Teaching Pearls from the Dean. Dr. Allan Jones, Regional Associate Dean, Interior. Master Teacher Certificate Program.

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1 Teaching Pearls from the Dean Dr. Allan Jones, Regional Associate Dean, Interior Master Teacher Certificate Program April 24, 2014

2 Master Teacher Certificate Program Objectives To reaffirm and to build on foundational clinical teaching skills To provide learners with focused practical techniques to improve their teaching and their enjoyment of teaching To strengthen the community of teachers and educational leaders in the Southern Medical Program

3 Learning Objectives Take home two Pearls that might help you become even a better teacher of medical students 1. Learning Climate: it makes you or breaks you 2. Asking questions: Socratic vs Socratic Traumatic (Pimping) 3. Why do students entering clerkship seem so ill prepared for your rotation? 4. Credible feedback is a treasured teaching moment not to be missed. 5. The seven most dangerous words in medical education 6. Top three ways to steadily improve as a clinical teacher over the long term

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6 Box 10.1 WHERE S THE EVIDENCE Attention and recall During the course of an hour long lecture: attention is at its height during the first minutes and the final minutes the most note taking occurs during the first 10 minutes only 42 percent of the key points of a lecture can be recalled immediately afterwards this drops to 20 percent within one week Understanding Medical Education, 2 nd Edition Tim Swanwick

7 Pearl #1 Learning Climate: It makes you or breaks you

8 The Paper Chase

9 Learning Climate Answers question: do learners want to be there? Equally important: does the teacher want to be there?

10 Everybody Knows Your Name

11 Pearl #2 Asking questions: Socratic vs Socratic Traumatic (Pimping)

12 Ground Rules for Questioning During Rounds There will be questioning on rounds as one mode of teaching. The purpose of these questions is never to show that you don t know something but rather is to find the limits of what you know in order to add to your understanding

13 My preceptor was very anatomy oriented, which is great, but I felt that if I was unable to answer a question he got very annoyed. Some answers were things I had never heard about! Questions help students learn, but I do not think it is necessary to make us feel bad when we don t know an answer. Clinical Clerk Class of 2015

14 Figure 6.1 Interactive Effect of Student Development and Course Climate on Learning How Learning Works Ambrose, et al

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16 SMP Teaching Quality Assessment Report Year 1 & 2: & % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% DPAS FMED FMPR INDE Exceeds Requirements Meets Requirements Requires Improvements

17 Clinical Faculty Indispensable Engines of Medical Education The men and women behind the guns William Osler

18 Guidelines for the New Medical School Although physical facilities and unique educational program are important in the development of any medical school, the essential components for success are the qualities, abilities and enthusiasm of the teaching staff in their pursuit of programs of excellence in medical education. This is what establishes the reputation of such an institution. W.A. Cochrane, 1968

19 No bubble is so iridescent or floats longer than that blown by the successful teacher William Osler

20 Your most vivid memory of starting Clinical Clerkship

21 Pearl #3 Why do students entering clerkship seem so ill prepared for your rotation?

22 Structure of Medical Knowledge in Memory Categories and Prototypes Both medical textbooks and classroom teaching abound in the limitless presentation of detailed lists of disorders. More often, both fail to provide a categorization scheme that is best suited for their retrieval in a clinical problem solving situation. Bordage Med Educ 1984

23 Medical students don t remember or can t use the knowledge they learned in the traditional basic science courses because the knowledge is structured into mental organizations that are not useful in the clinic Barrows, 1985

24 Ask any physician of 20 years standing how he has become proficient in his art and he will reply, by constant contact with disease; and he will add that the medicine he learned in schools was totally different from the medicine he learned at the bedside. Wm. Osler 1932

25 Readiness for Clerkship Evaluation Report : Evaluation Studies Unit 2014 Competencies Rated Lowest by Students Survey Item Role Student Rank Formulate a problem list Medical Expert 33 Interpret relevant key laboratory results obtained on your patient Medical Expert 34 Verbally present your findings to the resident or faculty Communicator 35 Propose a basic short term management plan for your patient's Medical Expert major problems 37 Interpret (explain the meaning of) relevant imaging reports for the common health problems of your patient Medical Expert 38 Identify appropriate medications based on the clinical problems Medical Expert of your patient 39 Explain the choice of medication based on mechanism of action Medical Expert and the clinical problems of your patient 40

26 Influences on Storage and Retrieval from Memory: Encoding Specificity The probability and efficiency of retrieving an item from memory depends on the similarity between the conditions of encoding and the conditions of retrieval. Navy Divers (context) Alphabet; Months of Year (processing)

27 Skills Decline

28 Pearl #4 Credible feedback is a treasured teaching moment not to be missed

29 Figure 5.1 Cycle of Practice and Feedback How Learning Works Ambrose, et al

30 Observe and provide feedback Effective clinical teachers gather data on their trainees first hand. They watch the trainees interact with patients, nursing staff and others. This should be the rule rather than the exception to provide credible information to improve future performance.

31 Figure 5.2 Unequal Effects of Practice on Performance How Learning Works Ambrose, et al

32 Pearl #5 The Seven Most Dangerous Words in Medical Education:... But, we ve always done it this way...

33 Giant CV Waves of Tricuspid Regurgitation 2n2BCQ

34 Credit: Felson s Principles of Chest Roentgenology, Lawrence R. Goodman 23 year old man with previous history of cancer. Routine follow up X ray. Diagnosis?

35 Interpret Credit: McGraw Hill Specialty Board Review. Cardiology

36 Pearl #6 Top three ways to steadily improve as a clinical teacher over the long term

37 Best Ways to Develop as a Medical Educator Learning on the job (including reflective reading) Formal staff development activities Belonging to a community of educators

38 What is a Medical Educator? The medical educator is someone who critically reflects on the quality of the educational experience and tries to innovate and improve on what they have done Yvonne Steinert Understanding Medical Education 2014

39 Table 4 3 Personal Checklist to Analyze a Teaching Encounter Think about your last clinical teaching encounter What did I do well? What could I have done differently? 2. What did I hope to achieve in this encounter/session (e.g. change in knowledge, attitudes, or skills)? How did I communicate this to the learner? 3. What methods or teaching skills did I use to help the resident/student learn (e.g. questioning, case presentation, oneon one teaching, role modeling)? 4. How did I allow for appropriate autonomy for the resident/student? Steinert, Y; Clinical Teaching 2005; 2:104 10

40 Table 4 3 Personal Checklist to Analyze a Teaching Encounter Think about your last clinical teaching encounter How did I provide feedback? 6. Did I have an opportunity to evaluate the resident/student? What was my evaluation based on (e.g. case presentation, observation)? 7. What problems, if any, did I encounter, and how would I address them? 8. What were my lessons learned from this experience? What is my action plan for my next teaching encounter? Steinert, Y; Clinical Teaching 2005; 2:104 10

41 To be Effective, Aspire to be Great Perhaps the single most important characteristic of effective teachers is that they try to be the best possible teachers they can be, to have their learners come away with something useful from each encounter. Effective teachers work hard.

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44 SMP Faculty T Shirt I am a teacher at the SMP and

45 SMP Faculty T Shirt Yes, I am great at it!

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