Using the One-minute Preceptor Teaching Model to Improve Problem-Solving and Clinical Reasoning
First, Get Learners to Make a Commitment
by Anna Greer Pitts, PGY-1 Pharmacy Practice Resident, Baptist Memorial Hospital - North Mississippi
Learning during introductory practice and advanced practice experiences is critically important to our development as new practitioners during a health professions program. Most health professional programs have learners assigned to different clinical sites so they can experience a variety of patient populations and practice environments. Unfortunately, during some introductory and advanced practice experiences, students are only permitted to “shadow” practitioners - they are not actively participating in clinical decision-making. During my first experiences as a student, I shadowed a practitioner and witnessed what they did. It was not until much later in my professional program and now during my residency that I was given opportunities to make decisions – practicing the “hands-on” skills I’ll need as a future practitioner.
Clinical educators (aka preceptors) need effective and efficient techniques to help them teach learners critical thinking skills and promote problem-solving. One technique that can be used is the one-minute preceptor method. This evidence-based teaching strategy helps guide the preceptor-student encounter using five different microskills: 1) getting a commitment, 2) probing for supporting evidence, 3) reinforcing what is right, 4) correcting mistakes, and 5) explaining general rules.1,2 It is a brief teaching strategy that promotes the development of decision-making skills, enables an assessment of the student’s knowledge, and provides timely feedback.1
The one-minute preceptor technique can be used in any clinical setting.2 The first microskill, getting a commitment, requires the learner to focus on a patient encounter (or other situation), to think about what could be happening, and to make a decision about what to do next.1,2 The act of getting a commitment can boost the learner’s confidence and makes the encounter more active and personal.5 Once the student comes up with a course of action, the preceptor then probes the learner for the evidence or rationale supporting their decision.1,2 In most educational settings, students are rewarded for a correct guess (even when they don’t really understand the material).5 But in the clinical setting, it is important to be able to “show the work,” – so these follow-up questions are intended to explore the learner’s reasoning.5 Only after the learner has made a commitment and explained their rationale does the preceptor correct any mistakes in the decision or provide feedback about what was done well.1,2When correcting mistakes or giving positive feedback, it is important to be specific by providing examples, instead of saying “good job” or “not the best choice.”5 Faculty will then discuss the important features of the patient case or the scenario with the student.1,2 By explaining the general rules, the preceptor helps the learner understand the “big picture” principles that can be generalized and applied to future decisions.5
In a pediatric clinic in South India, researchers initiated the one-minute preceptor method as a teaching and assessment strategy.2 Ten preceptors involved in teaching residents were trained in the method, and twelve second-year residents participated in the study to evaluate its effectiveness.2 The residents assessed the faculty members’ teaching effectiveness and provided feedback regarding whether the one-minute preceptor method improved their clinical reasoning skills and confidence.2 After training on the method, mean ratings for the five micro skills increased from pre-intervention (3.95 out of 10) to post-intervention (8.45 of 10).2 All residents agreed that the feedback from preceptors was more effective and increased their confidence level when they were required to commit to a decision.2
In a cross-sectional study at OB/GYN medical residency program, four faculty preceptors and 20 residents were instructed on how to use the one-minute preceptor method.3 The satisfaction index of preceptors and residents was very high (95% and 96.3%, respectively).3 All participants agreed that the method was more effective at uncovering and addressing learning gaps in busy environments compared to other teaching methods.3 All of the residents either strongly agreed (n=18) or agreed (n=2) that they were more satisfied with the one-minute method compared with traditional methods.3
Another cross-sectional study, an OB/GYN medical residency program in northeastern Brazil, implemented the one-minute preceptor model. Participants completed a questionnaire about their experiences prior to the implementation of the one-minute preceptor model and thirty days following the intervention.4 Pre-intervention questionnaire revealed that 91.7% of the residents agreed that there were inconsistencies with what teaching model preceptors used.4 After training on the one-minute preceptor technique, preceptors agreed that the method more effectively engaged learners in the decision-making process.4 Post-intervention questionnaire results showed that 95.8% agreed that the one-minute preceptor technique is more appealing than other traditional clinical precepting practices and a majority of the residents (70.9%) believe it improved their learning.4 The study found a significant improvement in the receptiveness to feedback before (20.8%) and after (66.7%) implementing the method.4
The one-minute preceptor technique helps students and residents develop critical thinking and problem-solving skills. The five microskills can be efficiently used in fast-paced environments. This technique helps increase learner confidence, provides effective feedback, and uncovers learning gaps. The one-minute preceptor method is not intended to replace other teaching methods that a preceptor might use, but it is a quick and effective strategy that can be used in many situations.1 To get started, first ask learners to make a commitment to a course of action and probe them for their rationale.
References:
Neher JO, Gordon KC, Meyer B, and Stevens N. A five-step “microskills” model of clinical teaching. J Am Board Fam Pract 1992; 5 (4): 419-424.
Ravichandran L, Sivaprakasam E, Balaji S, Swaminathan N. Effectiveness of the 1-minute preceptor on feedback to pediatric residents in a busy ambulatory setting. J Grad Med Educ 2019; 11(4s): 204–6.
Sharma R, Badyal DK, Sharma R, Seth S, Singh M. Implementation of One-Minute Preceptor for Clinical Teaching in Obstetrics and Gynaecology. J Obstet Gynaecol India 2022;73(1):69–76.
Machado MA, Medeiros EL. Training Preceptors of Obstetrics-Gynecology Residents Through the One-Minute Preceptor Model. Rev Bras Ginecol Obstet. 2021; 43(8):622–6.
The One Minute Preceptor: 5 Microskills for One-on-One Teaching. MAHEC Office of Regional Primary Care Education [Internet]. [cited 2025 Jan 27].