00 / CHAPTER 10
A practical teaching approach
Find out what the learner needs. Give them a chance to try.
Teaching can be a short conversation, an observed examination, a practical demonstration or work through an image or result. Choose a method that suits the task and the learner. A framework helps you organise this; it should not make the interaction feel rehearsed.
At FRCEM level, include how you supervise safely, adapt when someone struggles and give useful feedback. These are part of RCEM’s expectations for supporting, supervising and educating. Read the station brief and domain weightings rather than assuming a fixed teaching mark scheme.
Assess the learner
Introduce yourself and establish the learner’s role, experience and immediate need. Ask what they have seen or tried, then check their starting point with a brief explanation or demonstration. Someone’s confidence alone does not tell you what they can do.
“Talk me through how you would start.” “Which part are you least sure about?”
Choose a suitable time and place. Invite questions and make it clear that uncertainty can be discussed without embarrassment.
Agree a goal
Choose one achievable task together. Be specific about what the learner should be able to do at the end: for example, demonstrate a technique or interpret a new example and explain the next action. Match the scope to the time, equipment and supervision available.
“Shall we focus on that first step? I’ll demonstrate, then you can try it and we’ll go through it together.”
Explain or demonstrate
Use what the learner already knows. Explain in short stages, demonstrate the important actions and say why a decision matters. For interpretation, show your method on one example. Check understanding before adding more detail.
Use a model, trainer or anonymised example where appropriate. If a patient is involved, explain who will take part, obtain permission and protect comfort, privacy and dignity. The patient can decline teaching without losing care.
Let the learner practise
Hand the task over at the agreed level of supervision. Watch what happens and listen to the learner’s reasoning. Do not do all the work yourself or turn every pause into another explanation.
Intervene promptly if safety is at risk. For a non-urgent difficulty, ask which part is unclear, simplify the task or demonstrate that part again. Agree how the learner can pause or ask for help.
Give specific feedback
Ask the learner how it went, then describe something you observed: what worked, what needs to change and why. Choose one manageable improvement. Keep feedback respectful and focused on the action, not the person.
“You kept checking the patient was comfortable. When you reached the next step you stopped; talk me through what you were deciding.”
Acknowledge uncertainty in your own teaching. Check an answer you do not know instead of bluffing. The GMC’s guidance on teaching and supervision emphasises appropriate supervision and fair, objective feedback.
Reassess and close
Ask the learner to repeat the part they are improving or try another example. Check the agreed goal through what they can now explain or demonstrate, rather than asking only whether they understood.
Summarise what changed. Agree what they can practise next, what supervision they still need and when someone will observe them again. Point to one useful resource. A single successful practice attempt is not a declaration of independent competence.
Teaching while caring for a patient
Make sure urgent care is covered. Match participation to competence, arrange appropriate supervision and agree when you will take over. Follow the procedure preparation and aftercare checks for practical tasks. Explain the learner’s role to the patient, obtain permission and use anonymised material for teaching away from care whenever possible.
For a longer discussion with a group, the Educator’s guide covers preparation, cases and facilitation.
01 / CHAPTER 10
Potential teaching topics
Use the topics below to practise teaching a colleague or a patient. The procedures in Chapter 9 and examinations in Chapter 6 and Chapter 7 also make useful practice tasks. These are revision examples, not a prediction of the examination circuit.
For a practical skill, demonstrate and supervise an attempt. For a result or image, ask the learner to explain their method, findings and next action. For a patient device, check that they can use their own device safely.
02 / CHAPTER 10
Teach a colleague
Match the session to the learner’s starting point. A colleague should leave knowing both how to approach the task and when to seek help.
Practical skills, examinations and ECGs
Demonstrate the technique or method, then ask the learner to try. For intimate examinations, include consent, dignity, a chaperone and appropriate supervision. The NHS infection-control appendices include current hand-hygiene and PPE techniques.
Interpretation: fluid analysis
Start with the clinical question, specimen and relevant reference ranges. Ask the learner to describe the result, explain its significance and identify the next action. Avoid interpreting a number in isolation from the patient.
Interpretation: radiology and ultrasound
Teach a consistent approach to image quality, anatomy and abnormal findings. Check that the learner can recognise an urgent finding and explain how it changes management. Educational examples support practice; they do not replace the appropriate clinical report or supervision.
03 / CHAPTER 10
Teach a patient
Use plain language, explain a little at a time and invite the patient to show or explain it back. This checks how clearly you have taught it and gives you a chance to clarify anything that was missed.
“To check I’ve explained that clearly, could you show me how you would use it at home?”
Use the patient’s prescribed device, or its matching trainer, and current instructions. Include when to use it, practical difficulties, what to do if it does not help and how to get support.
Adrenaline auto-injector: EpiPen
Use a trainer to demonstrate and observe a return demonstration. Explain recognition of anaphylaxis and when to use the prescribed pen. Follow the instructions for that specific brand; do not assume all devices are operated in the same way.
For EpiPen, the current UK instructions specify holding it against the outer thigh for 3 seconds and calling 999 for an ambulance, stating “anaphylaxis”, immediately after use. Rehearse the complete emergency plan, including positioning and when a second pen is needed, using the manufacturer’s patient instructions.
Inhaler and spacer technique
Identify the exact inhaler and prescribed regimen. Ask the patient to demonstrate their usual technique, then address the steps they find difficult and recheck. Match the breathing technique and any spacer advice to the device and the patient’s age and ability.
NICE recommends observing inhaler technique, including a spacer where used, at asthma reviews and asthma-related consultations. Use the device-specific Asthma + Lung UK videos for demonstration and practice.
Peak flow measurement
Demonstrate the meter and observe the patient using it. Take three readings and record the highest. Explain what the reading means for that person and how to record it if monitoring is part of their care plan.
Regular peak-flow monitoring is not needed for every person with asthma. Follow the personalised asthma action plan and make clear what symptoms or readings should prompt help.
04 / CHAPTER 10
Practise the teaching interaction
Choose one task from the chapter. Agree the learner’s role and starting experience and check the relevant teaching material first. One person teaches; the other participates as the learner and gives feedback afterwards. A third person can observe if available.
For OSCE rehearsal, use the current eight-minute station time. Keep feedback outside that timed attempt, then repeat the part you want to improve and swap roles. For learning a new skill, allow more time rather than rushing to finish.
Ask your partner
- Did the goal fit my starting point?
- Did I get a chance to explain or try the task?
- When I struggled, did you find out why and adapt?
- Did the feedback describe something I could change?
- Did you check my next attempt and agree what supervision or practice I still need?
If time runs short, narrow the task. Keep one observed attempt, specific feedback and a check of the improvement. Agree how any remaining learning will be completed.
On your next shift, choose a suitable teaching opportunity, ask the colleague’s permission and try the same approach. Seek feedback on your teaching and follow up whether they can use the skill with the required supervision.