Pocket Guide to Teaching for Clinical Instructors




Previously known as Pocket Guide to Teaching
for Medical Instructors
with the new emphasis
acknowledging the broader target audience
and community of interest

Pocket Guide to Teaching for Clinical Instructors

Third Edition

Advanced Life Support Group and Resuscitation Council (UK)

Edited by

Ian Bullock

London, Executive Director, Care Quality Improvement Department
COO, National Clinical Guideline Centre, Royal College of Physicians
Lead Educator, RC(UK), GIC Working Group

Mike Davis

Blackpool, Consultant in Continuing Medical Education
Lead Educator, ALSG, GIC Working Group

Andrew Lockey

Halifax, Consultant in Emergency Medicine
Director of Medical Education, Calderdale and Huddersfield Foundation Trust
Clinical Lead, RC(UK), GIC Working Group

Kevin Mackway-Jones

Manchester, Consultant in Emergency Medicine, Central Manchester Foundation Trust
Medical Director, North West Ambulance Service
Clinical Lead, ALSG, GIC Working Group






Working group

Ian Bullock
London

Mike Davis
Blackpool

Sue Hampshire
London

Andrew Lockey
Halifax

Kevin Mackway-Jones
Manchester

Sarah Mitchell
London

Sue Wieteska
Manchester

Contributors to the third edition

Ian Bullock
London

Mike Davis
Blackpool

Kate Denning
Plymouth

Sue Hampshire
London

Andrew Lockey
Halifax

Kevin Mackie
Birmingham

Kevin Mackway-Jones
Manchester

Sarah Mitchell
London

Elizabeth Norris
Bath

Sue Wieteska
Manchester

Contributors to the first and second editions

Ian Bullock
London

Andrew Coleman
Northampton

Mick Colquhoun
Cardiff

Pat Conaghan
Manchester

Mike Davis
Blackpool

Kate Denning
Plymouth

Peter Driscoll
Manchester

David Gabbott
Bristol

Carl Gwinnutt
Manchester

Bob Harris
London

Duncan Harris
London

Sara Harris
London

Jane Hatfield
Oxford

Gareth Holsgrove
Cambridge

Pauline Howard
Oxford

Melanie Humphreys
Wolverhampton

Lynn Jones
Manchester

Andrew Lockey
Halifax

Kevin Mackie
Birmingham

Kevin Mackway-Jones
Manchester

Sarah Mitchell
London

Jerry Nolan
Oxford

Gavin Perkins
Birmingham

Russell Perkins
Manchester

Mike Walker
London

Terence Wardle
Chester

Celia Warlow
Northampton

Sue Wieteska
Manchester

Jonathan Wyllie
Middlesbrough

Jackie Younker
Bristol

Foreword

The third edition of the Pocket Guide to Teaching for Clinical Instructors (commonly known as the ‘Blue Book’) is certainly a success story. Written for the first time in 1998 by medical educators engaged with the RC (UK) and the ALSG to support the generic instructor courses (GIC), it was quickly appreciated throughout Europe with its second expanded edition published in 2008. Translations into several languages followed and during the last few years it was adopted by the ERC as the written teaching source for their GIC.

Some might argue that teaching is a practical skill that ignites the learning process and it cannot be learnt from a book. Without solid theoretical background about how learning is promoted through different teaching approaches, a medical instructor’s entire teaching effort is reduced to empiricism and merely passing on beliefs.

It is fascinating how the authors of the ‘blue book’, all excellent practitioners in teaching, have been able to condense their knowledge into the well-structured chapters of this book. As a guide for instructors, it is not just another textbook on teaching in medicine.

It is a comprehensive and concise theoretical framework for effective teaching in life support courses and contains many practical tips. Reading this book before or after a GIC helps one to understand the background of the discussions and exercises, and gain keen insight into how teaching can be improved.

New chapters have been added to this new edition, which reflects the current developments of the learning needs in the GIC. Scenario teaching and role play are now discussed under the title of simulation. Instructors are not only expected to ‘run a scenario’, but rather to try as much as possible to imitate the clinical reality of the course candidates. This connects the learning objectives of the simulation to the daily clinical practice of the participants with the aim of fostering deeper understanding and enhancing retention. Important background is provided on how to ‘buy in’ professionals even in low and very low fidelity simulation settings, which is the case in many resuscitation courses.

Other important adaptations include the ‘learning conversation’ as a more direct approach to feedback. It's a move away from a rather closed structure of feedback as in the ‘feedback sandwich’ or also the Pendleton model of feedback. The learning conversation opens a discussion about the views of the participants on events during simulation and includes other team members in critical reflection with the instructor. All this is funnelled down in the end to an action plan for new learning goals to improve performance.

In the last few years, the patient safety movement has recommended that increasing attention should be given to non-technical skills (NTS) in medicine. Therefore, this version of the book encourages instructors to also teach NTS during life support courses. The reader will find a chapter on the teaching of teams, which touches upon differences between teaching individuals and groups and what makes an effective working team. That is of utmost importance for the challenges medicine faces in the 21st century.

The chapter ‘Supporting Learners’ takes up the team teaching idea and adds to the discussion about the ‘role of the instructor’ with important perspectives on mentoring candidates. This chapter also includes new inputs on the function and purpose of faculty meetings and how they can improve teaching and learning in GIC.

I hope this edition will meet the expectations of medical instructors and help them to improve their teaching so that the newest medical knowledge can to be translated into effective inter-professional and inter-disciplinary team-based patient treatment.


Robert Tino Greif
Director of Training and Education, European Resuscitation Council
Bern, Switzerland


This concise but comprehensive publication (the so called ‘blue-book’) will provide background reading for participants and instructors before and after their ERC GIC. With this support, the ERC and ALSG/RC (UK) authors and editors wish all GIC-participants successful teaching experiences on their provider courses.


Preface to the third edition

It is with great pleasure that we introduce the third edition of the “Blue Book” to you. Our first edition in 1998 laid some important foundations for the practice of course presentation and reflection on that experience; our second edition in 2008 built on these and extended the original approach in breadth and depth. This latest edition reflects ongoing developments and adaptations, including the introduction of blended learning in instructor training and the nature of the changing role of the instructors, particularly in relation to giving feedback, the structure and purpose of small group teaching and further thoughts on initiating and maintaining psychological realism in simulated learning events. We introduce for the first time, attention to non-technical skills and a focus on management of life support being a team, as opposed to an individual, endeavour.

We continue to provide a firm basis for the more practical components by drawing attention to important and relevant adult education theory. We also continue to maintain a robust model of effective planning and preparation for the variety of teaching modalities that you are likely to meet on courses. We recognise the contribution that this can make to other teaching that you might engage in your day to day interaction with colleagues and elsewhere.

We welcome the endorsement of the European Resuscitation Council and its formal adoption of the Blue Book as background reading for their instructors and candidates on their Generic Instructor Course.

The Blue Book is now just one element of a more complex educational experience than that which emerged in the late 20thPocket Guide to Teaching for Clinical Instructors


Ian Bullock
Mike Davis
Andrew Lockey
Kevin Mackway-Jones
(Editors)