Resident Educator Development The RED Program A Residents-as-Teachers Curriculum Developed by Heather A. Thompson, MD

The RED Program Team Leadership How to Teach at the Bedside The Microskills Model: Teaching during Oral Presentations How to Teach EBM The Ten Minute Talk Effective Feedback Professionalism Patient Safety and Medical Errors

How to Give a 10 Minute Talk on Anything Adapted from the Advanced Clinical Teaching (ACT) Course Karyn Baum, MD

Exercise Recall a high quality teaching session. What made this teaching session a positive experience? Recall a teaching session where learning was ineffective. What factors made it so?

Survey of Graduate Medical Students in the UK Behaviors of effective teachers: 1. Organizational skills and clarity of presentation 2.Enthusiasm 3.Teacher’s knowledge base 4.Group teaching skills 5.Clinical supervisory skills 6.Clinical competence 7.Modeling of professionalism

Objectives By the end of this session, participants should be able to: --Describe one way of structuring a teaching session --Describe three ideas for making the body of the session effective --Describe the four elements of closure --Use the above to plan a teaching session of their own

One way to structure a teaching session Set the Scene Teach the Body Close the Session “Set-Body-Closure”

Set The Scene “OPERA” Objectives, Plan, Environment, Relevance, Assess the learner

Set The Scene 1.Objectives: what the learner should be able to do/demonstrate after your teaching session. 2.Plan: what is going to be covered. 3.Environment: where is it held? Is the mood formal, casual? What AV tools do you use? 4.Relevance: explain to the learner why they might need to know this. 5.Assess the learner: have they seen this before? What is their level of expertise? Area of interest?

Body Main content or “meat” of the teaching session. Three tenets: --Less is More! --Vary the Stimulus! --Particular to General!

Less is More What do you suppose this graph represents?

Less is More Attention is highest in the first 5 minutes, and tends to wane after 15 minutes. Presenting less content means attention span won’t fall off. Avoiding information overload enhances retention of important material.

Vary the Stimulus What do you suppose this graph represents?

Vary the Stimulus Each time a new stimulus is introduced you get a transient bump in attention span. Move from overheads, to a white board, to a flip chart, to looking at an image (peripheral smear, chest Xray). Consider live demonstration of a physical exam maneuver or finding--the more “active” participation the better.

Particular to General When using a specific clinical case, it helps to extend the thought process to the general population as a whole.

Particular to General “In this immune suppressed patient, we performed a flex sig with biopsies to evaluate for CMV colitis. However, in the general population, the approach to acute diarrhea is…”

Closure SRAN (think Saran Wrap!!) --Summarize --Relate back to the set --Accomplishment (sense of) --No new material

Timing Set the Scene: one minute Teach the Body: eight minutes Close the Session: one minute

Example: Back Pain Patient seen with acute back pain; student not sure how to proceed. Set the Scene: OPERA

Example: Back Pain --Objective: learner will be able to evaluate back pain with a focused H&P to screen for both common problems and worrisome causes. --Plan: review Ddx, discuss historical “red flags”, discuss physical findings or data that will help us.

Example: Acute Back Pain --Environment/Mood: “we know back pain can be difficult to evaluate…” round table discussion format --Relevance: “This is a very common clinical problem, #2 reason to visit a primary MD behind URI…” --Assess knowledge base: “Have any of you evaluated back pain before?”

Example: Acute Back Pain BODY: --Less is more: cover only initial workup of back pain, not all potential treatment(s). --Vary the stimulus: look at a plain film of the spine demonstrating a compression fracture; practice straight leg raise on volunteer.

Example: Acute Back Pain BODY: --Particular to general: “in this case, we got an MRI because we were concerned about spinal stenosis. However, not every patient needs imaging.”

Example: Acute Back Pain CLOSURE—”SRAN” --Summarize: “back pain needs a systematic approach”. --Relate back to the objectives. --Accomplishment, sense of: “now you can impress your future attendings with your evaluation of back pain!” --No new material

View a Video of a 10 Min Talk Clear objectives Emphasized “take home points” Used humor appropriately Used clinical case Could have varied the stimuli a bit more Ended with “any questions?”

Work through a clinical example Split into pairs. Pick a topic or clinical entity that you see frequently on the wards. Within your topic, you can be as broad or as focused as you like. Referring to the handout, jot down a few notes on how you will proceed, using the Set-Body-Closure model.

Discussion How did it feel to use the Microteach model (“set-body-closure”) to prepare a teaching session? Anything that went well? Any particular difficulties?

Objectives By the end of this session, participants should be able to: --Describe one way of structuring a teaching session --Describe three ideas for making the body of the session effective --Describe the four elements of closure --Use the above to plan a teaching session of their own