see figure 2).
  • Second-year students are responsible for presenting information on the medications the patient is taking, any illnesses the patient has, and risk factors.
  • Third-year students are expected to answer a clinical question using evidence-based principles.
  • Fourth-year students select one of their patients for the case presentation and coordinate the team project while working with their patient. They also must demonstrate leadership skills through coordination of their team, and afterwards they conduct a self-assessment.

“For the peer-review element, the students analyze one another as a team by reflecting on the project to discover areas for improvement and assess factors of one another’s teamwork, presentation, and time-management skills. We also have mentors for each team — faculty and clinical staff members who oversee the team and monitor its progress.”

Read the complete “Integrating 21-st Century Workplace Skills into Lecture Based Courses article.

Tips For Giving Feedback in the Clinical Environment

  1. Establish a respectful learning environment.
  2. Communicate goals and objectives for feedback.
  3. Base feedback on direct observation.
  4. Make feedback timely and a regular occurrence.
  5. Begin the session with the learner’s self-assessment.
  6. Reinforce and correct observed behaviours.
  7. Use specific, neutral language to focus on performance.
  8. Confirm the learner’s understanding and facilitate acceptance.
  9. Conclude with an action plan.
  10. Reflect on your feedback skills.
  11. Create staff-development opportunities.
  12. Make feedback part of institutional culture.

Learning Tech @ CVM: Recording procedure demonstrations and virtual tours for clinical orientation

This week, the Office of Teaching and Learning (OTL) had an opportunity to work with several more instructors on recording videos for the clinical orientation for current VME III students.

Dr. Cooper recorded several videos, including filling in the ICU treatment sheet, a virtual walking tour of the ICU and isolation room, entering and exiting the isolation room, and the use of fluid and syringe pumps.

“If [the students] have something to watch before they come into the [rotation to reduce their fear and anxiety] … I think it [is] worth it [to spend the time and effort on these videos] … I’m also hoping that this will cut down [time spent on the orientation, which is done] every two weeks” – Dr. Edward Cooper

Other projects this week included Dr. Daniels recording a memorable video on Infection Control…

… As well as  Joelle Nielsen’s tour to track down the materials needed for making Paw Prints!

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Learning Tech @ CVM: Recording authentic scenarios for clinical orientation

Earlier this week, we had an opportunity to work with Dr. Susan Barrett, Dr. Adam Rudinsky, and Joelle Nielsen, MSW, to record authentic teaching scenarios that current VME III students will use as part of their clinical orientation. We were not only able to capture the footage that we needed, but the experience also prompted many creative ideas for multimedia that the faculty members can incorporate into their courses.

“For procedural skills such as working with clients on end-of-life care, I feel it’s important for us for provide students with an actual conversation, because the majority of them will have to have such conversations when they graduate into practice.” – Joelle Nielsen, MSW

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