AoTrauma Regional Hand Course

• Running a practical exercie

A N Moharram MD, FRCSEd

Precourse meeting

Professor of Orthopedic Surgeon, Cairo University Egypt

Dubai UAE October 10, 2011

What is a practical exercise?

• « I hear and I forget. I

see and I remember. I

do and I underestand» Confucius (551 BC- 497 BC)

What is a practical ?

• Structured and interactive learning• Demonstration of new skill• Explanation of the steps• Talking through procedure• Practicing new skill• Reflection on performance• Feedback & support

Who is Practical Director?

• Planning of the session

• Preparing effective and stimulating session

• Following the A,B,C of learning

• Focusing on learning outcomes

• Communication with participants

What does table instructor do?

• Works with the director

• One-on-one instruction and support

• Delivers constructive support

• Works within assigned group

• Observe and interact with all group members

How people learn?

Affective Psychomotor

Cognitive

Key points

• Skill is not reflex action

• Complex movements require practice

• Reinforced practice

• Environmental factors

• Feedback

Before the session

• Sufficient numbers of artificial bones, Instruments, and implants

• Review all the video/DVD

• Preview the video(table instructors)

• Flip chart (key steps)

• Has enough time been allocated• Time for supervised practice• Time for feedback• Time for evaluation

Structuring the practical

• Set

• Dialogue

• Closure

Set

• Room temperature, light, and quietness

• Does all the equipment work? Do you know how to use them?

• Welcome the participants

• Keep the introduction brief and to the point

Dialogue

• Keep in mind that adult

learners need to know

the application of what

you want them to learn

or to do

Dialogue

• Divide the content into short manageable section

• Do you have the attention of the all learners

• Consider the safety issues

• Apply the four-step approach

Closure

• Reflect on outcomes and key learning points

• Address questions

• Summarize main points

• Deliver a final “take-home” message

Four-step approach

• 1- Silent demonstration

• 2- Demonstration with explanation

• 3-Learner talks through the task (faculty performs the task)

• 4- Learner perform the task (50% time of the session)

Video CCTVPractical director

Table instructor

Closure

• Show the finished result

• Summarize the key points

• Invite questions

• Strong positive “take home message”

Role of the table instructor

• Reinforcement of the correct procedure and give constructive

feedback

• Explain the steps

• Discuss the principles involved before the hand-on practice

Faculty Pitfalls

• Lecturing at the work station

• Faculty doing the skill

• Disinterested faculty

• “ I-don’t-use-this-implant” attitude

• Unfamiliarity with equipment & instruments

• Telling learners that you have better way of performing the skill

Student Pitfalls

• Talking through the demonstration

• Taking pictures or video instead of doing the exercise

• Experimenting with unsolicited or untaught techniques

• A general lack of interest

• Not interacting with other participants

• Inappropriate level of participation:• Monopolizing• Rushing ahead• Too complacent

Some advices Dealing with some personalities

• Beware alternate agendas

• Direct disruptive or monopolizing learners

• Silence the chatterboxes

• Engage the silent learners

• “Excellence is an art

won by training and

habituation”

Aristole

(384 BC-322BC)

Table Instructor Checklist

• Internalize the four-step approach

• Familiarize yourself with exercise procedure

• Get to know the learners at your table

• Reinforce the demonstration before hands-on

• Stick to the script – don’t show off

• Be aware of time

• Deliver constructive feedback

• Provide positive reinforcement and lots of praise