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Teaching Residents Teaching Residents
to... to... TeachTeach
Peter DeBlieux,MDLSUHSC Clinical Professor of MedicineLSUIH Emergency Department DirectorEmergency Medicine Director of Resident and Faculty Development
ObjectivesObjectivesAt the end of this presentation At the end of this presentation
participants will be able to:participants will be able to:
Demonstrate principles of Adult Demonstrate principles of Adult LearningLearning
Perform a One Minute Preceptor Perform a One Minute Preceptor
Reflect on their own teaching Reflect on their own teaching practicespractices
Great Teachers are... Great Teachers are...
Made not Made not BornBorn
Example is not the main thing in Example is not the main thing in influencing others. It is the only influencing others. It is the only
thing.- Albert Schweitzerthing.- Albert Schweitzer
Majority of Academic Majority of Academic Physicians are…Physicians are…
Accidental Accidental EducatorsEducators
Did you actually plan on a life of teaching?Did you actually plan on a life of teaching?
Accidental Educator
Medical EducationMedical Education
– – Learning the knowledge, Learning the knowledge, skills, attitudes, and skills, attitudes, and behaviors that promote the behaviors that promote the development of a physician.development of a physician.
The Golden Rule of Medical The Golden Rule of Medical Education...Education...
––Treat learners as you Treat learners as you would like them to would like them to treat patients. As if treat patients. As if that patient was you!that patient was you!
The Purpose of The Purpose of Education is to Education is to Make Yourself Make Yourself Obsolete as a Obsolete as a
TeacherTeacher
Continuum of Medical Continuum of Medical Education/Competence Education/Competence
ContinuumContinuum
StudentStudent ClinicianClinician
Patient Care Responsibility
Faculty Supervision
ExpertNovice
Patient Caring Patient Caring and Learningand Learning
PatientPatient
FacilitatorFacilitator Learner Learner
Establishing Ground RulesEstablishing Ground Rules
Creates a safe learning environmentCreates a safe learning environment No put downs verbal or non-verbal, no No put downs verbal or non-verbal, no matter how temptingmatter how tempting
Speak for yourselfSpeak for yourself Everyone is responsible for their own Everyone is responsible for their own learninglearning
Expect unfinished business, too many Expect unfinished business, too many exercises, not enough timeexercises, not enough time
Why Should Doctors Teach?Why Should Doctors Teach?
Enhancement of their own knowledge Enhancement of their own knowledge base and problem solving skillsbase and problem solving skills
Development of learning habits and Development of learning habits and skills enabling lifelong maintenance of skills enabling lifelong maintenance of professional competenceprofessional competence
Creation of and fostering a TEAM Creation of and fostering a TEAM mentalitymentality
Why Should Doctors Teach?Why Should Doctors Teach?
Fosters goodwill among house-Fosters goodwill among house-staffstaff
Self satisfaction of teachingSelf satisfaction of teachingAvailability of residents – you are Availability of residents – you are doing it anyway, near peer doing it anyway, near peer phenomenon, role modelingphenomenon, role modeling
Barriers to TeachingBarriers to TeachingTimeTimeTrainingTrainingService vs EducationService vs Education
Structure of Adult Structure of Adult LearningLearning
Problem SolvingProblem Solving
Concepts ConceptsConcepts Concepts
Principles Principles PrinciplesPrinciples Principles Principles
Facts Facts Facts Facts FactsFacts Facts Facts Facts Facts
Principles of Adult Principles of Adult LearningLearning
Motivation is established, the Motivation is established, the material is usefulmaterial is useful
Assurance that learning is activeAssurance that learning is active Concepts not facts are taughtConcepts not facts are taught Feedback is provided promptlyFeedback is provided promptly
Principles of Adult Principles of Adult LearningLearning
Environment is non-threateningEnvironment is non-threatening Material is related to existing Material is related to existing
knowledgeknowledge Learners are treated as Learners are treated as
individualsindividuals Learning is best when self-pacedLearning is best when self-paced
Bedside TeachingBedside TeachingMedicine is learned at the bedside Medicine is learned at the bedside
and not in the classroom; the best and not in the classroom; the best teaching is that taught by the teaching is that taught by the patient himself.-patient himself.-
Sir William OslerSir William Osler
Attributes of Effective Attributes of Effective TeachersTeachers
Enthusiasm for the missionEnthusiasm for the mission Incorporates student in the Incorporates student in the
learning processlearning process Problem solving emphasisProblem solving emphasis Student-centered instructionStudent-centered instruction Humanistic OrientationHumanistic Orientation
Attributes of Effective Attributes of Effective TeachersTeachers
Organization/clarityOrganization/clarity KnowledgeKnowledge Group instructional skillsGroup instructional skills Clinical supervisionClinical supervision Clinical competenceClinical competence Modeling professional characteristicsModeling professional characteristics
Techniques for Successful Techniques for Successful Bedside InstructionBedside Instruction
• Clear planning and preparationClear planning and preparationEffective leadershipEffective leadershipTotal and constructive Total and constructive
participationparticipation
Delivering Delivering FeedbackFeedback
Performance Performance ModelModel
EvaluationsEvaluationsSummativeSummative–JudgementJudgement
–After the factAfter the fact
FormativeFormative–Change in behaviorChange in behavior
–OngoingOngoing
Ideal Behaviors for Ideal Behaviors for Delivering FeedbackDelivering Feedback
Eye contact Eye contact EnthusiasmEnthusiasmAsk and encourage Ask and encourage questionsquestions
Ideal Behaviors for Ideal Behaviors for Delivering FeedbackDelivering Feedback
Clinical supervisionClinical supervisionClinical competenceClinical competenceModeling professional Modeling professional characteristicscharacteristics
Ideal Behaviors for Ideal Behaviors for Effective FeedbackEffective Feedback
Interested in the learnerInterested in the learnerHonestHonestWell defined goalsWell defined goals
Ideal Behaviors for Ideal Behaviors for Effective FeedbackEffective Feedback
Clear explanationsClear explanationsProblem solving emphasisProblem solving emphasisStudent centered instructionStudent centered instruction
Ideal Behaviors for Ideal Behaviors for Effective FeedbackEffective Feedback
Timely fashionTimely fashionFocused on behaviorsFocused on behaviorsLimited in volumeLimited in volume
Ideal Behaviors for Ideal Behaviors for Effective FeedbackEffective FeedbackSafe environment chosenSafe environment chosenFocused on patient caringFocused on patient caringAllows learner self assessmentAllows learner self assessment
Ideal Behaviors for Ideal Behaviors for Effective FeedbackEffective FeedbackUse of open ended questionsUse of open ended questionsOffers recommendations for Offers recommendations for improvementimprovement
Summarizes for closureSummarizes for closure
Barriers to Effective Barriers to Effective FeedbackFeedback
–Requires role modelsRequires role models–Emotional Emotional investmentinvestment–Observable behaviorsObservable behaviors–TimeTime
Pearls for Effective Pearls for Effective FeedbackFeedback
–Praise in public….Perfect in privatePraise in public….Perfect in private–Ego sandwich- first praise for Ego sandwich- first praise for
appropriate responses then- identify appropriate responses then- identify performance challenges and correct performance challenges and correct lastly-- finish with encouragement for lastly-- finish with encouragement for participationparticipation
–Ask learner to summarize “take home Ask learner to summarize “take home messages”messages”
One Minute PreceptorOne Minute PreceptorTeaching on the Go!Teaching on the Go!
Get a commitmentGet a commitmentProbe for supporting evidenceProbe for supporting evidenceTeach general rulesTeach general rulesReinforce what is done correctlyReinforce what is done correctlyCorrect mistakesCorrect mistakesReinforce what is done correctlyReinforce what is done correctly
One Minute PreceptorOne Minute PreceptorTeaching on the Go!Teaching on the Go!
Get a commitmentGet a commitment A 3 year old with ear pain- do you think A 3 year old with ear pain- do you think
this OM?this OM? Probe for supporting evidenceProbe for supporting evidence
What leads you to make this diagnosis?What leads you to make this diagnosis? Teach general rulesTeach general rules Reinforce what is done correctlyReinforce what is done correctly Correct mistakesCorrect mistakes Reinforce what is done correctlyReinforce what is done correctly
One Minute PreceptorOne Minute PreceptorTeaching on the Go!Teaching on the Go!
Get a commitmentGet a commitment Probe for supporting evidenceProbe for supporting evidence Teach general rulesTeach general rules
The majority of OM cases are not caused by The majority of OM cases are not caused by bacteria bacteria
Reinforce what is done correctlyReinforce what is done correctly I like the way that you made the child feel safe I like the way that you made the child feel safe
and comfortable during your examand comfortable during your exam Correct mistakesCorrect mistakes Reinforce what is done correctlyReinforce what is done correctly
One Minute PreceptorOne Minute PreceptorTeaching on the Go!Teaching on the Go!
Get a commitmentGet a commitment Probe for supporting evidenceProbe for supporting evidence Teach general rulesTeach general rules Reinforce what is done correctlyReinforce what is done correctly Correct mistakesCorrect mistakes
I think you should spend more time teaching I think you should spend more time teaching the mother about the risk-benefit of antibiotics the mother about the risk-benefit of antibiotics in OM in OM
Reinforce what is done correctlyReinforce what is done correctly I think that your search on OM and I think that your search on OM and
complications was a brilliant way to prepare complications was a brilliant way to prepare you for …..you for …..
One Minute PreceptorOne Minute PreceptorTeaching on the Go!Teaching on the Go!
Select a partner-one plays the role of the Select a partner-one plays the role of the student/learner, the other the preceptorstudent/learner, the other the preceptor
Choose one of the following:Choose one of the following: URI-viral syndromeURI-viral syndrome AsthmaAsthma VaccinationsVaccinations
Get a commitmentGet a commitment Probe for supporting evidenceProbe for supporting evidence Teach general rulesTeach general rules Reinforce what is done correctlyReinforce what is done correctly Correct mistakesCorrect mistakes Reinforce what is done correctlyReinforce what is done correctly