Practice Perfect 836
The One-Minute Preceptor: A Tool to Help Clinical Educators

This one is for all of you oh-so-busy clinical teachers, doing your best to eke out the time to teach your trainees while balancing the needs of an active practice. Providing feedback to your learners is one of the most important aspects of an educator’s job, and people much smarter than me have thought of effective and efficient ways to do this.

One of the most popular methods to teach “on the job” is the One-Minute Preceptor (OMP). The method provides teachers with a quick tool to engage the student or resident in an active learning experience to supplement their clinical patient encounter to maximize that learning experience. It consists of what have been termed “five microskills.”

In all its glory, here’s the One-Minute Preceptor:

  1. Get a commitment
  2. Probe for supporting evidence
  3. Teach general rules
  4. Reinforce what was done well
  5. Correct errors/provide feedback

What I listed above is the suggested order from the original paper, but I’d like to recommend a slightly different order.

  1. Get a commitment
  2. Probe for supporting evidence
  3. Reinforce what was done well
  4. Correct errors/provide feedback
  5. Teach general rules

I switched around the last three, moving “teach general rules” to the end. It’s more natural to teach rules after pointing out errors or giving feedback so the learner can incorporate the improved method into their practice. Giving feedback on an error flows more smoothly into providing pointers on how to approach patient issues in the future than teaching rules first and then pointing out errors.

Here’s a short conversation to help us get the feel for how this works. You’re in clinic with James Smith, a first-year resident, presenting a patient with left medial arch pain.

You: “So, Dr Smith, what do you think is going on?” [Getting a commitment].

Dr Smith: “I think Mrs Jones has posterior tibial tendon dysfunction.” You: “What is in your history and physical support for your diagnosis?” [Probe for supporting evidence.]

Dr Smith: “Well, Mrs Jones has two weeks of flat feet associated with pain to palpation around the navicular and her radiographs show a decreased calcaneal inclination and Meary’s angles.”

You: “I like that you correlated your history and physical examination with the radiographs [reinforce what was done well], but I also heard an acute history with trauma and an avulsion fracture of the navicular tuberosity.” [Correct errors/provide feedback].

You: “Don’t forget when looking at the radiographs to be systematic, looking at all cortices to check for fractures, especially given the acute trauma history in this patient. In this patient, a flatfoot, since it was bilateral, was probably there before the injury.” [Teach general rules]

A rather quick modification of the One-Minute Preceptor (OMP) is to ask the learner their diagnosis, then have them provide supporting evidence, and ask for their treatment plan. It doesn’t incorporate all aspects of the (OMP), but, in a pinch, it starts the learner thinking and demonstrating their thought process.

When using this system try to be open to giving positive, nonjudgmental feedback, that is specific and focuses on providing clear methods to improve.
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Desert Foot 2022

As a final comment to this topic, the OMP is not particularly helpful for procedural teaching. There are other methods for this which – spoiler alert - we’ll cover in next week’s Practice Perfect.

Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

  1. Neher JO, Gordon KC, Meyer B, Stevens N. A five-step “microskills” model of clinical teaching. J Am Board Fam Pract. 1992 Jul-Aug;5(4):419-424.
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