Transcript On Teaching - University of North Carolina at Chapel Hill

The Teaching Center
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, MD
Division Chief, General Pediatrics and Adolescent Medicine
• Julie Byerley, MD, MPH
Director, Medical Student Education in Pediatrics
• Harvey J. Hamrick, MD
Residency Program Director, Pediatrics
• Allen Liles, MD
Residency Program Director, Medicine and Pediatrics
The Teaching Center
Welcome and
Introductions
Overview of the Teaching
Physician Program
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•
•
•
Session Curriculum
Project
Teaching Portfolio Preparation
Relationships and Support
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Session Curriculum
1. Clinical Teaching
2. Clinical Teaching II
3. Developing
Curriculum and
Assessing
Learners
4. Delivering
Feedback
5. Developing a
Teaching Portfolio
6. Large Group
Teaching
7. Small Group
Teaching
8. Evidence-Based
Education and
Educational
Research
The Teaching Center
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 teaching
portfolio 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 the
right people
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Session 1: Clinical Teaching
Clinical Teaching: The one-on-one
teaching that occurs centered around
patient care.
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Objectives for Session 1
• Provide a brief summary of background
information on adult learning theory
• Overview some strategies for effective and
efficient clinical teaching
• Illustrate appropriate approach to learners
• Prepare for more detailed discussions next
session
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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
The Teaching Center
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 coach…
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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 learner’s
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
The Teaching Center
First Steps (continued)
• Clarify the learner’s 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 doesn’t
have to be of each piece every time
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Clarify the
Learner’s Goals…
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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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The Art of Asking Questions:
Know What You are Trying to
Ask
• Different goals of asking questions –
» Determine where the learner’s knowledge
level is for the given situation
» Test factual recall
» Determine the learner’s thought processes
and connections
» Teach appropriate thought processes to
develop connections
» Illustrate unanswered questions
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What am I Thinking?
• It’s difficult to avoid asking “What am I
thinking?” questions
» Determine why you are thinking what
you’re thinking
» then re-focus your question
The Teaching Center
The Teaching Center
What is Feedback?
• The process of informing learners of your
perceptions 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 it’s
labeled as “feedback”
• Learners consistently say they want more
feedback
• Feedback can occur on any facet of the
encounter…communication skills, PE,
assessment, differential, written work,
presentation, literature review, etc.
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Evaluation
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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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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
Appropriate Treatment of
Learners
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•
•
•
•
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
The Teaching Center
Discuss additional teaching
techniques that you have found
valuable in clinical teaching.
The Teaching Center