Section 3: Efficient Teaching Tools for Preceptors

Teaching effectively during a busy clinic session can be challenging. Here are some strategies for balancing patient care and productivity, while making an educational impact during patient care.

One-Minute Preceptor

SNAPPS:

A six-step learner approach to clinical education; the learner talks about the case in more detail, taking the preceptor through their critical thinking process, while the preceptor acts as a facilitator for the process.

Written summary here: SNAPPS: A Six-Step Learner- Centered Approach to Clinical Education

Structured Chart Review and Feedback Opportunities

Have a designated time with each student to review charts and ensure they fully understand the clinical reasoning behind patient management. This dedicated review period also creates an intentional space for formative feedback. During these sessions, preceptors may guide students through questions such as:

  • “How does your assessment and plan connect to the patient’s chief complaint?”
     Encourage students to articulate the clinical logic linking symptoms, exam findings, assessment, and proposed management.
  • “Were there any unexpected findings or systemic conditions we may have overlooked?”
     This helps students practice identifying red flags, comorbidities, or subtle findings that may influence care.
  • “Is there anything from the previous exam that we need to carry forward for future visits?”
     This supports continuity of care and teaches students to track long-term issues, monitor changes, and update problem lists appropriately.

These discussions reinforce critical thinking skills, highlight gaps in clinical reasoning, and allow the preceptor to tailor feedback to the student’s level of training.

If time constraints prevent regular in-person review, consider using a shared, living document for ongoing comments, questions, and feedback throughout the rotation. Secure communication methods—such as institutional encrypted email, HIPAA-compliant messaging platforms, or the clinic’s secure EHR messaging system—are appropriate ways to follow up about specific patients when synchronous conversations are not feasible.

Throughout this process, be mindful of the distinction between your personal charting preferences and the standard of care, and make this clear to students as part of their professional development.

Preceptor Pearl:  Students often do not remember to review medications and allergies and need coaching to link the importance of these items to the management plan.  Encourage them to ask the patient the indication and/or jot them down in a small notebook and look up the indication for each medication.

Mini-Lecture: Effective Case Presentation Techniques

Preceptors can demonstrate clear expectations by modeling an organized and concise case presentation. A typical structure includes:

  1. Demographic Information: Age, ethnicity, gender
  2. Reason for Visit: Chief complaint and duration
  3. Pertinent History: Relevant review of systems, ocular and medical history, and updated medications/allergies
  4. Key Findings: Data that directly informs case history, diagnosis, and management

Assessment & Plan: Differential diagnosis, testing rationale, treatment plan, and follow-up recommendations

Preceptor Pearl: One of the most challenging skills for students is identifying pertinent details from the case history that meaningfully guide differential diagnosis and testing decisions.

Preceptor Pearl: Actively listen to the student’s presentation and reflect back what you heard. Ask, “Do you think this information is sufficient to form a differential diagnosis?” When appropriate, reorganize or restate the presentation to model a clearer, more structured version so the student can hear and emulate effective communication.

Prompts to Strengthen Assessment Skills

Linking Findings to the Chief Complaint

  • “How does your assessment address the patient’s chief complaint?”
  • “Which findings today directly support your working diagnosis?”
  • “Is there anything in the case history that you think is inconsistent with your assessment?”

Differential Diagnosis Development

  • “What are the top three differentials based on the findings so far?”
  • “What did you rule out, and how?”
  • “If the primary diagnosis is incorrect, what else could this be?”

Identifying Pertinent Positives/Negatives

  • “Which exam findings most strongly support your diagnosis?”
  • “Which expected findings were not present, and what does that tell you?”
  • “What systemic conditions might influence this presentation?”

Using Previous Exam Information

  • “Is there anything from the last exam that we need to carry forward today?”
  • “How has the condition changed over time, and what does that imply for our assessment?”
  • “Does the patient’s response to previous treatments affect your conclusion today?”

Prompts to Strengthen Plan-Writing Skills

Evidence-Based Decision Making

  • “What is the rationale behind your plan?”
  • “What clinical guideline or standard of care supports this decision?”
  • “What alternative management options could also be appropriate here?”

Prioritizing Interventions

  • “Which issue do we need to address first, and why?”
  • “What is most urgent for the patient’s health or safety?”
  • “Does your plan address both the acute concern and long-term management?”

Follow-Up and Monitoring

  • “What follow-up interval is appropriate, and why?”
  • “Which findings do we need to monitor over time?”
  • “What specific changes would prompt you to shorten or lengthen follow-up?”

Patient Communication Considerations

  • “How would you explain this diagnosis and plan to the patient?”
  • “What instructions should the patient take home today?”
  • “Are there lifestyle or systemic health factors the patient should know about?”

AI Prompts for Integrating Systemic and Ocular Health

  • “Could any systemic conditions contribute to these findings?”
  • “Should we coordinate with the patient’s PCP or a specialist?”
  • “What labs or imaging might be appropriate if this were systemic?”

AI Prompts for Refining Clinical Judgment

  • “If this patient returned tomorrow with worsening symptoms, how would your plan change?”
  • “What is the risk of doing nothing in this case?”
  • “Is your plan safe, efficient, and cost-appropriate?”

Prompts for Self-Assessment & Growth

  • “What part of writing this A/P felt most challenging for you?”
  • “What information do you wish you had gathered earlier in the exam?”
  • “If you observed another student present this case, what advice would you give them?”

Additional Resources:

AI Tools for Clinical Teaching

Artificial intelligence is a helpful tool for clinical teaching, with the right boundaries set to protect patient confidentiality and the critical thinking process for student learning.  

General guidelines for the usage of AI to convey to students: 

  • Absolutely no patient protected health information (PHI) should be entered into an AI platform without proper security measures through the insitution. This can include identifiable ocular imaging that can be traced back to a patient. 
  • Use the institution’s AI platforms to ensure security of information. Using personal AI platforms that are not under the institution’s Business Associate Agreement can put you at risk for breach of confidentiality. 
  • Students should develop their own management plans before using AI to refine their wording, if needed. 

Some examples of the use of AI in the clinical setting include: 

  • Devising cases for small group discussions 
  • Helping students to understand how to handle difficult situations with patient interactions 
  • Customer Service AI Role-Playing Exercise (used in Optometric Business Management Course on topic of Communication at NECO)
  • Refining asssessment and plans WITHOUT inserting protected patient health information (PHI)
  • Preparing students for OSCE’s

AI-Based Tools:

  • ChatGPT
  • SimConverse
  • Copilot

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