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Five Microskills Method 

The One- Minute Preceptor is a model of clinical teaching/precepting that was developed by Kay Gordon M.A.
and Barbara Meyer, MD, M.P.H in the early 1990s as a tool to help enhance and foster student critical thinking
and preceptor feedback. The intent is to have the student give a short 1-2-minute patient case presentation.
Following this the preceptor works through these skills in a stepwise fashion to help maximize the case
presentation, foster learning and ownership of the clinical problem, and allowing you both to identify gaps in
the learner’s knowledge base. The steps are as follows:

  1. Get a commitment
    1. Why- Encourages learner to process further and problem solve
    2. Examples
      1. What do you think is going on with this patient?
      2. What do you think needs to be accomplished on this visit?
      3. What other diagnosis would you consider in this setting?
      4. What laboratory tests do you think we should get?
      5. Based on the history you obtained, what parts of the interview should we focus on?
    3. Probe for supporting evidence
      1. Why- Helps you to assess the learner’s knowledge and thinking process.
      2. Examples...
        1. What are the major findings that lead to your conclusion?
        2. What made you choose that particular treatment?
        3. Why did you choose this particular medication?
        4. What factors in the history and assessment support your diagnosis?
      3. Reinforce what was done right
        1. Why- Behaviors that are reinforced will be more firmly established.
        2. Examples
          1. “I liked that your differential took into account the patient’s age, recent stressors, &
            symptoms.”
      4. Correct Errors
        1. Why- Corrects mistakes and forms foundation for improvement.
        2. Example…
          1. “During the assessment for depression you did not ask about suicidality...you could ask...”
      5. Teach General Rules
        1. Why- Allows learning to be more easily generalized to other situations.
        2. Examples…
          1. “Remember common side effects of SSRI's include GI upset and headache."

 

Adapted from Neher, J. et al. A five “micro-skills model of clinical teaching. Journal of American Board of Family Practice. 1992;5(4): 419-24