Avoiding 'consultation interruptus' - a model for the daily supervision and teaching of general practice registrars

In general practice placements, much of the teaching occurs when the supervisor is called into the consulting room by the registrar while the patient is still present. How should this unique learning environment affect on teaching strategies?

This article analyses the nature of general practice teaching and proposes a different model of teaching in a 'patient-present' environment.

General practice registrars are advanced learners who benefit from exploration of clinical reasoning in patient encounters. However, teaching interactions that undermine the patient-registrar relationship will affect the registrar's exposure to continuity of care. In this article, a model for the supervisor to follow when entering the registrar's consulting room while the patient is still present is described. This model emphasises leaving the registrar in control of the consultation and the use of 'thinking aloud' to explore clinical reasoning while at the same time preserving the relationship between registrar and patient.