What Teaching Tools DO residency Educators Use?
Even though we were trained as physicians, we will need new training, skills and practice to become the residency educator our learners need most. Thankfully, our master teachers are generous in sharing what they have found to be the most useful approaches to teaching residents and students.
In the 21rst century, physicians learn in the workplace. You will need to know how to observe them with a patient, what skills are needed for the task at hand and what feedback to give them to move towards less supervision. This kind of teaching is not about a data dump- your residents can use Up To Date for that. It's about the application of knowledge- bringing together the right skills- to improve patient care.
In this section, you will learn about tools that most effective medical educators use everyday on rounds, in the clinic or when seeing patients with their learners. Each tool includes the rationale, the evidence and examples for its use.
Set the LEarning Culture
As the rotation instructor, you need to be intentional about the culture you create for learning. Will learners be challenged on partial knowledge in a way that promotes self-learning? Will feedback be respectful and based on observation of the learner performing a skill? What expectatons form a hidden set of rules for your teaching?
As soon as you intereact with learners they need to know what you expect and how learning will be conducted. Use this worksheet to learn approaches from highly effective clinical teachers- and don't forget to be yourself and enjoy playing a role in helping clinicians develop core skills.
Download the Set the Culture Worksheet.Set the Learning Culture Worksheet
In the early 1990's educators assembled a sequence of questions which clinical teachers could use to engage a student or resident in decisions about the case they are seeing. Each "microskill" satisfies a learning objective in a very short period of time and will help you 'diagnose the learner' as well as the disease.
- Use of the Microskills method increases the usable feedback given to learners a factor of 2:1.
(Salerno, et al. Faculty development seminars based on the one-minute preceptor improve feedback in the ambulatory setting. J Gen Intern Med 2002:17:17:779-87)
- Faculty use of Microskills was associated with greater success in letting learners reason through cases, in evaluating learners and in creating and identifying next steps in learning.
Review the original "One Minute Preceptor" article (now called "Microskills").Microskills ArticleDr. Jones Presentation on Microskills
Understanding How we use ACGME Milestones to Evaluate and advance residents
As you develop your own teaching approach, it's important to understand how resident learners advance in our department. We use the ACGME Milestones (specific to IM and Transitional Year) to help residents self evaluate and work on competency gaps identified at Clinical Comopetency Committee. These reviews are done twice a year and this is discussed in a resident coaching session held with their advisor.Rotation and Curriculum Page
We generally want residents to be achieving at the 3 out of 5 column (Competent) level before progressing to a supervisory role as a second year.
Knowing what your interns need to achieve will help you set expectations for your own teaching.
Review the residency strategy and Milestones materials on the Rotation Page here: