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By A. Stewart Truswell

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With relatively little impact on the running of a clinic, students can participate more actively. For example, they can be Teaching during consultations has been much criticised for not actively involving learners 27 ABC of Learning and Teaching in Medicine asked to make specific observations, write down thoughts about differential diagnosis or further tests, or note any questions—for discussion between patients. ” Here, the student leads the consultation, or part of it. His or her findings can be checked with the patient, and discussion and feedback can take place during or after the encounter.

One to one teaching is ideally suited to encouraging reflective practice, because you can model the way a reflective practitioner behaves. Two key skills are (a) “unpacking” your clinical reasoning and decision making processes and (b) describing and discussing the ethical values and beliefs that guide you in patient care. Skilful teaching is not unlike skilful history taking “If musicians learned to play their instruments as physicians learn to interview patients, the procedure would consist of presenting in lectures or maybe in a demonstration or two the theory and mechanisms of the music-producing ability of the instrument and telling him to produce a melody.

The more reliable a test, the more likely it is that a similar result will be obtained if the test is readministered. Reliability is sensitive to the length of the test, the station or item discrimination, and the heterogeneity of the cohort of candidates. Standardised patients’ portrayals, patients’ behaviour, examiners’ behaviour, and administrative variables also affect reliability. The validity of a test is a measure of the degree to which the test actually measures what it is supposed to measure.

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