Teaching Residents
to... Teach
Peter DeBlieux,MD
LSUHSC Clinical Professor of Medicine
LSUIH Emergency Department Director
Emergency Medicine Director of Resident and Faculty Development
Objectives
At the end of this presentation
participants will be able to:
Demonstrate principles of Adult
Learning
Perform a One Minute Preceptor
Reflect on their own teaching
practices
Great Teachers are...
Made not
Born
Example is not the main thing in
influencing others. It is the only
thing.- Albert Schweitzer
Majority of Academic
Physicians are…
Accidental
Educators
Did you actually plan on a life of teaching?
Accidental
Educator
Medical Education
– Learning
the knowledge,
skills, attitudes, and
behaviors that promote the
development of a physician.
The Golden Rule of Medical
Education...
Treat learners as you
would like them to
treat patients. As if
that patient was you!
–
The Purpose of
Education is to
Make Yourself
Obsolete as a
Teacher
Continuum of Medical
Education/Competence
Continuum
Student
Clinician
Faculty
Supervision
Patient Care
Responsibility
Novice
Expert
Patient Caring
and Learning
Patient
Facilitator
Learner
Establishing Ground Rules
Creates a safe learning environment
 No put downs verbal or non-verbal, no
matter how tempting
 Speak for yourself
 Everyone is responsible for their own
learning
 Expect unfinished business, too many
exercises, not enough time
Why Should Doctors Teach?
 Enhancement of their own knowledge
base and problem solving skills
 Development of learning habits and
skills enabling lifelong maintenance of
professional competence
 Creation of and fostering a TEAM
mentality
Why Should Doctors Teach?
 Fosters goodwill among house-
staff
 Self satisfaction of teaching
 Availability of residents – you are
doing it anyway, near peer
phenomenon, role modeling
Barriers to Teaching
Time
Training
Service vs Education
Structure of Adult
Learning
Problem Solving
Concepts Concepts
Principles Principles Principles
Facts Facts Facts Facts Facts
Principles of Adult
Learning
 Motivation is established, the
material is useful
 Assurance that learning is active
 Concepts not facts are taught
 Feedback is provided promptly
Principles of Adult
Learning
 Environment is non-threatening
 Material is related to existing
knowledge
 Learners are treated as
individuals
 Learning is best when self-paced
Bedside Teaching
Medicine is learned at the bedside
and not in the classroom; the best
teaching is that taught by the
patient himself.Sir William Osler
Attributes of Effective
Teachers
 Enthusiasm for the mission
 Incorporates student in the
learning process
 Problem solving emphasis
 Student-centered instruction
 Humanistic Orientation
Attributes of Effective
Teachers
 Organization/clarity
 Knowledge
 Group instructional skills
 Clinical supervision
 Clinical competence
 Modeling professional characteristics
Techniques for Successful
Bedside Instruction
• Clear planning and preparation
Effective leadership
Total and constructive
participation
Delivering
Feedback
Performance
Model
Evaluations
Summative
–Judgement
–After the fact
Formative
–Change in behavior
–Ongoing
Ideal Behaviors for
Delivering Feedback
Eye contact
Enthusiasm
Ask and encourage
questions
Ideal Behaviors for
Delivering Feedback
Clinical supervision
Clinical competence
Modeling professional
characteristics
Ideal Behaviors for
Effective Feedback
Interested in the learner
Honest
Well defined goals
Ideal Behaviors for
Effective Feedback
Clear explanations
Problem solving emphasis
Student centered instruction
Ideal Behaviors for
Effective Feedback
Timely fashion
Focused on behaviors
Limited in volume
Ideal Behaviors for
Effective Feedback
Safe environment chosen
Focused on patient caring
Allows learner self assessment
Ideal Behaviors for
Effective Feedback
Use of open ended questions
Offers recommendations for
improvement
Summarizes for closure
Barriers to Effective
Feedback
–Requires role models
–Emotional investment
–Observable behaviors
–Time
Pearls for Effective
Feedback
–Praise in public….Perfect in private
–Ego sandwich- first praise for
appropriate responses then- identify
performance challenges and correct
lastly-- finish with encouragement for
participation
–Ask learner to summarize “take home
messages”
One Minute Preceptor
Teaching on the Go!
 Get a commitment
 Probe for supporting evidence
 Teach general rules
 Reinforce what is done correctly
 Correct mistakes
 Reinforce what is done correctly
One Minute Preceptor
Teaching on the Go!
 Get a commitment
 A 3 year old with ear pain- do you think
this OM?
 Probe for supporting evidence
 What leads you to make this diagnosis?
 Teach general rules
 Reinforce what is done correctly
 Correct mistakes
 Reinforce what is done correctly
One Minute Preceptor
Teaching on the Go!
 Get a commitment
 Probe for supporting evidence
 Teach general rules
 The majority of OM cases are not caused by
bacteria
 Reinforce what is done correctly
 I like the way that you made the child feel safe
and comfortable during your exam
 Correct mistakes
 Reinforce what is done correctly
One Minute Preceptor
Teaching on the Go!
 Get a commitment
 Probe for supporting evidence
 Teach general rules
 Reinforce what is done correctly
 Correct mistakes
 I think you should spend more time teaching
the mother about the risk-benefit of antibiotics
in OM
 Reinforce what is done correctly
 I think that your search on OM and
complications was a brilliant way to prepare
you for …..
One Minute Preceptor
Teaching on the Go!
 Select a partner-one plays the role of the
student/learner, the other the preceptor
 Choose one of the following:
 URI-viral syndrome
 Asthma
 Vaccinations
 Get a commitment
 Probe for supporting evidence
 Teach general rules
 Reinforce what is done correctly
 Correct mistakes
 Reinforce what is done correctly