Preparing Your Office

“How do I integrate a learner into my practice?”

1.  Prepare your patients.

Remember to advise patients that learners will be in the office. Most patients are happy to have learners provide some part of their care, but ensure your office has a system to identify patients who prefer not to see learners.

Integrating learners:

• Have staff use inclusive language to encourage patients to see learners - “Dr X, our resident, is working with Dr Smith today.”
• Place a university or RPAP teaching plaque at the reception desk.
• Leave a photo or brief bio of the learner in the waiting room
• Post an explanatory note in each examination room.
  Sample Notice: Residents form

2.  Staff preparation.

Clinic staff may also be hazy about the role of students and residents. Explain the learner’s role and the importance of including him in the clinical team. Discuss the impact of the learner; will the learner work from your appointment schedule or from his own? Should you book fewer patients in the day? Your staff has other key functions for developing a successful rotation.

Possible staff roles:

• Orienting learner to office and the EMR
• Teaching skills, such as injections, dressings, cast removals and billing
• Arranging accommodation
• Ensuring payment received for teaching

3.  Prepare your colleagues.

Teaching is a team sport – spread the work and the enjoyment. Discuss the educational level of the learner to ensure expectations are reasonable. Negotiate teaching responsibilities to cover gaps in the schedule. Don’t forget the financial implications of learners.

Financial issues:

• Distribution of teaching stipend
• How to bill with residents
• Students may slow you down

4.  Prepare your clinic.

Developing an orientation package will save time in the long run and a binder with clinical practice guidelines and key papers is a great resource. How will you manage your space?

Space concerns:

• Learners need a home base for mail, charts, lab reports, papers etc
• A separate exam room for the learner improves efficiency
• Are there enough computer terminals?
• Resource materials – is there access to reference texts or online sources?

5.  Prepare yourself.

Review the educational objectives for the rotation so you can focus the learning experience. Try to free up some time for key events in the rotation.

Scheduling:

• Book time for initial orientation, mid rotation review, final evaluation
• Consider changing patient scheduling
  • Fewer patients early in rotation
  • Wave schedule to improve patient flow.
    Sample: The_Wave_Scheduling_System

Preparing your office Integrate the learner into your clinical team Celebrate being selected as a teaching practice Encourage but don't force patients to see learners