1. PATRICK DUFF, M.D.

2. OVERVIEW Small group teaching One-on-one teaching Providing feedback

3. PERSPECTIVE Clerkship Director Residency Director Basic Science and Clinical Teacher Assoc Dean for Students Parent

4. MAXIMIZING TEACHING KEY PREMISE Presenting a lecture is the most EFFICIENT way to provide information to a large number of trainees

5. MAXIMIZING TEACHING KEY PREMISE However, most adults learn more EFFECTIVELY in smaller groups or during one-on- one instruction

6. KEYS TO EFFECTIVE SMALL GROUP TEACHING Quiet room Appropriate lighting Appropriate temperature Adequate and comfortable seating

7. KEYS TO EFFECTIVE SMALL GROUP TEACHING Avoid distractions

8. KEYS TO EFFECTIVE SMALL GROUP TEACHING Know the names of all participants Insist that students prepare beforehand by reading and/or completing written exercises

9. KEYS TO EFFECTIVE SMALL GROUP TEACHING Engage everyone Do not let a single individual dominate the discussion Present the question to everyone before asking someone to answer

10. KEYS TO EFFECTIVE SMALL GROUP TEACHING Provide an overview of the importance of the subject Tie the discussion to the care of a particular patient Correct inaccurate answers, but always in a positive way Try to find some kernel of truth in every response

11. KEYS TO EFFECTIVE SMALL GROUP TEACHING Stay within the allotted time period 30 minutes for a formal lecture 60 minutes for an interactive seminar Provide a clear summary of the key points

12. APPROPRIATE VENUES FOR ONE-ON-ONE TEACHING Laboratory Clinic Operating room

13. KEYS TO ONE-ON-ONE TEACHING Recognize that time is limited Accept that you do not have to teach everything at once

14. KEYS TO ONE-ON-ONE TEACHING Make the student commit to a diagnosis Probe for additional knowledge Differential diagnosis Complications resulting from the primary diagnosis

15. KEYS TO ONE-ON-ONE TEACHING Have the student identify the most useful laboratory/imaging tests to differentiate between the possible diagnoses

16. KEYS TO ONE-ON-ONE TEACHING Ask the student to explain the most appropriate treatment

17. KEYS TO ONE-ON-ONE TEACHING Correct obvious errors Provide a capsule summary

18. FEEDBACK

20. RECEPTIVENESS TO FEEDBACK “ Honest criticism is hard to take, especially from a relative, friend, acquaintance, or stranger.”

21. THE NECESSITY FOR FEEDBACK In the absence of feedback, the student may mistakenly assume that he/she is “doing fine”

22. CHARACTERISTICS OF EFFECTIVE FEEDBACK Private Controlled Even tempered

23. CHARACTERISTICS OF EFFECTIVE FEEDBACK Timely Consistent Frequent Clearly identified Descriptive, not evaluative

24. CHARACTERISTICS OF EFFECTIVE FEEDBACK Specific Focused on the behavior not the personality

25. CHARACTERISTICS OF EFFECTIVE FEEDBACK Does not infer thoughts or feelings “What you did made me feel bad.” Avoids personalization Avoids emotionally- charged words “Your work has been worthless.” Avoids inflammatory words

26. CHARACTERISTICS OF EFFECTIVE FEEDBACK Combined with praise for positive behavior The “feedback sandwich” Avoid false praise

27. CHARACTERISTICS OF EFFECTIVE FEEDBACK Provide constructive suggestions for improvement Provide a clear timeline for re- assessment of performance

28. CONCLUSIONS Small group and one-on-one instruction is preferred in most situations Students must take active responsibility for the educational encounter

29. CONCLUSIONS We all learn better when we are fully engaged in an interactive learning process We all learn better in a supportive environment – keep the learner’s chin “up”

30. CONCLUSIONS Feedback is an essential part of the educational process Feedback must be private, timely, frequent, and constructive