1. Varied clinical experience - not all students will see the same set of patients seen during different times of the clinical rotation. Like suggested earlier in class, to ensure uniformity of clinical experience, a list of the the must-know cases with the minimum required number of cases seen/encountered shld be given to the learner beforehand to allow them to choose their caseload to fulfill this requirement.
2. Time - always a precious commodity to both teacher and learner is scarcer as the learner ascends the hierarchy of their medical career. TLAs like the 1) one minute preceptor saves time for both parties and yet provides opportunities for learning and teaching at the same time. It can also be employed by senior residents on their subordinates. 2) staged flipped classroom strategy which allows students to see patients without then, at a later time, with the teacher and case discussion could be done in stages in doable chunks of time 3) providing a sacred time for learning - service rounds to ensure that teaching AND learning processes occur.
3. Creating confusion in students when there are differing opinions on how to manage one case. Can be resolved with multidisciplinary conference and facilitated by a non-judgmental clinician in a nurturing, academic safe space. Students can be taught to respect different perspectives and rationale of management while being guided on their own critical thinking, given the right teaching-learning atmosphere.
4. Service cases who were previously handled as private cases being "taboo" for case discussions, despite being a very fertile material for learning. Unique to PGH, that consultants are very supportive of academic learning and understand that critiques to management are not personal attacks to their management skills but rather a foray into understanding the rationale of the treatment. Sana all :) Outside of PGH, it is very hard to convince consultants to open their management to scrutiny, even in the aim of higher learning.
