Orienting Learners

What’s the best way to start a clinical rotation?

An effective orientation to a rural family medicine rotation has to walk a tightrope between bewilderment and information overload. Breaking it into two parts makes the process more effective and efficient. You are busy – delegate as much as you can.

1.  Day 1 - Remember the learner is coming!

View Orientation Video

Schedule a meeting time with the learner. 10 minutes over coffee is more valuable that an hour rushing around seeing patients in the ER. Use the time for short introductions and an overview of the rotation schedule.

Sample orientation:
Brief tour of hospital
Travel to clinic and introduce to other doctors, office manager, staff
Office manager:

• Orients learner to the clinic
• Explains charting / EMR and sets up passwords
• Provides learner with clinic information package

Learner begins work with preceptor under close supervision

An information package about the clinic and the community takes some time to put together but will help integrate the learner rapidly and deals with issues that may be embarrassing if left until later – for example, expectations about dress code or on-call frequency.

Information package contents:
Clinic expectations for learner.
Sample: Resident_Orientation

Instructions for the EMR and office procedures
Local medical resources

• Lab/xray/PFTs/physio/mental health etc

Reference materials

• Library (paper/on-line)
• Binder of CPGs/useful papers

Guide to the community

2.  Later in Week 1

The key tasks at this point are to establish the learner’s baseline, to review the objectives of the rotation and develop a learning contract.
Sample: Learning_Contract

By deferring this for a couple of days you will have had a chance to see the student or resident in action and she should now be more comfortable discussing personal goals.Find out what rotations have been completed and get a sense of preferred learning style. Is this a student who learns by watching, listening or by a more “hands-on” approach?

Developing learning goals
Review rotation objectives with the learner

• Where are the weaknesses and strengths?

What would the learner like to focus on?
Complete learning contract
Modify rotation to meet goals e.g.

• More/less time in OR
• More/less obstetrics
• Exposure to other disciplines

This is also a chance for you to clarify your expectations of the learner in terms of on – call frequency, level of supervision and professional issues such as punctuality, dress code and time off.

Orienting learners A clinic information package saves time and makes the learner happy Use your staff - delegate Set individual learning goals All learners need close supervision early in the rotation.