clinical teaching i b

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The Teaching Physician:

How to Become a More Effective

Medical Educator

The Teaching Center

UNC Department of Pediatrics

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Teaching Center Faculty

Jack Benjamin, MDDivision Chief, General Pediatrics and Adolescent Medicine

Julie Byerley, MD, MPHDirector, Medical Student Education in Pediatrics

Harvey J. Hamrick, MDResidency Program Director, Pediatrics

Allen Liles, MDResidency Program Director, Medicine and Pediatrics

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Welcome and

Introductions

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Overview of the Teaching

Physician Program

Session Curriculum

Project

Teaching Portfolio Preparation

Relationships and Support

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Session Curriculum

1. Clinical Teaching2. Clinical Teaching II

3. Developing

Curriculum and

Assessing

Learners

4. Delivering

Feedback

5. Developing a

Teaching Portfolio

6. Large GroupTeaching

7. Small Group

Teaching

8. Evidence-Based

Education and

Educational

Research

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Project

Develop an educational product that you can

keep and use to facilitate your teaching

efforts

Plan for evaluation of your teaching

effectiveness within your project

Present in poster form at Evening of

Scholarship

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Teaching Portfolio

Each participant will develop a teachingportfolio as a product from this course that

can be added to throughout your academic

career

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Relationships and Support

Curriculum adapted from The Teaching

Scholars Program

Each of us will be available to support you

either by ourselves or by helping you find theright people

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Session 1: Clinical Teaching

Clinical Teaching: The one-on-oneteaching that occurs centered around

patient care.

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Objectives for Session 1

Provide a brief summary of backgroundinformation on adult learning theory

Overview some strategies for effective andefficient clinical teaching

Illustrate appropriate approach to learners

Prepare for more detailed discussions nextsession

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Adults as Learners

Adults are self-directed

Want to set their own learning objectives

Learn from experience

Want knowledge that can be applied

Learn best in an environment of mutual

respect

Want to evaluate their progress

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Adult Learning - Applied

Teachers should coach, not prescribe

Learners should participate, not watch

Instruction should occur in the field, not the

classroom Learning requires action, reflection, and

feedback

Jack Ende, assessing Adult Learning Theory as understood by John Dewey

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Teachers should coachThe Teaching Center


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Clinical Coaching

Requires enthusiasm Requires teamwork

Improvement focused

The goal is that everyone succeeds

Requires observation Requires patience

Requires knowledge

Requires an appreciation for the learners

goals

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First Steps in Effective

Teaching:

Generate enthusiasm

For the process of teaching

or the subject matter

or the students

Teach what you love

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First Steps (continued)

Clarify the learners goals on day 1

Set the expectations on day 1

Establish the expectation of teamwork

Maintain a focus on improvement

Plan for observation

Time-consuming

Remember that observation doesnt

have to be of each piece every time

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Clarify the

Learners GoalsThe Teaching Center


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Observation

Photos Courtesy of http://www.uncbasketballupdate.com/04-05_championship.html

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Clinical Teaching

Situational

Not always carefully planned

Demands efficiency in teaching

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Efficiency in Clinical Teaching

Label your teaching

Take advantage of the Teachable Moment

But be sure to label it

Teach in small bites

Create your own teaching scripts

Teach through the work you are already doing

Think out loud

Illustrate your own questions and find answers

to those questions with your learners

Use The One Minute Preceptor

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The Art of Asking Questions

Ground rules

Give the learner time to answer

Give clear feedback on responses

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Th A t f A ki Q ti


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The Art of Asking Questions:

Know What You are Trying to

Ask

Different goals of asking questions

Determine where the learners knowledge

level is for the given situation Test factual recall

Determine the learners thought processes

and connections

Teach appropriate thought processes todevelop connections

Illustrate unanswered questions

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What am I Thinking?

Its difficult to avoid asking What am I

thinking? questions

Determine whyyou are thinking what

youre thinking then re-focus your question

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http://members.tripod.com/~michael_erickson/art-lib/products/feedback.jpg


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What is Feedback?

The process of informing learners of yourperceptions of their performance

Complimenting what was done well

Constructive acknowledgement of what

was not done well

The information that highlights the

dissonance between the actual and the

intended result.

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Feedback

Feedback is clinical teaching

Feedback is given a lot more often than itslabeled as feedback

Learners consistently say they want morefeedback

Feedback can occur on any facet of theencountercommunication skills, PE,assessment, differential, written work,

presentation, literature review, etc.

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EvaluationThe Teaching Center

A i t A h t


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Appropriate Approach to

Learners

Giving improvement-focused feedback to

learners is not maltreatment

Treat your learners, just like your patients,with Humanism

Identify multiple perspectives

Reflect on possible conflicts

Choose altruism

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I R l ti t


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Issues Relating to

Culture and Ethnicity

Lack of role models

Feeling ignored or looked over

Feeling like teachers are naturally drawn

toward people like themselves Needing to connect

Feeling that grades are sometimes influenced

by these subtle issues

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Appropriate Treatment of

Learners

Be professional.

Make attempts to connect.

Identify the commonality.

Involve all learners.

Be open to mentoring any learner.

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Commonality

Photo Courtesy of Gerry Broome, AP

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Effective Clinical Teaching

Based on shared and understood goals

With opportunity for action and self-reflection

Consistent, clear, improvement-focused

feedback In a humanistic environment

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Discuss additional teaching

techniques that you have foundvaluable in clinical teaching.

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