1. Creating a Positive Learning Climate and other thoughts on teaching Elizabeth Stuart March 28, 2008

2. …teachers possess the power to create conditions that can help students learn a great deal – or keep them from learning much at all. Parker Palmer, The Courage to Teach

3. Research Project What do students want from residents? What do students want from residents?

4. Themes Attention Attention Balance between challenge and support Balance between challenge and support Role Modeling Role Modeling Meaningful participation and roles Meaningful participation and roles

5. The Shift to Doctoring Student- centered learning Patient- centered, team- based learning

6. The Shift to Doctoring EARLY EDUCATION Focus on concepts, subjects Focus on concepts, subjects Goal is student learning Goal is student learning Student as recipient, customer Student as recipient, customer LATER EDUCATION Focus on patients, problems Goals include student learning, team functioning, patient care Student as part of a service team

7. Support-Challenge RetreatGrowth StagnationStasis LOW Support HIGH HIGH Challenge Risk Responsibility LOW

8. Flow LOW Skill HIGH HIGH Challenge Risk Responsibility LOW

9. Stanford Students Residency Match 2008

10. Residency Match 2008

11. Role Models Kaplowitz, 1996 Kaplowitz, 1996 11 medical schools 11 medical schools 1135 students 1135 students Survey – pre vs. post clerkship Survey – pre vs. post clerkship Proportion of students with a strong interest in pediatrics increased from 6.7% to 15.2%. Proportion of students with a strong interest in pediatrics increased from 6.7% to 15.2%.

12. Role Models Correlation between student ratings of aspects of the pediatrics clerkship and change in interest in a career in pediatrics Aspect of clerkship Correlation Ward residents Working with ward patients Working with outpatients Ward attending Interactions with families Outpatient attendings.228.150.130.129.100.096

13. Student Roles: Bottom Line Students need to feel that they are: LEARNING or HELPING or BOTH

14. Questions What do students want from residents? What do students want from residents? What gets in the way? What gets in the way?

15. 2008 Clerkship Themes Welcome to pediatrics Welcome to pediatrics Tell us a story Tell us a story No student left behind No student left behind