Teaching in Five Minutes: Applying the One-Minute Preceptor Model in Undergraduate Clinical Nursing Education
Student Name
Master of Science in Nursing Program, Aspen University
N582: Teaching Strategies in Nursing Education
Instructor Name
Month Day, Year
Teaching in Five Minutes: Applying the One-Minute Preceptor Model in Undergraduate Clinical Nursing Education
On a busy medical unit, a composite clinical instructor supervises eight second-year nursing students. Between medication passes, procedures and questions from staff, the instructor has only a few minutes with each student at a time. When a student reports that an older patient is "more confused today," the instructor usually responds with the answer: check the glucose, look at the medications, call the provider. The student acts correctly, but the instructor has done the thinking. Across a semester, students learn to report findings and wait for direction rather than to reason through them.
The One-Minute Preceptor is a clinical teaching model designed for exactly this situation. This paper describes the model and its five microskills, reviews the evidence for its effectiveness, applies it in a worked example with a nursing student, and discusses how clinical instructors can adopt it.
The Model
Neher et al. (1992) described five microskills that a busy clinical teacher can use in a brief encounter. The teacher first gets a commitment, asking the learner what they think is going on or what they would do, so that the learner must reason before being helped. Second, the teacher probes for supporting evidence, asking why the learner reached that conclusion, which reveals the learner's reasoning. Third, the teacher teaches a general rule, a brief principle the learner can apply to future cases. Fourth, the teacher reinforces what was done right, with specific rather than general praise. Fifth, the teacher corrects mistakes, specifically and constructively. The model is designed to fit into a few minutes and to shift the cognitive work to the learner.
Irby and Wilkerson (2008), discussing teaching when time is limited, identified the model as one of several strategies that allow clinical teachers to diagnose a learner's understanding and teach efficiently in the course of patient care. Its structure is especially useful for novice clinical instructors, who are often expert clinicians but new to teaching.
The Evidence
The model originated in medical education, and most research comes from medical settings, but it has increasingly been used with nurse practitioner and nursing students. A systematic review that synthesized 12 experimental quantitative studies and discussed 20 descriptive studies concluded that the literature supports the model's effectiveness and that both students and preceptors prefer it (Gatewood & De Gagne, 2019). The review found that the model increased the use of teaching techniques such as feedback and assessment of students' clinical reasoning, and suggested it could help overcome clinicians' barriers to precepting. Evidence specific to prelicensure nursing students is thinner, so programs adopting the model should evaluate it in their own setting.
The model also fits what is known about feedback in clinical teaching. Feedback that is specific, timely and linked to observed behavior is more useful to learners than general praise or criticism delivered days later, and the fourth and fifth microskills build exactly that kind of feedback into every encounter. Because the student has already committed to an interpretation and explained it, the feedback can address the reasoning directly rather than only the outcome, which is where much of the learning happens.
A Worked Example
Returning to the student with the confused patient, the instructor might proceed as follows. To get a commitment: "What do you think is causing Mr. D's confusion today?" The student answers that he may have a urinary tract infection because he was incontinent overnight. To probe for evidence: "What makes you think so, and what else could it be?" The student notes the incontinence and a low-grade temperature but has not considered his new oxycodone order or checked his glucose. To teach a general rule: "When an older adult becomes acutely confused, think of delirium, and check for common causes together: medications, infection, glucose, oxygen, pain, urinary retention and constipation. Several often act at once." To reinforce what was done right: "You noticed the change from yesterday and brought it to me quickly; that early recognition matters because delirium is easy to miss." To correct a mistake: "You went straight to one cause. Next time, check the medication list and a glucose before deciding, and screen for delirium with the unit's tool."
The exchange takes about four minutes. The student leaves with a plan, a rule that transfers to other patients and specific feedback, and the instructor has learned where the student's reasoning stopped, information that can shape the post-conference discussion.
Adopting the Model
Adopting the model requires practice, because instructors' habit of giving answers is strong. Programs can introduce it in clinical faculty orientation with role-play, provide a pocket card listing the five microskills, and pair new instructors with experienced ones who use the model. Instructors should resist skipping the first step when busy, since getting a commitment is what shifts the thinking to the student. They should also adapt the model to the student's level: a beginning student may commit to a single observation, while a senior student should commit to a priority and a plan. The model is not suited to emergencies, when the instructor must act or direct immediately, but can be used afterward to debrief what happened.
Evaluation
A program adopting the model could evaluate it in three ways. Students can rate the usefulness of feedback on a short survey at midterm and the end of the rotation. Instructors can record a sample of teaching encounters, with consent, and score them for use of the microskills. And clinical evaluation tools can be examined for change in students' ratings on clinical reasoning items. Comparing a semester before and after adoption, with the same evaluation tool, would give the program local evidence to add to the published literature.
Conclusion
Clinical instructors rarely have time for long teaching conversations, and supplying answers is the fastest way through a busy shift. The One-Minute Preceptor offers a structured alternative that fits into a few minutes and makes students do the reasoning: commit, explain, learn a general rule, hear what they did well and what to change. The evidence, mostly from medical and advanced practice education, supports its effectiveness and acceptance. For the instructor with eight students and a confused patient, the model turns a quick answer into a quick lesson, one that students can carry to the next patient who is "more confused today."
References
Gatewood, E., & De Gagne, J. C. (2019). The one-minute preceptor model: A systematic review. Journal of the American Association of Nurse Practitioners, 31(1), 46-57. https://doi.org/10.1097/JXX.0000000000000099
Irby, D. M., & Wilkerson, L. (2008). Teaching when time is limited. BMJ, 336(7640), 384-387. https://doi.org/10.1136/bmj.39456.727199.AD
Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-step "microskills" model of clinical teaching. Journal of the American Board of Family Practice, 5(4), 419-424.
How this N 582 Module 6 example is structured
Aspen does not publish N582 module prompts, so check your classroom for the exact instructions. This example opens with a clinical teaching habit and its cost, explains the model's five microskills, reviews the evidence and its limits for prelicensure students, works through a full exchange, discusses adoption and closes with evaluation.
N582 Module 6 questions, answered
What does N582 Module 6 usually ask for?
Aspen's N582 description includes teaching strategies for clinical settings, so a paper on one clinical teaching strategy with an example of its use is a typical module shape. Check your classroom for the exact focus.
What are the five microskills of the One-Minute Preceptor?
Get a commitment, probe for supporting evidence, teach a general rule, reinforce what was done right, and correct mistakes.
Can the model be used with beginning nursing students?
Yes, adapted to their level. A beginning student might commit to one observation or concern, while a senior student should commit to a priority problem and a plan.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.