If you are looking for ways to teach students how to put theory into practice, and if your students will deal with patients (be they human or animal) in their future professional life, then  ‘clinics’ are  a well-suited teaching method.  Although this Education Tip uses examples from the Dentistry and Veterinary Medicine programmes to illustrate this particular teaching method, this does not mean that other programmes working with patients/clients cannot implement it as well.

Clinic as a Teaching Method: What? 

Definition

A clinic is an individual or collective learning situation during which students acquire knowledge, skills and attitudes under the supervision of a clinician. They discuss and examine specific patients/patient cases taken from clinical practice, determining suitable treatments, and analysing the patient’s progress. 

Setting

Unsurprisingly, the name ‘clinic’ refers to the specific setting in which the (teaching and/or later professional) activities take place. In the Veterinary Medicine programme, for example, there is an animal clinic and different labs, where veterinary care is given to pets (companion animals like cats and dogs; farm animals like horses and bovines) as well as special animals (rodents, reptiles, fish). In the Dentistry programme, we find a setting of dental surgeries.

Domain-specific and generic competencies

This teaching method is mainly used to help students put their acquired theoretical and domain-specific knowledge into practice. In other words, you might say that the clinic is a special form of case-based education. In addition to the case-based content, the clinic also addresses a number of generic competencies. Think, for instance, of reflective skills and self-management (intrapersonal competencies), communication and collaboration (interpersonal competencies), and critical and problem-solving thought (creative and innovative competencies).

Supervision

Throughout the process, the supervisors apply a differentiated approach based on the students’ prior knowledge, and adjust the learning process when students lack specific knowledge, skills or attitudes.

How to Implement Clinics as a Teaching Method?  

Preparation through pre-clinics/skills labs 

It goes without saying that students cannot just start working with flesh-and-blood patients. The Veterinary Medicine programme organises skills labs (consult this UGent Practice for more information); the Dentistry programme sets up pre-clinics.  In both instances, students are offered the opportunity to practice isolated skills in a simulated context by way of preparation for the work placements and clinics to come. In the Veterinary Medicine programme, the skills labs not only precede the clinics, but also run parallel with them. 

Clinics

During the clinics in the Master’s curriculum, students learn to apply these isolated skills to acute cases.  

In the Veterinary Medicine programme, students participate in so-called ‘thematic clinics’ on topics such as ‘medical imaging’, ‘obstetrics and reproduction’, ‘pathology/autopsies’, and ‘parasitology’, applied to different species.  All the students rotate in all these clinics throughout their study career.. 

They receive a schedule, including night and weekend shifts. Their attendance is logged by means of a scanning system. During these shifts, small groups of students under the supervision of a head of clinic (an advanced Master’s student, a PhD student, an assistant, a professor, ...) take on patient care. Per patient, students are assigned  a different role: if they take the lead in the anamnesis and the diagnosis in one case, they administer patient treatment in the next. 

In the Dentistry programme, the clinics are a reflection of the day-to-day practice at a dentist’s office. The students see patients that have not been carefully selected in advance to illustrate a particular case. Rather, they see ‘regular’ patients with any type of ‘unpredictable’ complaint.  The difference with their later professional practice, of course, lies in the fact that students are supervised during the clinic. 

During the clinic sessions, students are given the opportunity to transfer theoretical knowledge to technical skills, to organise the  practice themselves, and to manage the communication to all those involved. The latter not only concerns the patients, but also other caregivers, social services, insurance funds and insurance companies.

What are Points to Consider?  

Involve the students in the complex organisation of the clinics

Running a clinic demands of the students a considerable investment of time. To give students more breathing space during the academic year, they are allowed to do some mandatory clinic time during the Summer prior to the academic year.  This is a way to give students more responsibility in planning and organising their study time. Clinic scheduling is a complex matter, that has to take into account all the rules and regulations (incl. night work). In the Veterinary Medicine programme, the student representatives are involved in drawing up the clinic schedules.  

Anticipate the students’ concerns 

Running a clinic involves living human and animal beings. Although this  aspect is particularly appealing to students, at the same time clinics also come with a  strong factor of unpredictability (e.g. patients presenting unusual pathologies) that deters them. Patients may need a particular treatment that the students have not been able to practice in the skills lab yet. And although the heads of clinic are available to assist the students if such a case presents itself,  these can still be tense situations for students.  The Veterinary Medicine programme anticipates this by offering students virtual tours per clinic in advance. These 360° tours give students a clear view of clinic locations and the type of procedures they will have to carry out. This, in turn, t gives them a feeling of mastery.

Accept that clinics may be chaotic

Clinics are a reflection of professional reality. As such, they are equally unpredictable and unscriptable and will therefore often be  chaotic and hectic. If patients come and go in rapid succession, little time remains to give the students feedback on how they  carried out the anamnesis or the procedure. Embrace these contextual limitations but keep in mind that insecure students especially will have a strong need for feedback. 

Want to Know More?  

• watch the video clip on the Veterinary Medicine skills lab.