The Teaching Physician: The Teaching Physician: How to Become a More Effective How to Become a More Effective

Medical EducatorMedical Educator

The Teaching Center

UNC Department of Pediatrics

The Teaching CenterThe Teaching Center

Teaching Center FacultyTeaching Center Faculty

• Jack Benjamin, MD Division Chief, General Pediatrics and Adolescent Medicine

• Julie Byerley, MD, MPHDirector, Medical Student Education in Pediatrics

• Harvey J. Hamrick, MDResidency Program Director, Pediatrics

• Allen Liles, MDResidency Program Director, Medicine and Pediatrics

The Teaching Center

Welcome and Welcome and IntroductionsIntroductions

The Teaching Center

Overview of the Teaching Overview of the Teaching Physician ProgramPhysician Program

• Session Curriculum• Project• Teaching Portfolio Preparation• Relationships and Support

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Session CurriculumSession 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

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ProjectProject

• 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 PortfolioTeaching 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 SupportRelationships 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 TeachingSession 1: Clinical Teaching

Clinical Teaching: The one-on-one teaching that occurs centered around

patient care.

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Objectives for Session 1Objectives 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 LearnersAdults 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

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Adult Learning - AppliedAdult 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…Teachers should coach… The Teaching Center

Clinical CoachingClinical 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 First Steps in Effective Teaching:Teaching:

• Generate enthusiasm» For the process of teaching » or the subject matter» or the students

• Teach what you love

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First Steps (continued)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 Clarify the Learner’s Goals…Learner’s Goals…

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ObservationObservation

Photos Courtesy of http://www.uncbasketballupdate.com/04-05_championship.html

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Clinical TeachingClinical Teaching

• Situational• Not always carefully planned• Demands efficiency in teaching

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Efficiency in Clinical TeachingEfficiency 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 QuestionsThe 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: The Art of Asking Questions: Know What You are Trying to Know What You are Trying to

AskAsk

• 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?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

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What is Feedback?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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FeedbackFeedback

• 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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EvaluationEvaluation The Teaching Center

Appropriate Approach to Appropriate Approach to LearnersLearners

• 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 Issues Relating to Culture and EthnicityCulture 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

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Appropriate Treatment of Appropriate Treatment of LearnersLearners

• Be professional.• Make attempts to connect.• Identify the commonality.• Involve all learners.• Be open to mentoring any learner.

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CommonalityCommonality

Photo Courtesy of Gerry Broome, AP

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Effective Clinical TeachingEffective Clinical Teaching

• Based on shared and understood goals• With opportunity for action and self-reflection• Consistent, clear, improvement-focused

feedback• In a humanistic environment

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Discuss additional teaching Discuss additional teaching techniques that you have found techniques that you have found

valuable in clinical teaching.valuable in clinical teaching.

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