Small Group Teaching Teaching Residents and Fellows to Teach… Deb Bynum, MD Division of Geriatric...
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Transcript of Small Group Teaching Teaching Residents and Fellows to Teach… Deb Bynum, MD Division of Geriatric...
Small Group Teaching
Teaching Residents and Fellows to Teach…Deb Bynum, MD
Division of Geriatric Medicine
University of North Carolina
Introduction to the Series… Teaching to Teach See one, do one, teach one…
Importance of Teaching
Student perspective: validate importance of resident teaching in student curriculum
-written curriculum-unwritten curriculum…
Resident perspective: validate importance of teaching as something that should be taught in the curriculum
Importance of Teaching
Informal (hidden, unwritten) curriculumProfessionalismTeamworkRole modelingCulture of the institutionHow to get things done at your site (nuts and
bolts of every day)
Importance of residents as teachers Informal curriculum Residents “closer” to student experience Amount of time residents/interns spend with students Recognition from School of Medicine accreditation
councils Ability to “think aloud” Residents oversee the “team”, assign patients to
students, dictate how/when rounds occur Residents feed in to student evaluations
What is Small Group Teaching?
It is what we do in clinical education
Dr. Bates – The book is not enough…
What do you Need?
-Teacher
-Students
-Patient/Case
Small Group Teaching – When?
Work Rounds “Down Time” Admitting patients Teaching rounds Acute Care
What are the Benefits?
Active participation and learning Ultimate in Case based learning Takes advantage of the “teachable
moment” Efficiency: combining care of patients with
teaching
What are the Challenges?
Different learners at different levels Time restraints Acuity of patients Perceived lack of knowledge: What do I
have to offer?
The Game Plan…
PrePlan Orient the group Ask open ended questions Summarize, summarize, summarize Give individual feedback Correct errors when needed Receive feedback and evaluate your own
skills
Switch it up…
Orientation
Ask learners what they need/wantGoals and objectives
Determine needs Determine levels of learners Set expectations
Will they present?Will they look up questions?
Plan for feedback sessions
General Principles
Keep it fun Keep it interactive Keep it patient/case based Ask questions
Techniques
One Minute Preceptor Model Canned Talks Think out loud Case based short presentations Evidence based medicine: start with a
clinical question
One Minute Preceptor…
Get a Commitment Probe for Supporting Evidence Reinforce What Was Done Well Give Guidance About Errors and
Omissions Teach a General Principle Conclusion : Summarize, Review
One Minute Preceptor…
Get a Commitment: What do you think is going on? Probe For Supporting Evidence: Why? Reinforce what was done well: You have a thorough
differential… Give guidance/correct errors: It is also important to
consider…. Teach a general principle: When you see this, you
should always think of… Conclusion: Let’s go see…
One Minute Preceptor: Basics
WHATWhat do you think is going on?
WHYWhy do you think that?
WHEN….When you see this, you need to think of ….
Other strategies
Role playing Case discussions (resident report) Student/learner short presentations Scavenger hunt for physical findings Teach at bedside Check out: learners share one thing learned from
the day Sign out exercises Unknown pictures Summarize at end of presentation, day, week…
Feedback
Call it feedback Separate from evaluation Be explicit, give details Ask learners to self assess Do in private Correct errors immediately Have plan of action if needed Do not always need the “sandwich” Ask for feedback also
Tradition: Just Because You’ve Always Done it That Way Doesn’t Mean It’s Not Incredibly Stupid