Teaching medical students

Teaching delivered in primary care has always been a feature of medical education, but in recent years this aspect of future doctors' training has increased. The following tips will make teaching and learning more enjoyable and rewarding for students and GPs alike.

Set ground rules
Several common concerns arise when teaching students, such as punctuality and attendance, students not preparing agreed work and not participating in, or dominating, discussions.

Sometimes students' expectations of what they can achieve while on GP placements are too high. Therefore, it is always worth asking the students to formulate their own ground rules of how they want you to facilitate their teaching.

You can then negotiate with them about their expectations of you and what you will be able to provide, and your expectations of them in terms of scholarliness, professionalism and intergroup relationships.

If, later, things do not go well, the ground rules can be revisited and you can ask students to suggest ways you might help to get things back on track. This type of approach will share the responsibility for the smooth running of the group, rather than it being seen as the sole responsibility of the tutor.

All of this is easier to do if the students feel a sense of ownership of their own ground rules.

Plan the teaching
Lesson planning takes a little time, but is an opportunity to think through what is the most effective way you can help the students learn. Written lesson plans can also be shared with colleagues, or used for other purposes, such as in professional portfolios.

Useful information for a lesson plan includes: context - how this material relates to what comes before and after it; length of the session; participants - how many and what you can expect them to know or have experience of already; equipment - laptop and data projector, internet access, flip-charts and so on; and intended learning outcomes - these should be in the course documentation provided by the medical school.

Vary your methods
The range of possible teaching methods you might use is only limited by your imagination (and the equipment and time available). The learning outcomes will often point you to the teaching methods you could use.

Are students expected to be able to list, recognise, employ, judge, create and assess? These verbs indicate an increasing level of complexity, and should suggest to you different ways you may teach. For example:

• Give the students a journal paper, news item, clinical case or critical incident to read and organise a seminar-type discussion.
• Show a video of a clinical case from online resources, or with permission you can make your own video/audio clips using fellow professionals or patients.
• Ask the students to prepare a presentation about their own piece of work, such as a forthcoming essay or project.
• Devise a quiz to start a session and then plan the rest of the session around the answers.
• Organise a debate.
• Set up role plays.
• Form subgroups that each work on a flip-chart poster to present to the larger group.
• Do 'fishbowl' exercises, where a subgroup or pair is observed debating or role playing by the larger group.
• Do skills-based exercises, using either models and equipment or examining each other.
• Teach at the 'bedside' using real patients.

Divide up the time
Most people have a short attention span, so divide up sessions - alter the activities, change the pace, come at the material from a range of different directions. You can do anything except deliver a long mini-lecture with no participation.

Start sessions by asking what students already know, because even new students may bring experiences from their personal lives. This also avoids pitching the material at the wrong level by either revisiting material or assuming they know more than they do.

When you end a session, one way to focus participants on what they have learnt is to ask them to share one thing they will take away from this session and how that will influence their practice.

In summary, if students recognise that you are an enthusiastic teacher, who has given thought to planning and making their teaching engaging, they will respond to that positively and learn more effectively.

You will also increase your own enjoyment of teaching and hopefully experience fewer problems in terms of student behaviour.

• Dr Washer is a lecturer in community based medical education at Barts and The London School of Medicine and Dentistry, London

Reflect on this article and add notes to your CPD Organiser on MIMS Learning