introduction to teaching
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Introduction to Teaching. University of Pittsburgh School of Medicine Academy of Master Educators Teaching Residents to Teach Committee Jason Rosenstock MD, CHAIR Jonathan Finder MD, VICE-CHAIR. Academy of Master Educators Residents as Teachers Committee. Jason Rosenstock MD - PowerPoint PPT PresentationTRANSCRIPT
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Introduction to Introduction to TeachingTeaching
University of PittsburghUniversity of Pittsburgh School of MedicineSchool of Medicine
Academy of Master EducatorsAcademy of Master EducatorsTeaching Residents to Teach CommitteeTeaching Residents to Teach Committee
Jason Rosenstock MD, CHAIRJason Rosenstock MD, CHAIR Jonathan Finder MD, VICE-CHAIRJonathan Finder MD, VICE-CHAIR
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Academy of Master Educators Residents as Teachers Committee
Jason Rosenstock MD– CHAIR, Assistant
Professor of Psychiatry
– Dir Medical Student Edu
Jonathan Finder, MD– VICE-CHAIR– Associate Professor
of Pediatrics
Raquel Buranosky, MD,MPH– Associate
Professor of Medicine
– PD, Internal Medicine Residency
Peter Ferson, MD– Professor of
Surgery
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Committee Members
James Johnston, MD– Professor of Medicine – PD, Nephrology
Fellowship– President, AME
Rita M Patel MD– Professor & Vice-Chair,
Anesthesiology– Clinical Procedures
UPSOM Course Director– Associate Dean for GME
Kathleen McIntyre-Seltman, MD– Professor of OB/GYN &
Reproductive Sciences– Advisory Dean, UPSOM
Petronilla Vaulx-Smith, MD, PhD– Assistant Professor of
Psychiatry Basil Zitelli, MD
– Professor of Pediatrics
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Introduction to TeachingGoal:To help incoming house staff 1) recognize the importance of
teaching2) understand basic do’s and don’ts3) be open to further development of
teaching skills
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Orientation ProgramOrientation Program Introduction to Teaching Introduction to Teaching
Why?Why?
Helps with patient careHelps with patient care Makes you look goodMakes you look good Learners expect itLearners expect it
It’s requiredIt’s required– ACGME CompetenciesACGME Competencies– Program/Institutional RequirementsProgram/Institutional Requirements
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Intro to Teaching:Intro to Teaching:The The APPLEAPPLE Curriculum Curriculum
APPLEAPPLE Curriculum Curriculum – AApplication of pplication of PPrinciples and rinciples and PPractice ractice
of of LLearning and earning and EEducationducation CoreCore
– Fundamental principles of educationFundamental principles of education– Teaching OpportunitiesTeaching Opportunities– Assessment/Evaluation/FeedbackAssessment/Evaluation/Feedback
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Conduct of SessionConduct of Session
Brief introduction to teachingBrief introduction to teaching Case-Based ScenariosCase-Based Scenarios Reflection (Table Discussion)Reflection (Table Discussion) Open DiscussionOpen Discussion Summary – Teaching PointsSummary – Teaching Points
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Agenda CoreCore
– Fundamental principles of educationFundamental principles of education– Teaching OpportunitiesTeaching Opportunities– Assessment/Evaluation/FeedbackAssessment/Evaluation/Feedback
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Adult Learning Adult Learning PrinciplesPrinciples
Learners are: Learners are: – Goal-oriented (Why, What and How)Goal-oriented (Why, What and How)– Autonomous and self-directingAutonomous and self-directing– with preexisting resources (life experiences)with preexisting resources (life experiences)
Make it relevant, practical & contextual Make it relevant, practical & contextual (problem solving)(problem solving)
Be respectful (safe learning Be respectful (safe learning environment) environment)
Motivate and reinforceMotivate and reinforce
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Teachable Moments Not just a ‘lecture’ Modeling professional behavior Daily opportunities
– Work rounds– Procedures– Ambulatory settings
Pick your targets (can’t do it all) Be brief (“teaching on the fly”)
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What type of teaching What type of teaching useful?useful?
010203040506070
% R
espo
nses
A B C DHigh ------------------------------------------------Low
MS Resident Prog Dir
A.A. Procedures, Procedures, Case Case Management, Management, 5-min talks, 5-min talks, Bedside Bedside TeachingTeaching
B.B. Physical Physical Diagnosis Diagnosis RoundsRounds
C.C. Lectures, PBL, Lectures, PBL, Simulated Simulated Cases, Socratic Cases, Socratic questioningquestioning
D.D. MS I & MS II MS I & MS II coursescourses
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Microskills for Clinical Microskills for Clinical TeachingTeaching
1.1. Get a commitmentGet a commitment2.2. Probe for supporting evidenceProbe for supporting evidence3.3. Teach general rules and think Teach general rules and think
out loudout loud4.4. Tell your learner what he or she Tell your learner what he or she
did rightdid right5.5. Correct the learner’s mistakesCorrect the learner’s mistakes
Irby, 1997 The One-Minute Preceptor: Microskills for Clinical Teaching
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SCENARIO #1 Answer the following questions1.1. How can you use adult learning How can you use adult learning
principles to improve the principles to improve the educational experience?educational experience?
2.2. Identify the teachable moments Identify the teachable moments and critique what you sawand critique what you saw
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Comments?
1. 2.3.4.
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5 Microskills of Teaching
1. Get a commitment– Ask learner to articulate his/her
own diagnosis or plan– Get him/her to commit to an
answer (even if wrong)
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5 Microskills of Teaching
2. Probe for supporting evidence– Evaluate the learner’s
knowledge/reasoning– Ask probing questions
Ask why he/she thinks so Ask “what if …” scenarios Broader / deeper than learner’s answer
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5 Microskills of Teaching3. Teach general rules
• Generalize from the case at hand• Give the learner a pearl /take home
point• Point out how this case is same or
different from the general rules
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5 Microskills of Teaching
4. Reinforce what was done well• Provide positive feedback• “Catch them doing something right”
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5 Microskills of Teaching
5. Correct errors• Provide constructive corrections and
feedback Specific Targeted Recommendations for improvement
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The One Minute PreceptorChoose a single teachable point per
encounter– Most generalizable (most useful)– Most important (don’t miss the life
threatening diagnosis)– Targeted at learner’s area of weakness– Building on previous teachable point– Can be diagnosis, management, skill etc
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Agenda CoreCore
– Fundamental principles of educationFundamental principles of education– Teaching OpportunitiesTeaching Opportunities– Assessment/Evaluation/FeedbackAssessment/Evaluation/Feedback
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FeedbackFeedback vs.vs. EvaluationEvaluation ImmediateImmediate InformalInformal ObjectiveObjective SpecificSpecific Improvement Improvement FormativeFormative InformationInformation
ScheduledScheduled FormalFormal ObjectiveObjective GlobalGlobal GradeGrade SummativeSummative JudgmentJudgment
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RIMERIME Evaluation Evaluation FrameworkFramework RReporter eporter – Provides data– Provides data
– WBC count 15; chest x-ray infiltrateWBC count 15; chest x-ray infiltrate IInterpreternterpreter – Integrates data – Integrates data
– Differential diagnosis including pneumoniaDifferential diagnosis including pneumonia MManager anager – Implements– Implements
– Treats with antibiotic, arranges hospital admissionTreats with antibiotic, arranges hospital admission EEducator ducator – Teaches – Teaches
– Shows how individual data led to diagnosis of Shows how individual data led to diagnosis of pneumonia and how to treat itpneumonia and how to treat it
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SCENARIO #2
Answer the following questions:
1.1. How would you improve the How would you improve the feedback that was given? feedback that was given?
2.2. Use the RIME System to assess Use the RIME System to assess the learnerthe learner
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Comments?
1. 2.3.4.
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Feedback Feedback in thein the Clinical Clinical SettingSetting
Observe the learnerObserve the learner Describe a notable aspect of Describe a notable aspect of
performanceperformance Wait for a responseWait for a response Recommend a next step to Recommend a next step to enhance their performanceenhance their performance Arrange for a retryArrange for a retry
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Evaluation Evaluation ofof Clinical Clinical LearnersLearners Reinforce what they are doing wellReinforce what they are doing well Educate about areas in which Educate about areas in which
improvement is possibleimprovement is possible Affirm your belief in their ability to Affirm your belief in their ability to
follow this advicefollow this advice Check for their understanding by Check for their understanding by
asking for a planasking for a plan Commit to helpCommit to help
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Teaching Challenges The unmotivated student The unprofessional student Confrontation/Conflict Time constraints Navigating the learner/teacher
role
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Intro to Teaching: Conclusions
It’s important and you’ll do it regularly Make it relevant, practical Capitalize on teachable moments Use microskills (1min teaching!) Give timely feedback, assess with
RIME Ask for help, more to come
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So Just Take the Plunge