Program review

Resident as teacher

• Principles of learning lecture/discussion series– Activating a student's prior knowledge enhances learning

– How students organize knowledge affects learning

– Students' motivation determines how effectively they learn

– Repetition is key to learning

– Appropriate feedback enhances learning

– Students should become self-directed learners

• Structured curriculum

• Educational resources website

Program overview: three components

• Unit one: Approach to the patient– History

– Examination

– Pap smear and DNA probes/cultures

– Diagnosis and management plans

– Personal interaction and communication skills

– Legal and ethical issues in obstetrics and gynecology

– Preventative care and health maintenance

Structured curriculum

• Section A: Normal obstetrics– Maternal-fetal physiology

– Preconception care

– Antepartum care

– Intrapartum care

– Immediate care of the newborn

– Postpartum care

– Lactation

Unit two: Obstetrics

OB chief

OB jr

OB chiefOB chief

Clinic chiefOB chief

OB jr

• Section B: Abnormal Obstetrics– Ectopic pregnancy

– Spontaneous abortion

– Medical and surgical complications of pregnancy

– Preeclampsia/eclampsia

– Alloimmunization

– Multifetal gestation

– Fetal death

– Abnormal labor

– Third trimester bleeding

– Preterm labor

– Preterm rupture of membranes

– Intrapartum fetal surveillance

– Postpartum hemorrhage

– Postpartum infection

– Anxiety and depression

– Post term pregnancy

– Fetal growth abnormalities

Unit two: Obstetrics

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Clinic chief

OB jr

OB jr

OB chief

MFM

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MFM

MFM

OB jr

OB jr

Gyne jrGyne jr

Roles MFM

OB jr

Clinic chiefOB chief

Gyne jr

Gyne chief

Onc

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•Night float team•REI•Urogynecology•Off service PGY1

• You ask a student to take an H&P from a patient in triage– What can go wrong? Why?

• You ask a student to present a clinic patient to the attending– What can go wrong? Why?

• You ask a student to position a gyne patient before surgery– What can go wrong? Why?

• You pimp a student on a topic they learned in lecture yesterday– What can go wrong? Why?

Scenarios

• They do not understand the task they are given

• They do not plan or see the importance in planning

• They use familiar strategies that don’t work as well

• After they fail:– The effort put into adjusting their strategy is proportionate to their

belief about their own ability to learn

– They belive the reason for their failure is external

What students do wrong

• To become self-directed learners, students must learn to:

Students should become self-directed learners

Assess the demands of the

task

Evaluate their own knowledge

and skills

Plan their approach

Monitor their progress

Adjust their strategies as

needed

• Initially, be more explicit than you may think is necessary about expectations– Tell students what you do not want

– Check that the student understands the assignment

• Provide performance criteria with the assignment

• Have students create their own plan– Create assignments that focus on strategizing instead of

implementation

What can we do?

• Provide opportunities for self-assessment– Provide simple questions students can ask themselves

– Use peer review

• Prompt students to analyze the effectiveness of their skills– Study skills

• Directly address their beliefs about learning

What can we do?

• Model our own metacognitive processes

• Use scaffolding to help

What can we do?