Teaching practices and Trainers are selected for the educational opportunities they offer to their Trainees. Trainees may learn from

Why a training practice?

Learners are heavily influenced by their environment as well as anything the Trainer may attempt to put across. If the environment and the teaching produce mixed messages then the overall effectiveness of the teaching is diminished. When the tension is between do what I say and do what we do the latter is the more powerful message.

For Trainees to get the maximum benefit from their training therefore, it is important that the training practice provides a high standard of care and is efficiently organised. These features exemplify and reinforce the messages of good practice that the Trainee receives from other sources such as reading or day release courses.

Doing a job well should not be regarded as elitist. Trainees need to see General Practice conducted and managed in an exemplary way. Effective training for General Practice should equip the Trainees to cope with all types of practice regardless of social or economic circumstance.

The training practice as a learning resource

For a Trainee to get the best out of training, a wide range of methods and resources should be developed. This is impossible for Trainers to provide on their own as the range of knowledge, skills and attitudes needed is enormous and cannot be encompassed by one individual. In a training practice each Partner has different expertise as do the Practice Nurses and Health Visitors. Many aspects of practice management and the organisation are best taught by Practice Managers and administrative staff.

Becoming a Training Practice is not a once and for all transformation but a maturation and continual evolution influenced by many factors. These include, national and regional criteria, individual Trainees, local trainers group, courses and reading. The most important factor however is the motivation of the doctors and members of the practice.

Good practice and good teaching?

The development of a practice requires both the promotion of good practice and the fostering of a good learning environment. This involves consideration of various aspects of the practice:

Teaching methods

Honey & Mumford (1986) describe four types of learning style:

  1. Activist style. Learning comes best from your experiences, active involvement and work and people.
  2. Reflective style. Learning comes best when a student is able to stand back and think and review carefully the task in an unhurried way.
  3. Pragmatist style. Learning is maximised when the theory and the job are obviously linked; where the task is practical and there is a chance to try out the techniques.
  4. Theorist style. A student learns best from being offered and using a theoretical model, can question and analyse the task and deal in terms of concepts.

The awareness of a Trainees preferred learning style can be useful for a Trainer to encourage initial learning and enthusiasm for a subject. For example,in a teamwork exercise:

The Trainer must not confuse learning style with personality and must appreciate that learning style is not fixed. Indeed, the Trainers role should be to help Trainees to be aware of their own learning styles and develop a wider range of styles to facilitate learning later on in their career. There are four recognised teaching styles.

  1. Authoritarian - tell and sell. The teacher makes a point and does not encourage questions because they will question his authority. This style is probably only good for conveying facts (but so is reading).
  2. Socratic - question and answer. The teacher always asks and the learner always answers, each answer triggering the next question. Information is only provided when the learner demonstrates an area of ignorance.
  3. Heuristic - find out yourself. Encouragement of learning by doing.
  4. Counselling - understand what is behind it. This is a less directive style than the others with the aim that the learner should understand the interactions that are taking place between him and the material being learned. Under this, ideally, Trainers should be able to use different styles for different situations. It is, however, difficult to move from one style to another. Trainers must be aware of their own strengths and weaknesses.

Summary