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Creating and supporting opportunities to learn through work participation

We know that learning is most effective when students/trainees are given opportunities to engage actively in real workplace activity. These opportunities are obviously bounded by competing demands, concerns and priorities, which will include the complexity of the activity, the potential risks involved, the competence and confidence of the student/trainee, the time available and the willingness (and consent) of patients to be involved in training activity.

There will be times when, with adequate preparation and ‘safety netting’, you will delegate tasks to students/trainees in their entirety. However, there are many other opportunities in which you can work with students and trainees in parallel, to delegate aspects of work to enhance their learning or to provide participatory opportunities that will increase their confidence and readiness to undertake aspects of work activity.

One of the ways in which you can prepare and safety net is by ensuring you start with learning needs analysis. A brief yet really focused conversation with a trainee can inform your decision making about what to delegate and the support strategies you need to put in place. This will usually include finding out what they ‘know’, what they have ‘done’ before that is of relevance, any concerns or anxieties they have about what is proposed and how you can offer back-up support (or rescue) if things don’t go according to plan.

See the Assessing educational needs and Setting educational objectives modules in this series for further ideas and information.

For example, a trainee might not yet be ready to perform a complete surgical procedure. They may, however, be ready to take the history, perform the examination, consent the patient, prep the patient and perform one part of the procedure, monitor in recovery and write up the charts. This gives them a sense of taking responsibility for the patient’s management and time to focus their attention fully on the aspects they are not yet doing, but might do next time.

See ‘Integrating teaching and learning in clinical practice’ and ‘Teaching and learning through active observation’ in Explore around this topic.

This is another situation where you can use assessments for learning purposes. By looking at the trainee’s profile, you can spot patterns of competence and obvious gaps in either experience or competence. By focusing on these, you can ensure that you guide the trainee to the types of experience that are best aligned with their development needs.

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