Intended for healthcare professionals

Clinical Review ABC of learning and teaching in medicine

One to one teaching and feedback

BMJ 2003; 326 doi: (Published 08 March 2003) Cite this as: BMJ 2003;326:543
  1. Jill Gordon

    Although it is not clear whether Dr Sylvius (above) was describing his teaching method in relation to a group of students or to a succession of individual students, he understood the essential features of clinical education. He understood, for example, the need for active learning in an authentic clinical setting.

    Wards, operating theatres, general practice, and community clinics provide a context for active learning

    “My method (is) to lead my students by hand to the practice of medicine, taking them every day to see patients in the public hospital, that they may hear the patients' symptoms and see their physical findings. Then I question the students as to what they have noted in the patients and about their thoughts and perceptions regarding the cause of the illness and the principles of treatment”

    Dr Franciscus de la Boe Sylvius, 17th century professor of medicine at the University of Leyden, Netherlands

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    Dr Franciscus de la Boe Sylvius

    Dr Sylvius also understood another important feature of one to one teaching—close behavioural observation (of each other, teacher and learner). No other setting provides the same opportunity for this. Dr Sylvius led his students “by [the] hand.” He cared about his role as a teacher. In the closely observed one to one relationship your unguarded statements, your reactions under pressure, and your opinions about other people and the world at large are all magnified.

    As a teacher, you are an important role model whether you wish it or not

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    What's different about one to one teaching?

    Just as you cannot hide from the learner, so the learner's knowledge, skills, and attitudes will become apparent to you. Provided that you have created a trusting relationship, you can discuss his or her personal and professional attitudes and values in a way that is seldom possible in a …

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