Introduction to Teaching
University of Pittsburgh
Academy of Master Educators
Teaching Residents to Teach Committee
Jonathan Finder MD
Raquel Buranosky, MD
Jamie Johnston, MD
Petronille Vaulx-Smith, MD
Academy of Master Educators
Residents as Teachers Committee
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Jonathan Finder, MD
– Professor of Pediatrics
– Clinical Director,
Pediatric Pulmonology
Jason Rosenstock MD
– Assistant Professor of
Psychiatry
– Director Med Student
Education
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Raquel Buranosky,
MD,MPH
– Associate Professor
of Medicine
– Director, Internal
Medicine Residency
Peter Ferson, MD
– Professor of Surgery
Committee Members
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James Johnston, MD
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– Professor of Medicine
– PD, Nephrology Fellowship
– President, AME
Rita M Patel MD
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– Professor & Vice-Chair,
Anesthesiology
– Clinical Procedures UPSOM
Course Director
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– 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
Introduction to Teaching
Goal:
To help incoming house staff
1) recognize the importance of teaching
2) understand basic do’s and don’ts
3) be open to further development of
teaching skills
Orientation Program
Introduction to Teaching
Why?
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Helps with patient care
Makes you look good
Learners expect it
It’s required
– ACGME Competencies
– Program/Institutional Requirements
Intro to Teaching:
The APPLE Curriculum
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APPLE Curriculum
– Application of Principles and Practice of
Learning and Education
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Core
– Fundamental principles of education
– Teaching Opportunities
– Assessment/Evaluation/Feedback
Conduct of Session
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Brief introduction to teaching
Case-Based Scenarios
Reflection (Table Discussion)
Open Discussion
Summary – Teaching Points
Agenda - 1
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Core
– Fundamental principles of education
– Teaching Opportunities
– Assessment/Evaluation/Feedback
Dr. Vaulx-Smith
Adult Learning Principles
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Adult learners:
– Are goal-oriented (Why, What and How)
– Are autonomous and self-directing
– Have preexisting resources (life experiences)
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Make it relevant, practical & contextual
(problem solving)
Be respectful (safe learning environment)
Motivate and reinforce
Agenda - 2
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Core
– Fundamental principles of education
– Teaching Opportunities
– Assessment/Evaluation/Feedback
“Teachable Moments”
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Not just a ‘lecture’
Modeling professional behavior
Daily opportunities
– Work rounds
– Procedures
– Ambulatory settings
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Pick your targets (can’t do it all)
Be brief (“teaching on the fly”)
What type of teaching useful?
% Responses
70
60
A.
50
B.
40
30
C.
20
D.
10
0
A
B
C
D
High ------------------------------------------------Low
MS Resident Prog Dir
Procedures, Case
Management, 5-min
talks, Bedside
Teaching
Physical Diagnosis
Rounds
Lectures, PBL,
Simulated Cases,
Socratic questioning
MS I & MS II courses
*Students value
case-based &
bedside teaching
over lectures.
“The One Minute Preceptor”
1.
2.
3.
4.
5.
Get a commitment
Probe for supporting evidence
Teach general rules and think out
loud
Tell your learner what he or she did
right
Correct the learner’s mistakes
Irby, 1997 The One-Minute Preceptor: Microskills for Clinical Teaching
SCENARIO #1
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1.
2.
Answer the following questions
How can you use adult learning
principles to improve the educational
experience?
Identify the teachable moments and
critique what you saw
Comments?
1.
2.
3.
4.
1 Minute Preceptor: 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)
One Minute Preceptor 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
One Minute Preceptor: 3
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
Microskills of Teaching: 4
Reinforce what was done well
• Provide positive feedback
• “Catch them doing something right”
One Minute Preceptor: 5
Correct errors
• Provide constructive corrections and
feedback
Specific
Targeted
Recommendations for improvement
The One Minute Preceptor
Choose 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
Agenda
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Core
– Fundamental principles of education
– Teaching Opportunities
– Assessment/Evaluation/Feedback
Dr. Buranosky
Feedback vs. Evaluation
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Immediate
Informal
Objective
Specific
Improvement
Formative
Information
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Scheduled
Formal
Subjective
Global
Grade
Summative
Judgment
RIME Evaluation
Framework
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Reporter – Provides data
– WBC count 15; chest x-ray infiltrate
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Interpreter – Integrates data
– Differential diagnosis including pneumonia
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Manager – Implements
– Treats with antibiotic, arranges hospital
admission
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Educator – Teaches
– Shows how individual data led to diagnosis of
pneumonia and how to treat it
SCENARIO #2
Answer the following questions:
1.
How would you improve the
feedback that was given?
2.
Use the RIME System to assess the
learner
Comments?
1.
2.
3.
4.
Feedback in the Clinical
Setting
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Observe the learner
Describe a notable aspect of
performance
Wait for a response
Recommend a next step to
enhance their performance
Arrange for a retry
Evaluation of Clinical
Learners
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Reinforce what they are doing well
Educate about areas in which
improvement is possible
Affirm your belief in their ability to
follow this advice
Check for their understanding by
asking for a plan
Commit to help
Teaching Challenges
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The unmotivated student
The unprofessional student
Confrontation/Conflict
Time constraints
Navigating the learner/teacher role
Intro to Teaching:
Conclusions
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It’s important and you’ll do it regularly
Make it relevant, practical
Capitalize on teachable moments
Use your new teaching skills (1 min.
preceptor)
Give timely feedback, assess with RIME
Ask for help, more to come
So Just Take the Plunge