Resident Teaching Elective OHSU Family Medicine
Resident Elective in Teaching
Background
The Medical Student Education Section of the Family Medicine Department often needs
additional instructors in the clinic, in didactics, and in small group settings. Teaching
residents to teach can be an effective way to improve the current and future supply of
Family Medicine Community and Faculty Instructors.
Many residents in the Family Medicine Department enjoy teaching.
Many residents desire an elective experience that is fun, local and requires little after
hours call.
Some residents require an elective experience that also allows a large amount of
continuity clinic (if their required RRC visit numbers are low).
Many residents graduate to work in the local community and serve as future communitybased Family Medicine Clerkship preceptors.
Most residents (and as such our future community physicians) have no training in
efficient clinical teaching, giving constructive negative feedback, evaluating students,
creating effective didactic instructions, or facilitating small-groups.
The purpose of this elective is to provide a variety of teaching experiences for the
resident in a setting that allows experienced faculty to give the resident feedback on their
teaching skills.
Goal: Develop Teaching Skills for future physicians.
Objectives: During this elective the resident will:
Teach students in a clinical setting and with guidance develop feedback skills.
Facilitate small group teaching and with guidance develop skills in effective small
group teaching.
Give negative and positive feedback in a constructive manner.
Develop and implement one instructional session/tool
(R3 Only) Co-precept in clinic with faculty: teach other residents.
Educational Methods
Clinical Instruction:
The resident will be assigned students when they are in clinic:
Five (or more) clinic half days will be scheduled any day except two, Tuesday
afternoons and Thursday all day.
The resident will debrief weekly with faculty (on Thursdays) what went well and
what could improve with clinical student teaching and feedback.
The resident will identify goals for each clinic session to work with students
The resident will give feedback to the student regularly at minimum weekly.
The resident will identify areas that the student(s) did well in and areas for student
improvement.
The resident will give feedback on the student note(s) daily.
Students will be asked to evaluate the resident’s instruction techniques
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Resident Teaching Elective OHSU Family Medicine
Small Group Facilitation:
The resident will shadow a faculty member during small group sessions:
Shadow and co-facilitate with faculty a School of Medicine Small Group
Discussion (1-3pm) and a Physical Small Group session (3-5pm).
The resident will co-facilitate/facilitate third year Family Medicine Clerkship
Small Group session
Faculty will debrief with the resident on what went well with small group
instructions and discuss suggested improvements.
Giving Feedback.
Once during the rotation, the resident will evaluate third year Family Medicine
Clerkship students during an Objective Structured Clinical Examination (OSCE).
The session will be video recorded. A selection of those OSCE feedback sessions
will be reviewed with faculty the following week.
Didactics: Developing and implementing an Instructional Tool
The resident will choose one focused topic and choose an audience.
The resident will develop an interactive teaching session/tool (seminar, workshop,
website, etc) to teach the selected audience.
The faculty will give weekly guidance on defining Goals Objectives, development
of the teaching tool, and evaluation of the product.
The resident will implement the tool for the Third Year Clerkship didactic series
or for their fellow residents before the end of the residency.
(Optional) Co-Precepting (R3 only)
One to four times during the rotation, the residents will co-precept in clinic.
Faculty Preceptors will directly observe and give immediate feedback to residents
on their precepting suggestions.
Faculty will review the video recording of select precepting encounters.
Continuity Clinics During the elective:
Depending on the residents needs, this elective will allow five to seven or more
clinics per week (see schedule below for clinic scheduling options).
Exact clinic days should be determined as best fits the needs of the resident and
clinic, but should be set sixty days prior to the elective so patient scheduling is
assured.
Schedule options:
A Schedule is laid out for the resident based on the resident educational needs (what type
of teaching they would like to do), availability of student teaching opportunities
(didactics, small group, or workshops), resident teaching opportunities (didactics or
shadow-precepting), student -clinical teaching opportunities, and when the resident is
scheduled in continuity clinic.
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Resident Teaching Elective OHSU Family Medicine
The following is an example Schedule: in this example, there are didactics on
Thursday Mornings, small group sessions on Tuesday and Thursday afternoons.
The resident is instructed not to schedule continuity clinic during those times.
Monday
Tuesday
Wednesday
Thursday
Friday
Clinic with MS3 Feedback
Clinic with
AM Clinic with Clinic with
MS3
MS3
or
Review
MS3 (option
(Option for
Development
for R3 Weeks
R3 Weeks
time *
MS3 Didactics
2, 4: shadow
1, 3:
weeks 1,3,4, 5
Precepting
shadow
OSCE week 2
residents)
Precepting
residents)
Clinic with
Resident
Clinic with
PM
MS3
Small
Education Time Small Group
MS3
Group MS2
MS3
Developme
nt time*
EVE
Development
time*
1st Week Family
Medicine
Interest Group
Suture seminar
Resident should NOT schedule Continuity clinic in the shaded areas
*Development Time - time not spent in clinic will be spent preparing for small group, developing
instructional tools, working with students outside of clinic, or giving feedback to students on notes.
Clinic with MS3. The resident is assigned a third year clerk during all their continuity
clinics. They will be responsible for giving daily constructive feedback and writing. The
resident will reflect on the quality of their feedback and write a daily summary of the
feedback given to the student.
Small Group MS2. The second year students have group discussions held on Tuesday
afternoons. The Resident will shadow one group assigned to a family medicine faculty
for four weeks. The faculty demonstrates and instructs the resident on small-group
facilitation, giving feedback, and the art of using the mix of student personalities to
enhance the small group dynamic.
Resident Education Time. In this sample schedule, the resident meets for their usual
resident education time. Other residencies have daily noon-time conferences at the clinic,
so the schedule would be changed to accommodate the mandatory resident didactics.
Family Medicine Interest Group. The FMIG group holds seminars during the year for
interested students, the example schedule has the resident helping (or leading) a suture
workshop. Other FMIG workshops that have been successful include: casting, injections,
electrocardiogram reading, and radiographic interpretation. The budget for FMIG
supports a pizza dinner for the students in attendance.
MS3 Didactics. Third year Family Medicine Clerkship students in this example schedule
participate in weekly didactics. The resident leads one session toward the end of their
elective. The weeks prior are spent developing interactive didactic/seminar materials for a
common Family Medicine Topic.
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Resident Teaching Elective OHSU Family Medicine
OSCE. The Family Medicine Resident serves as an observer during a student Objective
Structured Clinical Examination (OSCE). The resident gives direct feedback to students
working with standardized patients. These sessions are video recorded.
Optional. R3 Shadow Precepting. Third year residents have the option to precept their
fellow residents in clinic while working directly with the faculty preceptor for 2
precepting sessions. The precepting room has video recording capability.
Feedback Review. The resident meets weekly with a faculty member 1-2 hours to:
- Review clinical teaching successes and challenges that occurred that week and
brainstorm ways to overcome challenges.
- Review clinical teaching concepts. The areas discussed are: tips for efficiently
working with students, working with advanced learners, working with difficult
students, grading.
- Review didactic and small group teaching concepts. The areas discussed include:
tools for interactive seminars, use and misuse of PowerPoint, balancing introverts
with extroverts in the small group setting.
- Review OSCE and precepting and teaching feedback video recordings.
- Discuss small group teaching experiences.
- Help the resident develop a MS3 Didactic Lecture: choice of topic, objectives,
methods, and review the resident schedule for implementing their instructional
seminar.
Evaluation:
Residents will complete pre and post self evaluation.
Faculty will meet weekly with the resident to provide verbal feedback on teaching
skills.
Faculty will give feedback to the resident on the OSCE video recorded session.
Students will be asked to give feedback on the resident’s clinical teaching style.
Students will be asked to give feedback to the resident’s small group facilitation
in Student-led Clinical Rounds.
Residents will evaluate the elective.
(optional) The resident will develop an evaluation tool for their interactive
teaching session and the intended audience will complete that evaluation.
(optional) The faculty will give the resident feedback on precepting skills.
COMPETENCIES ADDRESSED IN THIS TEACHING ELECTIVE
1) Interpersonal and Communication Skills
a) Develop skills to evaluate students and give feedback
b) Develop skills to identify strengths and weaknesses of learners
2) Professionalism
a) Give feedback to peers and faculty on performance
b) Develop skills needed to see patients efficiently while teaching
3) Patient Care
a) Provide increased continuity and access of care for patients
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Resident Teaching Elective OHSU Family Medicine
Tips for Running a Smooth Elective:
Maintain a Flexible Schedule.
Being flexible with the resident schedule is key for success.
For example if the resident needs to be at a conference on a certain day, then the teaching
schedule can change to a alternative teaching opportunity on a different day.
Recruit Senior Faculty Ahead of Time.
Recruiting senior faculty to mentor is usually relatively easy; just make sure to ask permission
before hand by email. An example might be: "X resident is doing a teaching elective. We are
pairing the resident with some of our gold-standard faculty and would be honored if you would
allow this resident to shadow with you during your small group next month. Please let us know if
you are available. Some suggested items to discuss with the resident include..."
Educate Senior Faculty.
Instruct the senior faculty as to why the resident is with them and offer suggestions for what they
should teach the resident before, during or after the teaching opportunity.
Send Reminders.
Administrative support personnel should remind the resident and faculty one week in advance
which teaching events they are doing and where and when they should show up.
Set Schedules up in Advance
Setting up the schedule far in advance is most helpful. This allows the resident to prepare in
advance and allows the senior faculty to schedule a small amount of extra time to debrief the
resident after or before the teaching sessions.
Teach What the Resident Needs
Resident meets with the faculty weekly to debrief on their teaching challenges and successes. The
topics that the faculty instructs, should flex according to the resident needs, but the most common
issues are not having enough time and giving feedback.
Common clinical instruction topics include:
Being efficient with clinical teaching while seeing patients
Giving negative feedback as well as positive feedback
Working with difficult learners
Challenging Advanced Learners
Common didactic instruction topics include:
Effective use of PowerPoint
Creating effective teaching materials
Interactive methods of instruction
Creating measurable objectives
Teach the Resident to Fish
Faculty share useful resources during this elective, however it is most useful to teach the resident
to ‘fish’ rather than “feeding them. Instruct the resident how to find resources by introducing
them to digital repositories such as www.fmdrl.org .
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