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

made the resident a made the resident a good teacher?good teacher?

Resident as Teacher: Resident as Teacher: An IntroductionAn Introduction

James H. Quillen College of James H. Quillen College of Medicine Medicine

PGY I OrientationPGY I Orientation

June 24, 2005June 24, 2005Bruce 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 ObjectivesSession Objectives A) Discuss resident role in teachingA) Discuss resident role in teaching B) Identify characteristics of good B) Identify characteristics of good

(resident) teaching(resident) teaching C) Introduce proven model(s) of C) Introduce proven model(s) of

clinical teachingclinical teaching D) Describe motivation for teachingD) Describe motivation for teaching E) Outline additional support for E) Outline additional support for

resident as teacherresident as teacher

Resident Role as Teacher:Resident Role as Teacher:

SignificantSignificant ImportantImportant

Under-supportedUnder-supported Rewarding (Potentially)Rewarding (Potentially)

Significant Role:Significant Role:

Between 40-70% student contact Between 40-70% student contact with instructors is with residentswith instructors is with residents

Percentage higher when “informal” Percentage higher when “informal” teaching addedteaching added

Role model often a form of informal Role model often a form of informal teachingteaching

Important Role:Important Role:

As resident teacher:As resident teacher: You can have an important, positive impact You can have an important, positive impact

upon studentsupon students Your knowledge base is considerable and Your knowledge base is considerable and

growing rapidlygrowing rapidly You are where your learners want to be (next You are where your learners want to be (next

level)level) You are not the expert but you can leadYou are not the expert but you can lead You can serve as the bridge (facilitate self You can serve as the bridge (facilitate self

learning in students)learning in students) You can impede learning (-)You can impede learning (-)

Under-Supported RoleUnder-Supported Role::

Residents rarely are:Residents rarely are: Rewarded for teachingRewarded for teaching Given feedback about their teachingGiven feedback about their teaching Have input into decisions regarding Have input into decisions regarding

teaching and curriculumteaching and curriculum Also, resident involvement in evaluation Also, resident involvement in evaluation

of learners often inadequateof learners often inadequate

Support is at hand!Support is at hand! Resident as Teacher Committee:Resident as Teacher Committee: Dr. Mary Hooks: SurgeryDr. Mary Hooks: Surgery Drs. Ann Gebka and Janet Drake: OB/GYNDrs. Ann Gebka and Janet Drake: OB/GYN Drs. Bruce Bennard and Mary Stephens: Drs. Bruce Bennard and Mary Stephens:

Family MedicineFamily Medicine Dr. Karen Schetzina: PediatricsDr. Karen Schetzina: Pediatrics Dr. K. Ramsey McGowen: PsychiatryDr. K. Ramsey McGowen: Psychiatry Dr. Susan Sloan: Internal MedicineDr. Susan Sloan: Internal Medicine

PGY I Workshop (Proposed)PGY I Workshop (Proposed)

Resident Teacher Elective (Proposed)Resident Teacher Elective (Proposed)

Rewarding Role Rewarding Role (Potentially):(Potentially): (Study) 77% of residents report that (Study) 77% of residents report that

they enjoy teachingthey enjoy teaching Active teaching can gain cooperation Active teaching can gain cooperation

from team membersfrom team members Teaching enhances/accelerates own Teaching enhances/accelerates own

learninglearning Can enrich relationship with Can enrich relationship with

attendings and faculty around attendings and faculty around common taskcommon task

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

made the resident a good made the resident a good teacher?teacher?

Characteristics of an Effective Characteristics of an Effective Clinical TeacherClinical Teacher

Be proactive and enthusiasticBe proactive and enthusiastic Be learner-orientedBe learner-oriented Clarify expectationsClarify expectations Be a role modelBe a role model Be availableBe available Provide effective supervisionProvide effective supervision Provide specific feedbackProvide specific feedback Be supportiveBe supportive

SOAP FormatSOAP 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: ObservationsO: Observations ““I observed that...”I observed that...” ““Things that seem to go well are...but you need to Things that seem to go well are...but you need to

work on...: (be specific)work on...: (be specific) A: AssessmentA: Assessment

Tie above sections togetherTie above sections together P: PlanP: Plan

““Continue to do...; Do more of...; and do less of...”Continue to do...; Do more of...; and do less of...”

Find the FeedbackFind 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 C) Why didn’t you get more family

history?history? D) Keep up the good work.D) Keep up the good work. E) Don’t be too hard on yourself...most E) Don’t be too hard on yourself...most

clerks have trouble interviewing a clerks have trouble interviewing a patient who is that tangential.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 Characteristics of Effective FeedbackFeedback

SpecificSpecific What happened and consequencesWhat happened and consequences Limited amountLimited amount Suggestions for improvementSuggestions for improvement

Not JudgmentalNot Judgmental