Think of a good resident teacher you encountered when in medical school. What one or two things made the resident a good teacher?

Resident as Teacher: An Introduction James H. Quillen College of Medicine PGY I Orientation June 24, 2005 Bruce Bennard, PhD, Department of Family Medicine K. Ramsey McGowen, PhD, Department of Psychology Karen E. Schetzina, MD, MPH, Department of Pediatrics J. Kelly Smith, MD, Professor Emeritus

Session Objectives A) Discuss resident role in teaching A) Discuss resident role in teaching B) Identify characteristics of good (resident) teaching B) Identify characteristics of good (resident) teaching C) Introduce proven model(s) of clinical teaching C) Introduce proven model(s) of clinical teaching D) Describe motivation for teaching D) Describe motivation for teaching E) Outline additional support for resident as teacher E) Outline additional support for resident as teacher

Resident Role as Teacher: Significant Significant Important Important Under-supported Under-supported Rewarding (Potentially) Rewarding (Potentially)

Significant Role: Between 40-70% student contact with instructors is with residents Between 40-70% student contact with instructors is with residents Percentage higher when “informal” teaching added Percentage higher when “informal” teaching added Role model often a form of informal teaching Role model often a form of informal teaching

Important Role: As resident teacher: As resident teacher: You can have an important, positive impact upon students You can have an important, positive impact upon students Your knowledge base is considerable and growing rapidly Your knowledge base is considerable and growing rapidly You are where your learners want to be (next level) You are where your learners want to be (next level) You are not the expert but you can lead You are not the expert but you can lead You can serve as the bridge (facilitate self learning in students) You can serve as the bridge (facilitate self learning in students) You can impede learning (-) You can impede learning (-)

Under-Supported Role: Residents rarely are: Residents rarely are: Rewarded for teaching Rewarded for teaching Given feedback about their teaching Given feedback about their teaching Have input into decisions regarding teaching and curriculum Have input into decisions regarding teaching and curriculum Also, resident involvement in evaluation of learners often inadequate Also, resident involvement in evaluation of learners often inadequate

Support is at hand! Resident as Teacher Committee: Resident as Teacher Committee: Dr. Mary Hooks: Surgery Dr. Mary Hooks: Surgery Drs. Ann Gebka and Janet Drake: OB/GYN Drs. Ann Gebka and Janet Drake: OB/GYN Drs. Bruce Bennard and Mary Stephens: Family Medicine Drs. Bruce Bennard and Mary Stephens: Family Medicine Dr. Karen Schetzina: Pediatrics Dr. Karen Schetzina: Pediatrics Dr. K. Ramsey McGowen: Psychiatry Dr. K. Ramsey McGowen: Psychiatry Dr. Susan Sloan: Internal Medicine Dr. Susan Sloan: Internal Medicine PGY I Workshop (Proposed) PGY I Workshop (Proposed) Resident Teacher Elective (Proposed) Resident Teacher Elective (Proposed)

Rewarding Role (Potentially): (Study) 77% of residents report that they enjoy teaching (Study) 77% of residents report that they enjoy teaching Active teaching can gain cooperation from team members Active teaching can gain cooperation from team members Teaching enhances/accelerates own learning Teaching enhances/accelerates own learning Can enrich relationship with attendings and faculty around common task Can enrich relationship with attendings and faculty around common task

Think of a good resident teacher you encountered when in medical school. What one or two things made the resident a good teacher?

Characteristics of an Effective Clinical Teacher Be proactive and enthusiastic Be proactive and enthusiastic Be learner-oriented Be learner-oriented Clarify expectations Clarify expectations Be a role model Be a role model Be available Be available Provide effective supervision Provide effective supervision Provide specific feedback Provide specific feedback Be supportive Be supportive

SOAP Format S: Sample learner’s thinking (focus on specifics) S: Sample learner’s thinking (focus on specifics) “How did it go?” “How did it go?” “What do you think is going on?” “What do you think is going on?” “What went well?” “What did you have trouble with?” “What went well?” “What did you have trouble with?” O: Observations O: Observations “I observed that...” “I observed that...” “Things that seem to go well are...but you need to work on...: (be specific) “Things that seem to go well are...but you need to work on...: (be specific) A: Assessment A: Assessment Tie above sections together Tie above sections together P: Plan P: Plan “Continue to do...; Do more of...; and do less of...” “Continue to do...; Do more of...; and do less of...”

Find the Feedback A) That was pretty good. A) That was pretty good. B) You need to be more complete. B) You need to be more complete. C) Why didn’t you get more family history? C) Why didn’t you get more family history? D) Keep up the good work. D) Keep up the good work. E) Don’t be too hard on yourself...most clerks have trouble interviewing a patient who is that tangential. E) Don’t be too hard on yourself...most clerks have trouble interviewing a patient who is that tangential. You have just observed a medical student perform an interview and heard the case presentation. Which of the following comments would qualify as “feedback”?

Characteristics of Effective Feedback Specific Specific What happened and consequences What happened and consequences Limited amount Limited amount Suggestions for improvement Suggestions for improvement Not Judgmental Not Judgmental