As a clinical teacher, I have encountered several challenges in clinical training. Some of these are the following:
1. Clinical teaching is highly unpredictable. For example, during the 8-week PDR 3 Pedia rotation, the cases on the ward were the same, such as pneumonia and acute gastroenteritis only. Because there is no diversity in the cases, not all learning outcomes can be met in this manner. This challenge can be handled using a recorded lecture video in TED-Ed, for example of all the focused clinical conditions during the rotation, which the students can watch on their own as SDL, followed by a small group discussion and follow-up test.
2. Assessments of students differ among preceptors due to rater biases, which result in an incorrect/unfair assessment of students' performance. Some preceptors gave students better ratings, others lower ratings than they probably deserved, while yet others provided only one rating to all students. This can be addressed by using objective assessment tools and observing how preceptors rate and provide appropriate feedback.
3. Preceptors arriving late and abruptly leaving for emergency situations during student encounters in the clinic. This is quite common, and providing a backup/ alternate for each rotation to cover absences will help. When an alternate is unavailable also, students are assigned to the senior resident for instruction. Here, the resident's teaching may have been inconsistent, but at least the students' exposure to the clinic was not wasted. Another option is to provide case-based scenarios as plan C for the students to work on and then discuss these at the next meeting.