Teaching in the Moment

Teaching in the flow of work: practical models that stick

October Faculty Development Blog

The clinic schedule is full. Rounds are moving quickly. Another admission is waiting. In these moments, teaching can feel like one more responsibility competing for your attention.

Yet everyday clinical work offers opportunities to help residents and fellows grow. A focused question, a brief explanation of your reasoning, or specific feedback can turn a routine encounter into a meaningful learning experience.

The goal is to make teaching intentional, manageable, and connected to the patient in front of you. Three approaches can help.

The One-Minute Preceptor: Make reasoning visible

When a learner presents a patient, it is tempting to move directly to your assessment and plan. The One-Minute Preceptor provides five micro-skills that help you uncover the learner’s thinking and offer focused teaching. Despite its name, the conversation may take more than one minute.

The five micro-skills of the One-Minute Preceptor
Micro-skill	A prompt to try
Get a commitment	“What do you think is happening?”
Probe for supporting evidence	“Which findings led you to that conclusion?”
Teach a general rule	“A useful principle to apply in similar cases is …”
Reinforce what was done well	“Comparing today’s findings with the patient’s baseline strengthened your assessment.”
Correct mistakes	“Next time, include the relevant negative findings so we can better evaluate your differential.”

Try it in the flow of work: After a case presentation, ask for the learner’s assessment before offering your own. Explore the reasoning, teach one transferable principle, and give specific feedback.

Keep the conversation focused. One useful teaching point gives the learner something concrete to apply to the next patient.

SNAPPS: Give learners a structure for thinking aloud

The SNAPPS model puts learners in an active role during case presentations. Originally developed for outpatient education, it provides six steps for sharing clinical reasoning, identifying uncertainty, and planning further learning.

Summarize the relevant history and findings briefly.
Narrow the differential to two or three likely possibilities.
Analyze those possibilities by comparing supporting and conflicting findings.
Probe the preceptor with questions about uncertainties or alternative approaches.
Plan management.
Select a related topic for self-directed learning.

Try it in the flow of work: Introduce the structure before clinic and invite a resident to use it for one patient presentation.

A learner might say: “These are my two leading possibilities. Here is why I favor one, and this is the part I am uncertain about.”

The faculty response matters. Saying, “That is a useful uncertainty to identify—let’s work through it,” encourages learners to reveal the questions that need attention. Close the loop by briefly revisiting the selected learning topic at a later encounter.

Micro-teaching: One point, one application

For this blog, micro-teaching means a brief, focused teaching exchange embedded in clinical work. It can fit into a chart review, handoff, procedure, or short debrief.

Try this simple pattern: Ask > Teach > Apply

Ask: “What is the most important information the receiving team needs?”
Teach: “An effective handoff makes the next action and contingency plan clear.”
Apply: “How would you revise your handoff to include both?”

Other opportunities include:

Before a procedure: Identify one skill to observe.
After a patient conversation: Discuss one communication choice.
During documentation review: Explain how one revision makes the clinical reasoning clearer.
After an urgent event: Return to one learning point once patient care allows.

Brief teaching still needs learner participation. Ask the learner to explain, demonstrate, or apply the point so you can check understanding.

Teaching in the Moment Through Simulation

Simulation offers another opportunity for focused teaching, even when time is limited. A brief scenario—such as practicing a handoff, responding to a change in patient status, or rehearsing a difficult conversation—can target one specific skill.

Set a clear goal, let the learner practice, and use a short debrief to ask, “What went well?” and “What would you change?” When appropriate, pause the scenario, offer one actionable coaching point, and let the learner repeat that part immediately. This practice-feedback-practice cycle gives learners a chance to apply feedback while the experience is fresh.

Close by asking, “How will you use this with your next patient?” to connect the simulation to clinical work.

Make it stick this October

Choose the approach that fits the moment: the One-Minute Preceptor to explore reasoning and give feedback, SNAPPS to structure a learner-led presentation, or micro-teaching to focus on one skill.

Then try a small habit: one intentional teaching moment per shift or clinic session. Revisit the point with the next relevant patient and ask, “How will you use what we discussed?”

Teaching in the moment begins with noticing an opportunity—and helping the learner carry it forward.