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Residents Teaching Workshop

Residents Teaching Workshop. UIC. University of Illinois. College of Medicine at Peoria. You are doctors. Why is teaching so important?. docere: Latin for “to teach”. Resident’s role as teacher. However, residents often did not… promote participation ask problem solving questions

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Residents Teaching Workshop

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  1. Residents Teaching Workshop UIC University of Illinois College of Medicine at Peoria

  2. You are doctors. Why is teaching so important? • docere: Latin for “to teach”

  3. Resident’s role as teacher However, residents often did not… • promote participation • ask problem solving questions • give feedback * 20% of time spent teaching What are the difficulties????? * Neal Whitman, Thomas L. Schwenk, The Physician As Teacher, Whitman Press

  4. Teaching and assessment skills improve with practice

  5. Do you make a difference?

  6. Workshop Overview • Setting Personal Goals Today’s 4 Modules: • Module I: Teachable Moments • Module II: The “One-Minute Preceptor”: Clinical Teaching Microskills Lunch • Module III: Providing Feedback Evaluating Students • Module IV: OSTE – putting it to work • Reflections

  7. Ground rules 3 • One person at a time • Everyone participates • Be concise • Show respect • No side conversations • Have fun!

  8. Personal Goals (p. 7) • Please identify three learning goals to enhance your own teaching skills that you would like to address during the residents as teacher’s workshop.

  9. Module I: Teachable Moments • At the end of this module, you will be able to • Discuss some of the educational principles behind medical education • Orient the students or intern to their new rotation • Identify the goals and objectives of the M3 clerkship in their area of residency training Note: on-line resources on p. 8

  10. Memorable teachers (p. 9) 5 Think back over medical school • Poor clinical teacher • Can’t remember what was taught What did that teacher do that made the teaching so ineffective?”

  11. Memorable teachers (p. 10) 6 Think back over medical school • Exceptional clinical teacher • You still remember the lessons What did that teacher do that made their teaching so effective?”

  12. Why teach? By learning you will teach, by teaching you will learn. Latin Proverb The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn. Alvin Toffler I believe that every human soul is teaching something to someone nearly every minute here in mortality. M. Russell Ballard

  13. Active Learning • What I hear, I forget. • What I hear and see, I vaguely recall. • What I hear, see, and discuss, I understand. • What I hear, see, discuss, and do, I remember. • What I teach to another, I master.

  14. Types of teaching Lecture • Teacher-centered • Discussion • Group-centered • Independent study • Student-centered

  15. Teacher – learner model Context Learner Teacher Content K Skeff, Faculty Development Fellowship Workshop, April 1999

  16. The Educational Cycle (p. 11) 7 Plan Assess Reflect Teach

  17. Teaching Encounters Average 4.5 min * • Presentation - 2.5 min. • Inquiry - 1 min. • Teaching - 1 min. • Teachers must • Analyze quickly • Teach efficiently • Teach effectively * DM Irby, Presentation, Faculty Development Workshop, April 1999

  18. Teachable Moment p. 12 • A medical student is starting a new clinical rotation. Review the film clip that will be shown to you. http://www.med-ed.virginia.edu/courses/fm/precept/module4/m4p2.htm • Discuss the strengths and weakness of these student- resident encounters in relation to the Plan-Assess-Teach-Reflectcycle.

  19. Orientation Brainstorming Exercise (p. 13) What were your expectations for your first rotation? • Reflect back on the time you started your first rotation: • Clarity of expectations?? • Effective communication of expectation?? • Large source of performance problems

  20. Learner’s needs (p. 14) • Reflect back on the same experience. • Put yourself in the position of the teacher • How can you best identify and address the learner’s various expectations and needs?

  21. Set & COMMUNICATEexpectations • Defined role makes learners and teachers more confident • Base teaching activities on learner’s needs &objectives • Evaluation drives learning Rationale:

  22. Set expectations • The “Orient Approach” • Orientation • Responsibilities • Interchange • Education • Needs • Timing of follow-up session

  23. Set Expectations • Orientation • Clarify mutual goals and expectations • Discuss mutual goals and objectives • Start with the learner • Responsibilities • Learner’s role in patient care and teamwork • Call, rounds, team dynamics, charting • Interchange • Balance service vs. learning during rotation • Adapted from BeST program UC Irvine

  24. Set Expectations • Education • Model self-directed learning • Suggestions for reading and learning during rotation • Needs • Other questions/interests learner has • Anything else going on that you might help with • Students need to feel like they are progressing • Timing of follow-up session • Final comments or questions • Set time for follow up on goals and expectations • Adapted from BeST program UC Irvine

  25. Examples 1 0 • ”You will do one H&P each admitting day.” • ”Each Friday, I meet with the students for feedback." • ”What do you hope to learn during this rotation?"

  26. Examples 1 0 • ”You will do one H&P each admitting day.” • ”Each Friday, I meet with the students for feedback." • ”What do you hope to learn during this rotation?"

  27. Non-examples • "Rounds start at 8:30. See you there.“ What wasn’t explained??????

  28. Goals and Expectations of M3 clerkship • How many of you are aware of the medical student clerkship requirements in your area of training?

  29. Fulfilling the Educational Objectives of the Clerkship 3 5 • Gather into groups by specialty. • Review the educational objectives for the clerkship in your specialty. • Select 2 objectives.

  30. Fulfilling the Educational Objectives of the Clerkship 3 5 • At your table: Devise a teaching strategy to accomplish the selected objective. p. 16

  31. Large Group Discussion

  32. Conclusion • One minute paper Identify 2-3 characteristics you will utilize during orientation to help your learner transition into their clinical experience.

  33. 10 minute break 9 minutes until the workshop resumes 8 minutes until the workshop resumes 7 minutes until the workshop resumes 6 minutes until the workshop resumes 5 minutes until the workshop resumes 4 minutes until the workshop resumes 3 minutes until the workshop resumes 2 minutes until the workshop resumes at 10:45 sharp! 10 minutes until the workshop resumes 2 minutes until the workshop resumes Please take your seats

  34. Module II- The Microskills of Clinical Teaching • At the end of this module, the resident will be able to: • Identify the five plus 2 microskills of clinical teaching • Recognize the teachable moment and apply the microskills effectively

  35. Teaching Encounters Average 4.5 min * • Presentation - 2.5 min. • Inquiry - 1 min. • Teaching - 1 min. • Teachers must • Analyze quickly • Teach efficiently • Teach effectively * DM Irby, Presentation, Faculty Development Workshop, April 1999

  36. Easy to learn Efficient Evidence based Use day-to-day Neher JO, et al, a Five-Step "Microskills" Model of Clinical Teaching, Journal of the American Board of Family Practice, Vol. 5, No. 4, pp. 419- 423. (1992) The Microskills 8 • Seven skills (5 + 2)

  37. To use microskills • Identify teachable moment • Diagnose the learner • No hard and fast rules

  38. To use the Microskills • When you hear a cue, use the appropriate Microskill • Listen for cues

  39. Scripted video Vignettes: Small group discussion • Common clinical teaching situations • Look for: • Opportunity to teach • Best way to teach

  40. Scene 1

  41. Summarize in One Sentence 1 2 Cue: Scenario 1 • The learner’s image of the case is unfocused • Response • “Tell me the key points of the case in one sentence.”

  42. Summarize in One Sentence 1 2 • Helps student “see” the diagnosis Rationale: • Brings the “big picture” into focus • (cognitive representation)

  43. Scene 2

  44. Generate Hypotheses 1 4 Cue: • The learner does not commit to a dx, or • commits to a diagnosis without considering important alternatives... • Response: • Resist the urge to list those alternatives • Ask, "What other diagnoses should we consider?”

  45. Generate Hypotheses 1 4 Rationale: • Teaches learner to consider alternatives • Reveals learners knowledge • Prevents premature closure

  46. Examples 1 4 • “What other diagnoses did you consider, and how did you exclude them?” • “What other pathophysiologic processes could cause this presentation?”

  47. Non-examples 1 4 • “What are the 12 causes of atrial fibrillation?"

  48. Scene 3

  49. Get a commitment 1 6 Cue: • Learner presents the facts, then stops ... • Response: • Resist the urge to fill in the verbal blank • Ask the learner what they think

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