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Steinhagen E, Khan SZ, Ofshteyn A, Terhune K, Selby L, Miller-Ocuin J, Stein SL, Ammori JB. Creation and Implementation of an Online Tool for Feedback on Resident Teaching: A Pilot Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:713-721. [PMID: 38580499 DOI: 10.1016/j.jsurg.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/11/2023] [Accepted: 01/16/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE There are few assessments of the competence and growth of surgical residents as educators. We developed and piloted an observation-based feedback tool (FT) to provide residents direct feedback during a specific teaching session, as perceived by medical students (MS). We hypothesized that residents' performance would improve with frequent, low stakes, observation-based feedback. SETTING This prospective study took place at an academic general surgery program. PARTICIPANTS Focus groups of MS, surgical residents, and faculty informed FT development. MS completed the FT regarding resident teaching. DESIGN The FT utilized 5 slider-bar ratings (0 to 100) about the teaching encounter and a checklist of 16 desirable teaching behaviors. QR codes and weekly email links were distributed for 12 months (6 clerkship blocks) to promote use. Residents were sent their results after each block. A survey after each block assessed motivation for use and gathered feedback on the FT. Descriptive statistics were used for analysis (medians, IQRs). Primary measures of performance were median of the slider-bar scores and the number of teaching behaviors. RESULTS The FT was used 111 times; 37 of 46 residents were rated by up to 65 MS. The median rating on the slider-bars was 100 and the median number of desirable teaching behaviors was 12; there were no differences based on gender or PGY level. 10 residents had 5 or more FT observations during the year. Four residents had evaluations completed in 4 or more blocks and 19 residents had evaluations completed in at least 2 blocks. Over time, 13 residents had consistent slider-bar scores, 1 resident had higher scores, and 5 residents had lower scores (defined as a more than 5-point change from initial rating). Frequency of use of the FT decreased over time (38, 32, 9, 21, 7, 5 uses per block). The post-use survey was completed by 24 MS and 19 residents. Most common reasons for usage were interest in improving surgical learning environment, giving positive feedback (MS), and improving teaching skills (residents). Most common reasons for lack of usage from residents were "I did not think I taught enough to ask for feedback," "I forgot it existed," and "I did not know it existed." CONCLUSIONS The FT did not lead to any meaningful improvement in resident scores over the course of the year. This may be due to overall high scores, suggesting that the components of the FT may require reevaluation. Additionally, decreased utilization of the instrument over time made it challenging to assess change in performance of specific residents, likely due to lack of awareness of the FT despite frequent reminders. Successful implementation of observation-based teaching assessments may require better integration with residency or clerkship objectives.
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Affiliation(s)
- Emily Steinhagen
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES).
| | - Saher-Zahra Khan
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - Asya Ofshteyn
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - Kyla Terhune
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Luke Selby
- University of Kansas Medical Center, Department of Surgery, Kansas City, Kansas
| | | | - Sharon L Stein
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH; University Hospitals Research in Surgical Outcomes & Effectiveness Center (UH-RISES)
| | - John B Ammori
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
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Michael SH, Brevik C, Miller DT, Hitt-Laustsen J, Kendall JL. Utilization of marketing automation tools for delivery of a faculty development curriculum. MEDEDPUBLISH 2024; 14:19. [PMID: 38846581 PMCID: PMC11153984 DOI: 10.12688/mep.20084.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 06/09/2024] Open
Abstract
Background Physician clinical educators play important roles in teaching, providing feedback, and evaluating trainees, but they often have variable preparation and competing demands on their time that make universal participation in workshops, seminars, or short courses designed to foster these skillsets inefficient or impossible. Methods We designed and implemented a 52-week synchronous curriculum designed to address faculty opportunities to improve teaching skills, feedback for residents and medical students, and evaluation skills, which were delivered using marketing automation tools, including text messaging and email. We evaluated the programmatic impact and feasibility of using the implementation science framework. Results Over a 104-week evaluation period, there were at least 10,499 total content impressions and 4558 unique recipients, indicating the significant reach of this program to approximately 120 faculty members. Faculty engagement with continuing education materials remained stable or increased over the 2-year evaluation period, indicating that programs like ours can have sustainable impacts. Resident evaluations of faculty across the six key domains also improved after the implementation of the program. Conclusions Our experience with digital marketing tools reflects that they can be used to deliver impactful curricular content to faculty for continuing educational purposes and that faculty can use these resources in a sustainable way. However, because of the incomplete reach with any single communication, this type of content delivery is not appropriate for isolation as a material of critical importance. More research is needed to identify the best practices and additional education-related uses of this technology.
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Affiliation(s)
- Sarah H. Michael
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80014, USA
| | - Cody Brevik
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80014, USA
| | - Danielle T. Miller
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80014, USA
| | | | - John L. Kendall
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, 80014, USA
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Jordan J, Amen A, Do AK, Osborne A, Weygandt PL, Moore KG. RaT race: A standardized open-access education resource provides a structured resident-as-teacher experience. AEM EDUCATION AND TRAINING 2023; 7:e10913. [PMID: 37817837 PMCID: PMC10560752 DOI: 10.1002/aet2.10913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023]
Abstract
Objectives There is no unified approach for training residents to be teachers. Foundations of Emergency Medicine (FoEM) is a national program that provides free resident education in emergency medicine (EM) utilizing small-group, case-based instruction delivered by individual program faculty and residents. This study seeks to explore the FoEM resident-as-teacher (RaT) experience. Methods We conducted a mixed-methods study of FoEM faculty site leaders and resident teachers in 2022. Site leaders completed an online survey consisting of multiple-choice, completion, and free-response items. We calculated descriptive statistics and applied a thematic qualitative analysis to free-response items. We conducted semistructured interviews with resident teachers. Interview transcripts were analyzed using a thematic approach with a constructivist-interpretivist paradigm. Results A total of 133 of 180 (74%) site leaders completed the survey and 11 resident teachers were interviewed. Forty-nine (37%) programs utilize resident instructors. The frequency of residents teaching and degree of faculty supervision varied. Commonly identified advantages include reinforcement of core content for resident teachers (44/49), structured format (35/49), and reduced need for faculty instructors (30/49). The most commonly identified challenges include variable instruction by residents (33/49) and challenge to providing feedback on teaching (20/49). Resident teachers identified benefits including strengthening residency community, improved EM knowledge, and greater teaching skills. For nearly all resident participants, FoEM RaT impacted their career goals by affirming their interest in teaching. Conclusions The FoEM curricular model appears to be a valuable and feasible method to incorporate a RaT experience into EM residency training programs.
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Affiliation(s)
- Jaime Jordan
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Amanda Amen
- Department of Emergency MedicineDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Anh Khoa Do
- UCLA School of Education and Information StudiesLos AngelesCaliforniaUSA
| | - Anwar Osborne
- Department of Emergency MedicineEmory UniversityAtlantaGeorgiaUSA
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Babenko O, Au L, Koppula S, Szafran O. Longitudinal Study of Family Medicine Residents' Clinical Teaching After Participation in the Residents-as-Teachers Program. Fam Med 2023; 55:539-543. [PMID: 37696023 PMCID: PMC10622039 DOI: 10.22454/fammed.2023.690209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Residents-as-teachers (RAT) programs provide opportunities for residents to gain teaching skills. Published studies have assessed RAT programs largely at a single point in time rather than longitudinally. To address this gap, we examined (a) longitudinal trends in RAT participants' interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; and (b) subsequent involvement in clinical teaching. METHODS We conducted a longitudinal survey of one cohort of family medicine residents (N=56) who participated in the RAT program during residency. We collected data before and after the RAT program and at one and three years into practice (2016-2020). We measured outcomes including interest, comfort, confidence, skill, familiarity with aspects of clinical teaching and involvement in clinical teaching. We performed longitudinal analysis using repeated measures analysis of variance. RESULTS Response rates at four data collections were 63% (n=35), 66% (n=37), 55% (n=31), and 34% (n=19), respectively. We observed consistent trends in interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; mean scores increased from before to after the RAT program and subsequently decreased in the early years in practice. At 1 and 3 years in practice, 71% and 74% of respondents, respectively, reported being involved in teaching, primarily teaching medical students. CONCLUSIONS The RAT program appears to be a positive contributing influence on family medicine graduates' perceived preparedness to teach and their involvement in teaching after graduation from residency. A relatively high proportion of residents are involved in teaching in the early years in practice.
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Affiliation(s)
- Oksana Babenko
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Lillian Au
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Sudha Koppula
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Olga Szafran
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
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Kochhar K, Cico SJ, Whitaker NP, Pettit KE, Brokaw JJ, Nabhan ZM. An Online Resident-as-Teacher Curriculum Improves First-Year Residents' Self-Confidence Teaching in the Clinical Learning Environment. MEDICAL SCIENCE EDUCATOR 2023; 33:847-851. [PMID: 37546196 PMCID: PMC10403463 DOI: 10.1007/s40670-023-01832-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/08/2023]
Abstract
We implemented an online Resident-as-Teacher curriculum for all incoming residents (PGY1s) to provide them with a basic foundation for effective teaching in the clinical learning environment. The curriculum consisted of 5 asynchronous modules delivered via the web from 2017-2021. Prior to starting the course, the PGY1s completed a self-assessment of their teaching ability (pre-test) and then again 7-8 months after completing the course (post-test). Analysis of the paired data from 421 PGY1s showed a statistically significant improvement in the self-ratings of their teaching from pre-test to post-test (p < 0.001). Our findings suggest that an online Resident-as-Teacher curriculum can produce lasting benefits in new residents' self-confidence as educators.
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Affiliation(s)
- Komal Kochhar
- Department of Family Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Stephen J. Cico
- Department of Emergency Medicine, UCF-HCA Florida Healthcare GME Consortium, Orlando, FL 32827 USA
| | - Nash P. Whitaker
- Department of Emergency Medicine, UnityPoint Health, Des Moines, IA 50309 USA
| | - Katie E. Pettit
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - James J. Brokaw
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Zeina M. Nabhan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202 USA
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Alwazzan L, AlHarithy R, Alotaibi HM, Kattan T, Alnasser M, AlNojaidi T. Dermatology residents as educators: a qualitative study of identity formation. BMC MEDICAL EDUCATION 2023; 23:199. [PMID: 36998009 PMCID: PMC10061385 DOI: 10.1186/s12909-023-04186-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND One of the many identities a physician comes to form during their career is their identity as an educator. Exploring formation of this identity may enrich our understanding of how physicians make decisions related to their roles as educators, their behaviors, and how this ultimately influences the educational environment. It is the aim of this study to investigate educator identity formation of dermatology residents while early in their careers. METHODS Drawing on a social constructionist paradigm, we conducted a qualitative study, utilizing an interpretative approach. We examined longitudinal data over a 12-month period using dermatology residents' written reflections from their professional portfolios and semi-structured interviews. We collected this data as we progressed through and beyond a 4-month professional development program designed to encourage residents' growth as educators. Sixty residents in their second, third, or final year of residency programs located in Riyadh, Saudi Arabia were invited to take part in this study. Twenty residents participated with sixty written reflections and 20 semi-structured interviews. Qualitative data were analyzed using a thematic analysis approach. RESULTS Sixty written reflections and 20 semi-structured interviews were analyzed. Data was categorized according to themes corresponding to the original research questions. For the first research question regarding identity formation, themes included definitions of education, the process of education, and identity development. For the second research question, 1 theme entitled professional development program included, the following sub-themes: individual act, interpersonal activity, and an organizational undertaking, with many believing that residency programs should prepare residents for their educator roles. Participants also described newfound leadership ambitions of creating new dermatology fellowship programs as a result of taking part in the Resident-as-Educator program. CONCLUSIONS Our study provides insights on the dynamic formation of educator identities amongst dermatology residents. Investment in developing residents as educators through professional development programs may instigate transformational change on the individual physician level and profession's level.
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Affiliation(s)
- Lulu Alwazzan
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
| | - Ruaa AlHarithy
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Thuraya Kattan
- Saudi Commission For Health Specialties, Riyadh, Saudi Arabia
| | | | - Taif AlNojaidi
- Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Hoyler MM, Pryor KO, Gotian R, Brumberger ED, Chan JM. Resident Physicians as Clinical Educators in Anesthesiology: A Narrative Review. Anesth Analg 2023; 136:270-281. [PMID: 36638511 DOI: 10.1213/ane.0000000000006243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The importance of resident physicians as clinical educators is widely acknowledged in many clinical specialties and by national accreditation organizations for medical education. Within anesthesiology training programs, there is growing attention to the role of trainees as clinical educators. This narrative review describes the theoretical and demonstrated benefits of clinical teaching by residents in anesthesiology and other medical fields, summarizes current efforts to support and promote residents as educators, and suggests ways in which anesthesiology training programs can further assess and develop the role of residents as clinical educators.
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Affiliation(s)
- Marguerite M Hoyler
- From the Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York
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Seelig S, Bright E, Bod J, Della-Giustina D, Goldflam K, Coughlin R, Tsyrulnik A. Educating Future Educators–Resident Distinction in Education: A Longitudinal Curriculum for Physician Educators. West J Emerg Med 2021; 23:100-102. [PMID: 35060872 PMCID: PMC8782133 DOI: 10.5811/westjem.2021.11.53890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/11/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sandra Seelig
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Erin Bright
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Jessica Bod
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - David Della-Giustina
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Katja Goldflam
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Ryan Coughlin
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Alina Tsyrulnik
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
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Rowat J, Johnson K, Antes L, White K, Rosenbaum M, Suneja M. Successful implementation of a longitudinal skill-based teaching curriculum for residents. BMC MEDICAL EDUCATION 2021; 21:346. [PMID: 34130680 PMCID: PMC8207581 DOI: 10.1186/s12909-021-02765-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite significant teaching responsibilities and national accreditation standards, most residents do not receive adequate instruction in teaching methods. Published reports of residents-as-teachers programs vary from brief one-time exposures to curricula delivered over several months. A majority of interventions described are one or two-day workshops with no clear follow-up or reinforcement of skills. A three-year longitudinal teaching skills curriculum was implemented with these goals: 1) deliver an experiential skill-based teaching curriculum allowing all residents to acquire, practice and implement specific skills; 2) provide spaced skills instruction promoting deliberate practice/reflection; and 3) help residents gain confidence in their teaching skills. METHODS One hundred percent of internal medicine residents (82/82) participated in the curriculum. Every 10 weeks residents attended a topic-specific experiential skills-based workshop. Each workshop followed the same pedagogy starting with debriefing/reflection on residents' deliberate practice of the previously taught skill and introduction of a new skill followed by skill practice with feedback. Every year, participants completed: 1) assessment of overall confidence in each skill and 2) retrospective pre-post self-assessment. A post-curriculum survey was completed at the end of 3 years. RESULTS Residents reported improved confidence and self-assessed competence in their teaching skills after the first year of the curriculum which was sustained through the three-year curriculum. The curriculum was well received and valued by residents. CONCLUSIONS A formal longitudinal, experiential skills-based teaching skills curriculum is feasible and can be delivered to all residents. For meaningful skill acquisition to occur, recurrent continuous skill-based practice with feedback and reflection is important.
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Affiliation(s)
- Jane Rowat
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
| | - Krista Johnson
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA
| | - Lisa Antes
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA
| | - Katherine White
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA
| | - Marcy Rosenbaum
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Manish Suneja
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA
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Zessis NR, Dube AR, Sadanand A, Cole JJ, Hrach CM, Daud YN. Teaching scripts via smartphone app facilitate resident-led teaching of medical students. BMC MEDICAL EDUCATION 2021; 21:331. [PMID: 34103029 PMCID: PMC8185492 DOI: 10.1186/s12909-021-02782-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app). METHODS Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships. RESULTS 44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention. CONCLUSIONS Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.
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Affiliation(s)
- Nicholas R Zessis
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 152, Chicago, IL, 60611, USA.
| | - Amanda R Dube
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Arhanti Sadanand
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jordan J Cole
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Christine M Hrach
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yasmeen N Daud
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
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Cohen A, Kind T, DeWolfe C. A Qualitative Exploration of the Intern Experience in Assessing Medical Student Performance. Acad Pediatr 2021; 21:728-734. [PMID: 33127592 DOI: 10.1016/j.acap.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Interns play a key role in medical student education, often observing behaviors that others do not. Their role in assessment, however, is less clear. Despite accreditation standards pertaining to residents' assessment skills, they receive little guidance or formal training in it. In order to better prepare residents for their role in medical student assessment, we need to understand their current experience. OBJECTIVE We aimed to describe the first-year resident experience assessing students' performance and providing input to faculty for student clinical performance assessments and grades in the inpatient setting. METHODS Pediatric interns at Children's National Hospital (CN) from February 2018 to February 2019 were invited to participate in semistructured interviews about their experience assessing students. Constant comparative methodology was used to develop themes. Ten interviews were conducted, at which point thematic saturation was reached. RESULTS We identified 4 major themes: 1) Interns feel as though they assess students in meaningful, unique ways. 2) Interns encounter multiple barriers and facilitators to assessing students. 3) Interns voice varying levels of comfort and motivation assessing different areas of student work. 4) Interns see their role in assessment limited to formative rather than summative assessment. CONCLUSIONS These findings depict the intern experience with assessment of medical students at a large pediatric residency program and can help inform ways to develop and utilize the assessment skills of interns.
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Affiliation(s)
- Adam Cohen
- Baylor College of Medicine, Texas Children's Hospital (A Cohen), Houston, Tex.
| | - Terry Kind
- George Washington University, Children's National Hospital (T Kind and C DeWolfe), Washington, DC
| | - Craig DeWolfe
- George Washington University, Children's National Hospital (T Kind and C DeWolfe), Washington, DC
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12
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Wolcott MD, Kornegay EC, Brame JL. Piloting a first-year resident-as-teacher workshop to foster evidence-based teaching. J Dent Educ 2020; 85:16-22. [PMID: 32915463 DOI: 10.1002/jdd.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/22/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE Residents function as important educators of dental students; however, they often have limited training in educational best-practices. Resident-as-teacher programs have been designed and implemented in other health professions to prepare residents to teach in clinic and classroom settings. In this research, we describe the design, implementation, and evaluation of a 2-day workshop for first-year advanced dental residents. METHODS The program engaged residents in techniques to: (1) foster psychological safety, (2) use the cognitive apprenticeship framework, (3) deliver quality feedback, and (4) conduct effective didactic instruction. Nineteen first-year residents attended 2 four-hour workshops in July 2019. The impact of the program was evaluated using Kirkpatrick's model, which included participant reactions, learning, and self-reported behaviors. RESULTS Most residents (at least 83.3%) reported the value and quality of the workshop was high or very high. With regard to knowledge, residents had statistically significant higher scores after the workshop on knowledge questions about cognitive apprenticeship (P < 0.01), feedback strategies (P < 0.05), and classroom instruction techniques (P < 0.05). Resident reported self-efficacy had a statistically significantly increase (P < 0.05) after the workshop in psychological safety, cognitive apprenticeship, and most items related to providing feedback; there were few changes in self-efficacy on classroom instruction strategies. CONCLUSION Overall, a workshop to prepare residents as teachers can improve knowledge and self-efficacy in evidence-based educational practices.
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Affiliation(s)
- Michael D Wolcott
- Division of Oral and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA.,Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - Elizabeth C Kornegay
- Division of Comprehensive Oral Health, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Jennifer L Brame
- Division of Comprehensive Oral Health, University of North Carolina Adams School of Dentistry, Chapel Hill, North Carolina, USA
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Hayes JR, Zeman J, Johnston B, Campbell N. Outpatient Teaching and Feedback Skills Workshop for Resident Physicians. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:10930. [PMID: 32754631 PMCID: PMC7394347 DOI: 10.15766/mep_2374-8265.10930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/14/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION There is a need for innovative workshops designed to teach students and residents the basics of clinical medical education. Resident physicians often spend a significant portion of their training teaching others and frequently have very little formal instruction on teaching techniques. Other teaching tools exist but are often either entirely lecture based or too extensive to easily incorporate into a residency teaching session. There is a need for the facilitated practice of teaching methods to improve the resident educational experience. METHODS This 80-minute workshop blends interactive role-play case studies with quick lectures on the ARCH feedback model, the RIME model of medical information mastery, and the One-Minute Preceptor. This workshop includes three short PowerPoint lectures, four case studies, a handout, a pre-/posttest, and a session evaluation form. RESULTS Resident and student learners were engaged for the entirety of this session. Pre-/posttest results showed an improvement in understanding of basic teaching and feedback techniques, and survey results showed a higher likelihood of the learners wanting to incorporate teaching into their future practice. DISCUSSION This workshop is quick and overall quite effective in teaching basic feedback and teaching techniques. It provides a much-needed opportunity for residents to practice teaching techniques immediately after they have learned the concepts. This training is ideal for a residency program looking to provide new senior residents with the teaching tools they need for success.
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Affiliation(s)
- John Ryan Hayes
- Assistant Professor, Department of Community and Family Medicine, Medical College of Wisconsin
| | - Jennifer Zeman
- Resident, PGY 3, Department of Family Medicine, Waukesha Family Medicine Residency Program
| | - Bryan Johnston
- Resident, PGY 3, Department of Family Medicine, Columbia St. Mary's Family Medicine Residency Program
| | - Neal Campbell
- Resident, PGY 3, Department of Family Medicine, All Saints Family Medicine Residency Program
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Radiography students' perceptions of Peer assisted learning. Radiography (Lond) 2019; 26:e109-e113. [PMID: 32052761 DOI: 10.1016/j.radi.2019.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/28/2019] [Accepted: 12/01/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Peer Assisted Learning (PAL) is collaborative learning in which students from the same or different academic levels learn from each other. It is meant to support the regular teaching and learning process. Learning in PAL can be explained by constructive social learning theories and has many advantages such as, students' perception of it and the ease of discussion between peers. This study aims to measure students' perception of PAL in the context of radiography education. METHODS A PAL programme was implemented in one module taught to second year radiography students. A questionnaire was then distributed to the participating students (n = 28) to measure their perception of PAL; the questionnaire consisted of 13 questions with a Likert scale of 5 (1 = strongly disagree to 5 = strongly agree). The results were analysed using SPSS to calculate the percentages, means, standard deviations, and factorial analysis. RESULTS Twenty-six students responded to the questionnaire (92.8%). The range of agreement in all questionnaire items ranged from 79.9% to 92.3%. The factor analysis revealed two main factors affecting students' acceptability. PAL enriched students' learning experience and helped them in preparation for exams. CONCLUSION The use of PAL is highly acceptable by students in context of radiography education. IMPLICATIONS FOR PRACTICE More studies are necessary to confirm the best methods of using PAL. These may involve both students and educators, and pre- and post-methods.
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Michael SH, Rougas S, Zhang XC, Clyne B. A Content Analysis of the ACGME Specialty Milestones to Identify Performance Indicators Pertaining to the Development of Residents as Educators. TEACHING AND LEARNING IN MEDICINE 2019; 31:424-433. [PMID: 30669871 DOI: 10.1080/10401334.2018.1560298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Construct: For curriculum development purposes, this study examined how the development of residents as educators is reflected in the Accreditation Council for Graduate Medical Education (ACGME) Milestones. Background: Residents teach patients, families, medical students, physicians, and other health professionals during and beyond their training. Despite this expectation, it is unclear how the development of residents as educators is reflected in the specialty-specific Milestones. Approach: We performed a textual content analysis of 25 specialty Milestone documents available as downloads from the ACGME website in December 2015. Syntactical units of interest included developmental progressions that describe the development of educators over the course of residency training and 16 key terms identified during the analysis. We then categorized the terms by associated Milestone level, ACGME core competency, and targeted learner(s). Results: We identified 10 developmental progressions and 546 instances of the 16 key terms that describe the development of physician educators. The frequency of terms among specialties was quite variable (5-46 terms per specialty, Mdn = 21). The majority of education-related terms appeared at advanced Milestone levels; there were 139 (26%) such instances in Level 4 and 296 (54%) in Level 5. Education-related terms were identified in all six ACGME core competencies, with greatest frequency in Patient Care (157, 29%). Other residents were the learners most frequently targeted by education-related Milestones (211, 40%). Conclusions: The current ACGME Milestones largely imply that resident teaching is a high-level or aspirational goal, achieved without a clear or consistently assessed developmental progression. These findings run counter to the theoretical basis that underlies the development of the Milestones. Wide variation among specialties indicates lack of consensus around the ideal skill set of the resident educator and limits the utility of these documents for curriculum development in this domain.
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Affiliation(s)
- Sarah H Michael
- a Department of Emergency Medicine, University of Colorado Denver , Aurora , Colorado , USA
| | - Steven Rougas
- b Department of Emergency Medicine, Brown University , Providence , Rhode Island , USA
| | - Xiao C Zhang
- c Department of Emergency Medicine, Thomas Jefferson University , Philadelphia , Pennsylvania , USA
| | - Brian Clyne
- b Department of Emergency Medicine, Brown University , Providence , Rhode Island , USA
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Hoffman LA, Furman DT, Waterson Z, Henriksen B. A Novel Resident-as-Teacher Curriculum to Improve Residents' Integration Into the Clinic. PRIMER (LEAWOOD, KAN.) 2019; 3:9. [PMID: 32537580 PMCID: PMC7205102 DOI: 10.22454/primer.2019.394096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Graduate medical education depends on senior residents to facilitate peer education. Previous studies have described the benefits of resident-as-teacher (RaT) curricula; however, means of assessing these interventions have proven difficult. The purpose of this study was to provide meaningful evaluation of a novel RaT curriculum and scribing activity. METHODS Didactic sessions on teaching skills were presented in July, 2017. First- and third-year residents then alternated scribing for each other for 4 weeks within the outpatient clinic to allow for near-peer educational exchange. Residents' attitudes toward teaching and perceptions of teaching abilities were assessed using preand postintervention surveys. Independent reviewers reviewed charts completed by PGY-1 residents during the scribing activity, and compared them to charts from the previous academic year. RESULTS All first-year (n=12; 100%) and third-year (n=10; 100%) residents participated in the study. After participating in the RaT curriculum, residents were more comfortable giving feedback to other residents and felt better prepared to teach and assess the effectiveness of their teaching. Although there was no significant difference in ratings between the 2016 and 2017 charts, reviewers noted that the 2017 charts contained fewer obvious omissions, and third-year residents felt the charts were completed in a timelier manner. First-year residents saw 16% more patients in 2017 than they had in 2016, which expedited integration into the clinic. CONCLUSION This innovative RaT curriculum with scribing activity improved residents' teaching and communication skills and provided first-year residents with a more efficient and meaningful orientation into the outpatient clinic.
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Fakhouri SA, Feijó LP, Augusto KL, Nunes MDPT. Teaching skills for medical residents: are these important? A narrative review of the literature. SAO PAULO MED J 2018; 136:571-578. [PMID: 30892488 PMCID: PMC9897134 DOI: 10.1590/1516-3180.2018.0147060818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is extensive evidence, mainly from the United States and Canada, that points towards the need to train medical residents in teaching skills. Much of the "informal curriculum", including professional values, is taught by residents when consultants are not around. Furthermore, data from the 1960s show the importance of acquiring these skills, not only for residents but also for all doctors. -Teaching moments can be identified in simple daily situations, like discussing a clinical situation with patients and their families, planning patients' care with the healthcare team or teaching peers and medical students. The aim here was to examine the significance of resident teaching courses and estimate the effectiveness of these courses and the state of the art in Brazil. METHODS We conducted a review of the literature, using the MEDLINE, PubMed, SciELO and LILACS databases to extract relevant articles describing residents-as-teachers (RaT) programs and the importance of teaching skills for medical residents. This review formed part of the development of a doctoral project on medical education. RESULTS Original articles, reviews and systematic reviews were used to produce this paper as part of a doctoral project. CONCLUSIONS RaT programs are important in clinical practice and as role models for junior learners. -Moreover, these educational programs improve residents' self-assessed teaching behaviors and teaching confidence. On the other hand, RaT program curricula are limited by both the number of studies and their methodologies. In Brazil, there is no such experience, according to the data gathered here, except for one master's thesis.
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Affiliation(s)
| | - Lorena Pinho Feijó
- MD. Professional Master’s Student, Centro Universitário Christus (UNICHRISTUS), Fortaleza (CE), Brazil.
| | - Kristopherson Lustosa Augusto
- MD, PhD. Adjunct Professor, Department of Clinical Medicine, Faculdade de Medicina da Universidade Federal do Ceará (FAMED - UFC) and Universidade de Fortaleza (UNIFOR), Fortaleza (CE), Brazil.
| | - Maria do Patrocínio Tenório Nunes
- MD, PhD. Associate Professor, Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
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Resident-as-teacher programs in general surgery residency - A review of published curricula. Am J Surg 2018; 217:209-213. [PMID: 30224071 DOI: 10.1016/j.amjsurg.2018.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/24/2018] [Accepted: 09/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The Liaison Committee on Medical Education (LCME) requires that residents are trained to fulfill their educational duties toward medical students. This study reviews the literature on resident-as-teacher programs (RATPs) aimed at surgical residents. METHODS Literature search with MeSH terms internship, residency, general surgery, teaching, education, and curriculum was performed using PubMed, Embase, Web of Science, and ERIC. Curriculum components and how curricula's success was measured were extracted for each study. Quality was scored using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS For the seven relevant publications the average MERSQI score was 9.9 (range 6.5-13.5). The RATPs were either lecture based (4/7) or content was distributed electronically (3/7). Change in attitude toward teaching was the most frequently assessed outcome. Highly rated curricular components were individualized feedback and iterative reminders to make teaching part of practice. CONCLUSIONS Few published RATPs in general surgery training exist. The literature suggests that pairing lectures with observation and feedback is successful. Distributing the content electronically is a feasible alternative to class-room based teaching in a busy surgical residency.
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Abstract
Residents are expected to be educators often without any formal schooling, and many continue a career in academic medicine where they play a pivotal role in education. However, few resident curricula have been published to include instruction in teaching, particularly in the field of Neurology. To guide Neurology residents as they take on their role as a clinician-educator, we developed a 1-year curriculum (Neurology Residents as Comprehensive Educators "Neuro RACE") with monthly sessions divided into didactics, small group discussions, and interactive kinetic learning. A postcurriculum survey was used to evaluate the residents' response to this curriculum. Residents reported an overall improvement in their comfort and confidence in their teaching abilities. As an integral part of academic training, residents-as-teachers curricula should take a prominent role in Neurology training programs.
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Cherney AR, Smith AB, Worrilow CC, Weaver KR, Yenser D, Macfarlan JE, Burket GA, Koons AL, Melder RJ, Greenberg MR, Kane BG. Emergency Medicine Resident Self-assessment of Clinical Teaching Compared to Student Evaluation Using a Previously Validated Rubric. Clin Ther 2018; 40:1375-1383. [PMID: 30064897 DOI: 10.1016/j.clinthera.2018.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/12/2018] [Accepted: 06/18/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE The quality of clinical teaching in the emergency department from the students' perspective has not been previously described in the literature. Our goals were to assess senior residents' teaching ability from the resident/teacher and student/learner viewpoints for any correlation, and to explore any gender association. The secondary goal was to evaluate the possible impact of gender on the resident/student dyad, an interaction that has previously been studied only in the faculty/student pairing. METHODS After approval by an institutional review board, a 1-year, grant-funded, single-site, prospective study was implemented at a regional medical campus that sponsors a 4-year dually approved emergency medicine residency. The residency hosts both medical school students (MSs) and physician's assistant students (PAs). Each student and senior resident working concurrently completed a previously validated ER Scale, which measured residents' teaching performance in 4 categories: Didactic, Clinical, Approachable, and Helpful. Students evaluated residents' teaching, while residents self-assessed their performance. The participants' demographic characteristics gathered included prior knowledge of or exposure to clinical teaching models. Gender was self-reported by participants. The analysis accounted for multiple observations by comparing participants' mean scores. FINDINGS Ninety-nine subjects were enrolled; none withdrew consent. Thirty-seven residents (11 women) and 62 students (39 women) from 25 MSs and 6 PA schools were enrolled, completing 517 teaching assessments. Students evaluated residents more favorably in all ER Scale categories than did residents on self-assessments (P < 0.0001). This difference was significant in all subgroup comparisons (types of school versus postgraduate years [PGYs]). Residents' evaluations by type of student (MS vs PA) did not show a significant difference. PGY 3 residents assessed themselves higher in all categories than did PGY 4 residents, with Approachability reaching significance (P = 0.0105). Male residents self-assessed their teaching consistently higher than did female residents, significantly so on Clinical (P = 0.0300). Students' evaluations of the residents' teaching skills by residents' gender did not reveal gender differences. IMPLICATIONS MS and PA students evaluated teaching by EM senior residents statistically significantly higher than did EM residents on self-evaluation when using the ER Scale. Students did not evaluate residents' teaching with any difference by gender, although male residents routinely self-assessed their teaching abilities more positively than did female residents. These findings suggest that, if residency programs utilize resident self-evaluation for programmatic evaluation, the gender of the resident may impact self-scoring. This cohort may inform future study of resident teaching in the emergency department, such as the design of future resident-as-teacher curricula.
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Affiliation(s)
- Alan R Cherney
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network
| | - Amy B Smith
- Department of Education, Lehigh Valley Health Network, Allentown, Pennsylvania; Faculty at University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Charles C Worrilow
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network; Faculty at University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Kevin R Weaver
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network; Faculty at University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Dawn Yenser
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network
| | - Jennifer E Macfarlan
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, Pennsylvania
| | - Glenn A Burket
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network
| | - Andrew L Koons
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network
| | - Raymond J Melder
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network
| | - Marna R Greenberg
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network; Faculty at University of South Florida, Morsani College of Medicine, Tampa, Florida
| | - Bryan G Kane
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network; Faculty at University of South Florida, Morsani College of Medicine, Tampa, Florida.
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Papanagnou D, Lee H, Rodriguez C, Zhang XCC, Rudner J. Not Your Typical Simulation Workshop: Using LEGOs to Train Medical Students on the Practice of Effective Communication. Cureus 2018; 10:e2094. [PMID: 29568715 PMCID: PMC5862464 DOI: 10.7759/cureus.2094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As students in the health professions transition from the classroom into the clinical environment, they will be expected to effectively communicate with their team members and their patients. Effective communication skills are essential to their ability to effectively contribute to their clinical team and the patient care they deliver. The authors propose an interactive workshop that can support students’ deliberate practice of communication skills. The authors designed a simulation workshop that affords students the opportunity to practice their communication and peer-to-peer coaching skills. Using LEGOs, a one-hour workshop was conducted with medical students. Students were divided into groups of two. Each student took on a different role: teacher or builder. Teachers were tasked with instructing builders on how to construct a pre-made LEGO structure, not allowing builders to look at the structure. A group debriefing followed to evaluate the activity and explore the themes that emerged. Twenty first-year medical students and 25 fourth-year medical students participated in this activity. Most groups were successful in reproducing the pre-made structure. Groups that pre-briefed before building were most successful. Unsuccessful groups did not define orientation or direction in mutually understood terms, resulting in the creation of an incorrect mirror image of the structure – a common phenomenon seen during the teaching of procedures in the clinical learning environment. The workshop was well received. Students made requests to have similar sessions throughout their training to better support the development of effective communication skills. The workshop can easily be applied to other specialties to assist with procedural skills instruction or in workshops focusing on effective communication.
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Affiliation(s)
| | - Hyunjoo Lee
- Department of Emergency Medicine, Thomas Jefferson University
| | | | | | - Joshua Rudner
- Department of Emergency Medicine, Thomas Jefferson University
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Gan H, Goh Y, Tiah L. Resident as Teacher: General needs Assessment in Emergency Medicine. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791502200404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Increasingly, residents are involved in the education of medical students, their peers and other health professionals. This study focused on the general needs assessment of the emergency medicine (EM) residents in developing a resident-as-teacher curriculum. Methods An anonymous and voluntary survey, which consisted of multiple choice and free text questions, was sent to all emergency physicians (EPs) working in the 7 restructured hospitals in Singapore. Results A total of 68 (60%) EPs completed the online survey. Overall, 19 (28%) EPs have undergone formal training in teaching. Majority of the EPs felt that it was important for the residents to acquire competent teaching skills at the end of their residency training. All of the EPs were in consensus that there should be formal instruction to the residents on how to teach. The four themes which emerged from the barriers to developing teaching skills in residents were time constraints, lack of faculty development, attitudes of both faculty and residents and a non-conducive work environment with high service requirements. Conclusions To develop the resident as an all rounded Emergency Physician, structured training and formal instruction for the developing of teaching and feedback skills must be included in the residency training. However in order for the new curriculum to be successful and achieve its primary objective of developing the residents' competencies in teaching, barriers hindering both the faculty and residents have to be addressed. Finally, faculty development needs to be done to equip the faculty with the appropriate teaching and feedback tools. (Hong Kong j.emerg.med. 2015;22:226-234)
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Affiliation(s)
- Hn Gan
- Changi General Hospital, Accident and Emergency Department, 2 Simei Street 3, Singapore 529889
| | - Ygk Goh
- Changi General Hospital, Accident and Emergency Department, 2 Simei Street 3, Singapore 529889
| | - L Tiah
- Changi General Hospital, Accident and Emergency Department, 2 Simei Street 3, Singapore 529889
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Doluee MT, Kakhki BR, Salehi M, Talebi M, Emadzadeh M, Ziaee M. Evaluation of the ability of emergency medicine residents in teaching and supervising emergency medicine interns. Electron Physician 2017; 9:4541-4545. [PMID: 28848628 PMCID: PMC5557133 DOI: 10.19082/4541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 04/14/2017] [Indexed: 11/20/2022] Open
Abstract
Background Approximately 25% of the residents’ time in each shift is allocated to educating lower-level assistants and interns. Assistants have played a major role in interns’ education. Aim To assess the teaching abilities of emergency medicine assistants in the training and monitoring of medical interns and undergraduate students. Methods This cross-sectional study was performed in 2015 at the emergency center of Imam Reza hospital in Mashhad University of Medical Sciences. We employed a researcher-made questionnaire to search the capability of emergency medicine residents to assess the teaching capabilities of emergency medicine residents to interns. This questionnaire was completed by 106 interns. The Validity of the questionnaire was confirmed by three specialist experts and reliability of the questionnaire was confirmed by Cronbach’s alpha (0.94). This questionnaire consists of 24 questions in six areas. The analysis was performed by descriptive statistics using SPSS 16. Result The study showed that the least favorable score was related to “residents get feedback on each shift” and the highest score was given to “a friendly relationship with the Interns and residents”. Conclusion Considering the key role of residents in the education and training of future healthcare specialists, training interventions and allocating sufficient time to the proper education of different members of healthcare teams and medical students could largely contribute to the development of clinical training systems.
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Affiliation(s)
- Morteza Talebi Doluee
- Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behrang Rezvani Kakhki
- Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Salehi
- Associate Professor of Community Medicine, Research Center for Patient Safety, Mashhad University of Medical Science, Mashhad, Iran and Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Talebi
- Assistant Professor of Psychiatry, Department of family medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Emadzadeh
- Assistant Professor of Community Medicine, Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Ziaee
- MD, Specialist in Community Medicine, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ting DS, Lee JC, Loo BK, Baisa K, Koo WH, Cook S, Lim BL. A nationwide, resident-led teaching programme for medical students in Singapore: SingHealth Student Internship Programme Bootcamp. Singapore Med J 2017; 57:233-7. [PMID: 27211310 DOI: 10.11622/smedj.2016092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to describe the planning, development and evaluation of the success of the first nationwide, resident-led, large-group teaching programme for medical students - the Singapore Health Services Student Internship Programme (SIP) Bootcamp. METHODS This was an initial feasibility study evaluating a half-day teaching boot camp initiated, developed and conducted by the resident educators. A three-month preparation period was required to set up an education subcommittee, liaise with medical student leaders, recruit resident educators, meet all the stakeholders and conduct the boot camp. During the SIP Bootcamp, resident educators conducted clinical case presentations using a question-and-answer format. Audience participation was strongly encouraged. A 15-item questionnaire was distributed to assess the participants' learning experience and the resident educators' teaching performance using a five-point Likert scale. RESULTS Overall, 94.8% (n = 110) of the 116 respondents agreed that the teaching sessions were of high quality and content was relevant to their training. The resident educators appeared well-informed (96.6%, n = 112) and enthusiastic about their respective topics (98.3%, n = 114). However, a few students (9.5%, n = 11) felt that the audio-visual aids and handouts could be improved to better aid their learning process. CONCLUSION This teaching boot camp for medical students was the first of its kind in Singapore and feedback from medical students showed that it was well-received. Further research using different teaching methods, including small-group discussions and surgical practical sessions by resident educators from different specialties, would be of great value to students.
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Affiliation(s)
- Daniel Sw Ting
- Singapore National Eye Centre, Singapore Health Services (SingHealth), Singapore
| | - Jill Cs Lee
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore Health Services (SingHealth), Singapore
| | - Benny Kg Loo
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore Health Services (SingHealth), Singapore
| | - Katherine Baisa
- Graduate Medical Education Office, Singapore Health Services (SingHealth), Singapore
| | - Wen Hsin Koo
- SingHealth Education Office, Singapore Health Services (SingHealth), Singapore
| | - Sandy Cook
- Office of Education, Duke-NUS Medical School, Singapore Health Services (SingHealth), Singapore
| | - Boon Leng Lim
- Graduate Medical Education Office, Singapore Health Services (SingHealth), Singapore.,Department of Anesthesiology, Singapore Health Services (SingHealth), Singapore
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Herrmann-Werner A, Gramer R, Erschens R, Nikendei C, Wosnik A, Griewatz J, Zipfel S, Junne F. Peer-assisted learning (PAL) in undergraduate medical education: An overview. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2017; 121:74-81. [PMID: 28545616 DOI: 10.1016/j.zefq.2017.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/29/2016] [Accepted: 01/14/2017] [Indexed: 11/26/2022]
Abstract
Peer-assisted learning (PAL) has a long tradition and is nowadays implemented in the curricula of most medical faculties. Besides traditional areas of application like problem-based learning, anatomy, or CPR, more and more departments and institutes have established PAL as part of their everyday teaching. This narrative review provides some background information and basic definitions of PAL. It offers an overview on features and determinants as well as underlying learning theories and developments in PAL. In addition, motives for implementation are highlighted followed by a comparison of advantages and disadvantages. After outlining aspects of quality management including the training of tutors and the evaluation and acceptance of PAL formats, this review concludes with an outlook on how PAL can proceed into the future and where further research is necessary.
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Affiliation(s)
- Anne Herrmann-Werner
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany; Medical Faculty Tuebingen, Interdisciplinary Training and Simulation Centre DocLab, Tuebingen, Germany.
| | - Regina Gramer
- Medical Faculty Tuebingen, Interdisciplinary Training and Simulation Centre DocLab, Tuebingen, Germany
| | - Rebecca Erschens
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany
| | - Christoph Nikendei
- University of Heidelberg, Department for General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - Annette Wosnik
- Medical Faculty Tuebingen, Dean's Office for student affairs, Tuebingen, Germany
| | - Jan Griewatz
- University of Tuebingen, Competence Centre for University Teaching in Medicine Baden-Wuerttemberg, Tuebingen, Germany
| | - Stephan Zipfel
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany; Medical Faculty Tuebingen, Dean's Office for student affairs, Tuebingen, Germany
| | - Florian Junne
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany
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Aripoli AM, Miller KA, Fishback SJ, Morgan RL. Engaging Senior Residents in Medical Student Education: A Resident's Perspective. J Am Coll Radiol 2017; 14:678-680. [PMID: 28185751 DOI: 10.1016/j.jacr.2016.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Allison M Aripoli
- Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas.
| | - Kirk A Miller
- Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Shelby J Fishback
- Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Rustain L Morgan
- Department of Radiology, University of Colorado's Anschutz Medical Campus, Denver, Colorado
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Ahn J, Jones D, Yarris LM, Fromme HB. A national needs assessment of emergency medicine resident-as-teacher curricula. Intern Emerg Med 2017; 12:75-80. [PMID: 27011214 DOI: 10.1007/s11739-016-1420-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
Both the Liaison Committee on Medical Education and the Accreditation Council of Graduate Medical Education require residents to be engaged in teaching to develop skills as educators. Although proposed guidelines for an emergency medicine (EM) resident-as-teachers (RAT) curriculum were published in 2006, little has been published regarding RAT curriculum implementation or outcomes since. A crucial first step in developing a formal RAT curriculum for EM educators to pilot, implement, and evaluate is an assessment of current needs and practices related to RAT curricula in EM residencies. The aim of this study was to conduct a needs assessment of EM residency programs regarding RAT curricular resources and practices. We invited all EM residency programs to participate in a web-based survey assessing their current RAT curricula and needs. 28 % responded to our needs assessment. Amongst responding programs, 60 % had a RAT curriculum. Of programs with a required medical student rotation, 59 % had a RAT curriculum. Of programs without a RAT program, 14 % had a program in development, and 18 % had a teaching resident program without a curriculum. Most RAT programs (72 %) were lecture-based and the majority (66 %) evaluated using survey data. 84 % of respondent programs demonstrated a desire for a national RAT curriculum. We find that despite national mandates, a large portion of programs do not have a RAT curriculum in place. There is wide variation in core content and curriculum evaluation techniques among available curricula. A majority of respondents report interest in a standardized web-based curriculum as one potential solution to this problem. Our results may help inform collaborative efforts to develop a national EM RAT curriculum.
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Affiliation(s)
- James Ahn
- Department of Medicine, Section of Emergency Medicine, University of Chicago Hospital Center, Chicago, USA.
| | - David Jones
- Department of Emergency Medicine, Oregon Health and Science University, Portland, USA
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Hosein Nejad H, Bagherabadi M, Sistani A, Dargahi H. Effectiveness of resident as teacher curriculum in preparing emergency medicine residents for their teaching role. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2017; 5:21-25. [PMID: 28124018 PMCID: PMC5238492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Over the past 30 years, recognizing the need and importance of training residents in teaching skills has resulted in several resident-as-teacher programs. The purpose of this study was to explore the impact of this teaching initiative and investigate the improvement in residents' teaching skills through evaluating their satisfaction and perceived effectiveness as well as assessing medical students' perception of the residents' teaching quality. METHODS This research is a quasi-experimental study with pre- and post-tests, continuing from Dec 2010 to May 2011 in Imam Hospital, Tehran University of Medical Sciences. In this survey, Emergency Medicine Residents (n=32) participated in an 8-hour workshop. The program evaluation was performed based on Kirkpatrick's model by evaluation of residents in two aspects: self-assessment and evaluation by interns who were trained by these residents. Content validity of the questionnaires was judged by experts and reliability was carried out by test re-test. The questionnaires were completed before and after the intervention. Paired sample t-test was applied to analyze the effect of RAT curriculum and workshop on the improvement of residents' teaching skills based on their self-evaluation and Mann-Whitney U test was used to identify significant differences between the two evaluator groups before and after the workshop. RESULTS The results indicated that residents' attitude towards their teaching ability was improved significantly after participating in the workshop (p<0.001). The result of residents' evaluation by interns showed no significant difference before and after the workshop (p=0.07). CONCLUSION On the whole, the educational workshop for Residents as Teacher for emergency medicine residents resulted in favorable outcomes in the second evaluated level of Kirkpatrick's model, i.e. it showed measurable positive changes in the self-assessments of medical residents about different aspects of teaching ability and performance. However, implementing training sessions for resident physicians, although effective in improving their confidence and self-assessment of their teaching skills, seems to cause no positive change in the third evaluated level of Kirkpatrick's model, i.e. the residents' behaviors, and it does not seem to raise students' satisfaction or meet their expectations.
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Affiliation(s)
- Hooman Hosein Nejad
- Department of Emergency Medicine, School of Medicine,Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Bagherabadi
- Department of Emergency Medicine, School of Medicine,Tehran University of Medical Sciences, Tehran, Iran; Department of Emergency Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sistani
- Department of Emergency Medicine, School of Medicine,Tehran University of Medical Sciences, Tehran, Iran; Department of Emergency Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Helen Dargahi
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Sheu L, O'Sullivan PS, Aagaard EM, Tad-Y D, Harrell HE, Kogan JR, Nixon J, Hollander H, Hauer KE. How Residents Develop Trust in Interns: A Multi-Institutional Mixed-Methods Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:1406-1415. [PMID: 26983076 DOI: 10.1097/acm.0000000000001164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Although residents trust interns to provide patient care, little is known about how trust forms. METHOD Using a multi-institutional mixed-methods study design, the authors interviewed (March-September 2014) internal medicine (IM) residents in their second or third postgraduate year at a single institution to address how they develop trust in interns. Transcript analysis using grounded theory yielded a model for resident trust. Authors tested (January-March 2015) the model with residents from five IM programs using a two-section quantitative survey (38 items; 31 rated 0 = not at all to 100 = very much; 7 rated 0 = strongly disagree to 100 = strongly agree) to identify influences on how residents form trust. RESULTS Qualitative analysis of 29 interviews yielded 14 themes within five previously identified factors of trust (resident, intern, relationship, task, and context). Of 478 residents, 376 (78.7%) completed the survey. Factor analysis yielded 11 factors that influence trust. Respondents rated interns' characteristics (reliability, competence, and propensity to make errors) highest when indicating importance to trust (respective means 86.3 [standard deviation = 9.7], 76.4 [12.9], and 75.8 [20.0]). They also rated contextual factors highly as influencing trust (access to an electronic medical record, duty hours, and patient characteristics; respective means 79.8 [15.3], 73.1 [14.4], and 71.9 [20.0]). CONCLUSIONS Residents form trust based on primarily intern- and context-specific factors. Residents appear to consider trust in a way that prioritizes interns' execution of essential patient care tasks safely within the complexities and constraints of the hospital environment.
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Affiliation(s)
- Leslie Sheu
- L. Sheu is chief resident in internal medicine, University of California, San Francisco School of Medicine, San Francisco, California.P.S. O'Sullivan is professor of medicine, University of California, San Francisco School of Medicine, San Francisco, California.E.M. Aagaard is professor of medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.D. Tad-y is assistant professor of medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.H.E. Harrell is professor of medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida.J.R. Kogan is associate professor of medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.J. Nixon is professor of medicine and pediatrics, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.H. Hollander is professor of medicine, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California.K.E. Hauer is professor of medicine, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California
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Ramani S, Mann K, Taylor D, Thampy H. Residents as teachers: Near peer learning in clinical work settings: AMEE Guide No. 106. MEDICAL TEACHER 2016; 38:642-55. [PMID: 27071739 DOI: 10.3109/0142159x.2016.1147540] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This AMEE Guide provides a framework to guide medical educators engaged in the design and implementation of "Resident as Teacher" programs. The suggested approaches are based on established models of program development: the Program Logic model to guide program design, the Dundee three-circle model to inform a systematic approach to planning educational content and the Kirkpatrick pyramid, which forms the backbone of program evaluation. The Guide provides an overview of Resident as Teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own program based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents, but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and program evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programs, encouragement of evidence-based approach to education and rewards for all levels of teachers.
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Affiliation(s)
- Subha Ramani
- a Department of Medicine , Brigham and Women's Hospital , Harvard Medical School, Boston , MA , USA
| | - Karen Mann
- b Division of Medical Education, Faculty of Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
| | - David Taylor
- c School of Medicine , University of Liverpool , Liverpool , UK
| | - Harish Thampy
- d Manchester Medical School, University of Manchester , Manchester , UK
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Dannaway J, Ng H, Schoo A. Literature review of teaching skills programs for junior medical officers. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2016; 7:25-31. [PMID: 26826798 PMCID: PMC4733566 DOI: 10.5116/ijme.5685.14da] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 12/31/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this review was to assess the current evidence regarding the efficacy of teaching skills programs for junior medical officers. We aimed to compare and contrast these results with findings from previous literature reviews, the last of which were published in 2009. METHODS In order to capture studies since the last published literature reviews, five databases and grey literature were searched for publications from January 2008 to January 2015. A search for literature reviews without using the timeframe limitation was also performed. RESULTS The search from January 2008 to January 2015 resulted in the inclusion of 12 studies. Five systematic reviews of the topic were found which included 39 individual studies that were also analysed. Nearly all studies reported positive effects. Twenty nine studies reported change in attitudes, 28 reported modification in knowledge, 28 reported change in behaviour, 6 reported change in the organisation and two reported change in program participant's students. There were substantial threats of bias present. CONCLUSIONS The literature reviewed demonstrated many positive effects of teaching skills programs, which supports their utilization. However, high level outcomes need to be evaluated over longer periods of time to establish their true impact. An organisation specific approach to these programs needs to occur using sound course design principles, and they need to be reported in evaluation trials that are designed with robust methodology.
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Affiliation(s)
- Jasan Dannaway
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
| | - Heryanto Ng
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
| | - Adrian Schoo
- Flinders University, School of Medicine, Sturt Road, Bedford Park, Adelaide, South Australia, Australia
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Sherbino J, Joshi N, Lin M. JGME-ALiEM Hot Topics in Medical Education Online Journal Club: An Analysis of a Virtual Discussion About Resident Teachers. J Grad Med Educ 2015; 7:437-44. [PMID: 26457152 PMCID: PMC4597957 DOI: 10.4300/jgme-d-15-00071.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In health professionals' education, senior learners play a key role in the teaching of junior colleagues. OBJECTIVE We describe an online discussion about residents as teachers to highlight the topic and the online journal club medium. METHODS In January 2015, the Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated an open-access, online, weeklong journal club on the JGME article "What Makes a Great Resident Teacher? A Multicenter Survey of Medical Students Attending an Internal Medicine Conference." Social media platforms used to promote asynchronous discussions included a blog, a video discussion via Google Hangouts on Air, and Twitter. We performed a thematic analysis of the discussion. Web analytics were captured as a measure of impact. RESULTS The blog post garnered 1324 page views from 372 cities in 42 countries. Twitter was used to endorse discussion points, while blog comments provided opinions or responded to an issue. The discussion focused on why resident feedback was devalued by medical students. Proposed explanations included feedback not being labeled as such, the process of giving delivery, the source of feedback, discrepancies with self-assessment, and threats to medical student self-image. The blog post resulted in a crowd-sourced repository of resident teacher resources. CONCLUSIONS An online journal club provides a novel discussion forum across multiple social media platforms to engage authors, content experts, and the education community. Crowd-sourced analysis of the resident teacher role suggests that resident feedback to medical students is important, and barriers to student acceptance of feedback can be overcome.
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Affiliation(s)
- Jonathan Sherbino
- Corresponding author: Jonathan Sherbino, MD, MEd, Hamilton General Hospital, McMaster Clinic, 237 Barton Street E, Hamilton L8L 2X2, Canada, 905.527.4322, ext 73542, fax 905.527.8457,
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Talmon GA, Czarnecki DK, Sayles HR. Does how much a resident teaches impact performance? A comparison of preclinical teaching hours to pathology residents' in-service examination scores. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2015; 6:331-335. [PMID: 25945073 PMCID: PMC4408938 DOI: 10.2147/amep.s73127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND While others have studied the effects of resident teaching on medical student performance, few have examined the benefits to the resident educator. Our study compared the quantity of pathology residents' didactic teaching with their performance on in-service examinations. METHODS The academic records of anatomic/clinical pathology residents over 10 years were reviewed. Scores on step I of the United States Medical Licensing Examination (USMLE(®)), the annual percentile on the in-service examination, and preclinical teaching hours for each resident were obtained. RESULTS Average annual teaching hours showed a weak positive correlation with mean in-service examination performance. Those below the 50th percentile had a lower number of teaching hours (average 7.8) than above the 50th percentile (mean 10.4, P=0.01). The incremental positive association between the two metrics increased by year in training and was strongest among senior residents, even controlling for USMLE performance (P<0.01). CONCLUSION There is an association between the amount of pathology residents' preclinical educational activity and their mean performance on in-service examinations.
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Affiliation(s)
- Geoffrey A Talmon
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Donna K Czarnecki
- Educational Support Office, University of Nebraska Medical Center, Omaha, NE, USA
| | - Harlan R Sayles
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
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Rivera V, Yukawa M, Aronson L, Widera E. Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors. J Am Geriatr Soc 2015; 62:2377-82. [PMID: 25516033 DOI: 10.1111/jgs.13187] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The entire healthcare workforce needs to be educated to better care for older adults. The purpose of this study was to determine whether fellows are being trained to teach, to assess the attitudes of fellowship directors toward training fellows to be teachers, and to understand how to facilitate this type of training for fellows. A nine-question survey adapted from a 2001 survey issued to residency program directors inquiring about residents-as-teachers curricula was developed and administered. The survey was issued electronically and sent out three times over a 6-week period. Of 144 ACGME-accredited geriatric fellowship directors from geriatric, internal medicine, and family medicine departments who were e-mailed the survey, 101 (70%) responded; 75% had an academic affiliation, 15% had a community affiliation, and 10% did not report. Academic and community programs required their fellows to teach, but just 55% of academic and 29% of community programs offered teaching skills instruction as part of their fellowship curriculum; 67% of academic programs and 79% of community programs felt that their fellows would benefit from more teaching skill instruction. Program directors listed fellow (39%) and faculty (46%) time constraints as obstacles to creation and implementation of a teaching curriculum. The majority of fellowship directors believe that it is important for geriatric fellows to become competent educators, but only approximately half of programs currently provide formal instruction in teaching skills. A reproducible, accessible curriculum on teaching to teach that includes a rigorous evaluation component should be created for geriatrics fellowship programs.
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Affiliation(s)
- Veronica Rivera
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York
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Ince-Cushman D, Rudkin T, Rosenberg E. Supervised near-peer clinical teaching in the ambulatory clinic: an exploratory study of family medicine residents' perspectives. PERSPECTIVES ON MEDICAL EDUCATION 2015; 4:8-13. [PMID: 25601040 PMCID: PMC4348229 DOI: 10.1007/s40037-015-0158-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Near-peer teaching is used extensively in hospital-based rotations but its use in ambulatory care is less well studied. The objective of this study was to verify the benefits of near-peer teaching found in other contexts and to explore the benefits and challenges of near-peer clinical supervision unique to primary care. A qualitative descriptive design using semi-structured interviews was chosen to accomplish this. A faculty preceptor supervised senior family medicine residents as they supervised a junior resident. We then elicited residents' perceptions of the experience. The study took place at a family medicine teaching unit in Canada. Six first-year and three second-year family medicine residents participated. Both junior and senior residents agreed that near-peer clinical supervision should be an option during family medicine residency training. The senior resident was perceived to benefit the most. Near-peer teaching was found to promote self-reflection and confidence in the supervising resident. Residents felt that observation by a faculty preceptor was required. In conclusion, the benefits of near-peer teaching previously described in hospital settings can be extended to ambulatory care training programmes. However, the perceived need for direct observation in a primary care context may make it more challenging to implement.
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Affiliation(s)
- Daniel Ince-Cushman
- Department of Family Medicine, McGill University, 5700, chemin de la Côte-des-Neiges, H3T 2A8 Montréal, QC Canada
| | - Teresa Rudkin
- Department of Family Medicine, McGill University, 5700, chemin de la Côte-des-Neiges, H3T 2A8 Montréal, QC Canada
| | - Ellen Rosenberg
- Department of Family Medicine, McGill University, St. Mary’s Hospital, 3830 Lacombe Avenue, H3T 1M5 Montréal, QC Canada
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de Villiers MR, Cilliers FJ, Coetzee F, Herman N, van Heusden M, von Pressentin KB. Equipping family physician trainees as teachers: a qualitative evaluation of a twelve-week module on teaching and learning. BMC MEDICAL EDUCATION 2014; 14:228. [PMID: 25335697 PMCID: PMC4287426 DOI: 10.1186/1472-6920-14-228] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/13/2014] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master's programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years. METHODS A qualitative study was undertaken, interviewing thirteen graduates of the programme. Thematic analysis of data was done by a team comprising tutors and graduates of the programme and an independent researcher. Ethical clearance was obtained. RESULTS The module influenced knowledge, skills and attitudes of respondents. Perceptions and evidence of changes in behaviour, changes in practice beyond the individual respondent and benefits to students and patients were apparent. Factors underlying these changes included the role of context and the role of personal factors. Contextual factors included clinical workload and opportunity pressure i.e., the pressure and responsibility to undertake teaching. Personal factors comprised self-confidence, modified attitudes and perceptions towards the roles of a family physician and towards learning and teaching, in addition to the acquisition of knowledge and skills in teaching and learning. The interaction between opportunity pressure and self-confidence influenced the application of what was learned about teaching. CONCLUSIONS A module on teaching and learning influenced graduates' perceptions of, and self-reported behaviour relating to, teaching as practicing family physicians. This has important implications for educating family physicians in and for Africa and indirectly on expanding capacity to educate health care professionals in Africa.
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Affiliation(s)
- Marietjie R de Villiers
- />Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Francois J Cilliers
- />Education Development Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- />Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Francois Coetzee
- />Ukwanda Rural Clinical School, Stellenbosch University, Stellenbosch, South Africa
| | - Nicoline Herman
- />Centre for Teaching and Learning, Stellenbosch University, Stellenbosch, South Africa
| | - Martie van Heusden
- />Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Klaus B von Pressentin
- />Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Sánchez-Mendiola M, Torruco-García U. The teaching role of residents: Time to come out of the closet? Rev Clin Esp 2014; 214:379-80. [DOI: 10.1016/j.rce.2014.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
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Quinn AM, Klepeis VE, Mandelker DL, Platt MY, Rao LKF, Riedlinger G, Baron JM, Brodsky V, Kim JY, Lane W, Lee RE, Levy BP, McClintock DS, Beckwith BA, Kuo FC, Gilbertson JR. The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics. J Pathol Inform 2014; 5:22. [PMID: 25191621 PMCID: PMC4141423 DOI: 10.4103/2153-3539.137717] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/13/2014] [Indexed: 12/05/2022] Open
Abstract
The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular “learning laboratories”. Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows’ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the pathology informatics asset in the network. Though the above approach has been in place less than a year, we are presenting it now as a technical note to allow for further discussion of evolving educational opportunities in pathology informatics and clinical informatics in general, and to highlight the importance of having a flexible fellowship with active participation from its fellows.
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Affiliation(s)
- Andrew M Quinn
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Veronica E Klepeis
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Diana L Mandelker
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Mia Y Platt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Luigi K F Rao
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gregory Riedlinger
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jason M Baron
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Victor Brodsky
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Ji Yeon Kim
- Regional Reference Laboratories, Southern California Permanente Medical Group, North Hollywood, CA 91605, USA
| | - William Lane
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Roy E Lee
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Main Campus, Cleveland, OH 44195, USA
| | - Bruce P Levy
- Department of Pathology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - David S McClintock
- Department of Pathology, The University of Chicago Medicine, Chicago, IL 60637, USA
| | - Bruce A Beckwith
- Department of Pathology, North Shore Medical Center, Salem, MA 01970, USA
| | - Frank C Kuo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - John R Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
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Tofil NM, Peterson DT, Harrington KF, Perrin BT, Hughes T, Zinkan JL, Youngblood AQ, Bartolucci A, White ML. A novel iterative-learner simulation model: fellows as teachers. J Grad Med Educ 2014; 6:127-32. [PMID: 24701323 PMCID: PMC3963769 DOI: 10.4300/jgme-d-13-00067.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/29/2013] [Accepted: 07/30/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Simulation is an effective method for teaching clinical skills but has not been widely adopted to educate trainees about how to teach. OBJECTIVE We evaluated a curriculum for pediatrics fellows by using high-fidelity simulation (mannequin with vital signs) to improve pedagogical skills. INTERVENTION The intervention included a lecture on adult learning and active-learning techniques, development of a case from the fellows' subspecialties, and teaching the case to residents and medical students. Teaching was observed by an educator using a standardized checklist. Learners evaluated fellows' teaching by using a structured evaluation tool; learner evaluations and the observer checklist formed the basis for written feedback. Changes in fellows' pedagogic knowledge, attitudes, and self-reported skills were analyzed by using Friedman and Wilcoxon rank-sum test at baseline, immediate postintervention, and 6-month follow-up. RESULTS Forty fellows participated. Fellows' self-ratings significantly improved from baseline to 6-month follow-up for development of learning objectives, effectively reinforcing performance, using teaching techniques to promote critical thinking, providing constructive feedback, and using case studies to teach general rules. Fellows significantly increased agreement with the statement "providing background and context is important" (4.12 to 4.44, P = .02). CONCLUSIONS Simulation was an effective means of educating fellows about teaching, with fellows' attitudes and self-rated confidence improving after participation but returning to baseline at the 6-month assessment. The simulation identified common weaknesses of fellows as teachers, including failure to provide objectives to learners, failure to provide a summary of key learning points, and lack of inclusion of all learners.
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Cobb T, Jeanmonod D, Jeanmonod R. The impact of working with medical students on resident productivity in the emergency department. West J Emerg Med 2014; 14:585-9. [PMID: 24381676 PMCID: PMC3876299 DOI: 10.5811/westjem.2012.12.12683] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 12/16/2012] [Accepted: 12/28/2012] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Academic emergency departments (ED) strive to balance educational needs of residents and medical students with service requirements that optimize patient care. No study to date has evaluated whether resident precepting of medical students affects residents' clinical productivity. Understanding the interplay of these variables may allow for ED staffing that maximizes productivity. We sought to determine whether the precepting of medical students impacts resident productivity. METHODS This study was performed at a tertiary care ED with a 70,000 annual patient census. We performed a computer-based (Verinet Systems, Alachua, Fl) retrospective review of patient encounters initiated by second- and third-year emergency medicine residents (PGY2 and PGY3) assigned to medical student precepting shifts and compared these shifts with those of the same residents when not working with students. Data collection over 12 months included shift length from the monthly schedule and number of patients and relative value units (RVUs) from the Verinet System. Patients seen per hour (pt/hr) and relative value unit per hour (RVUs/hr) were calculated. We compared parameters using two-tailed t-tests. The hospital's institutional review board approved this study. RESULTS Daily census was 202 on days without medical student rotators and 200 on days with student rotators (p=0.29). While precepting students, PGY3s saw 1.40 pt/hr versus 1.39 pt/hr without students (p=0.88) and PGY2s saw 1.28 pt/hr with students compared to 1.28 pt/hr without students (p=0.94). PGY3s generated 3.97 RVU/hr with students and 4.03 RVU/hr while working independently (p=0.68) and PGY2s generated 3.82 RVU/hr working with students versus 3.74 RVU/hr without (p=0.44). There were no productivity differences between resident precepting shifts and regular shifts. CONCLUSION In this study, resident productivity was not affected by precepting medical students.
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Affiliation(s)
- Travis Cobb
- St. Luke's University Hospital and Health Network, Bethlehem, Pennsylvania
| | - Donald Jeanmonod
- St. Luke's University Hospital and Health Network, Bethlehem, Pennsylvania
| | - Rebecca Jeanmonod
- St. Luke's University Hospital and Health Network, Bethlehem, Pennsylvania
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Naeger DM, Wilcox C, Phelps A, Ordovas KG, Webb EM. Residents Teaching Medical Students: How Do They Compare With Attending Educators? J Am Coll Radiol 2014; 11:63-7. [DOI: 10.1016/j.jacr.2013.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/29/2013] [Indexed: 11/26/2022]
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Hickie C, Nash L, Kelly B. The role of trainees as clinical teachers of medical students in psychiatry. Australas Psychiatry 2013; 21:583-6. [PMID: 23873897 DOI: 10.1177/1039856213496856] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To consider the role of specialty trainees as clinical teachers of medical students in psychiatry. METHOD We discuss the role of specialty trainees as teachers and approaches to improving their skills and capacity, giving examples from the local and international literature and our own experience as psychiatry medical educators. RESULTS Good clinical teaching is crucial for medical students' learning but sharp increases in numbers combined with economic and workforce pressures have stretched capacity. Specialty trainees do much of the medical student teaching during their clinical placements but infrequently receive instruction on how to teach. The two common approaches to increasing capacity are, first, establishing education rotations for individual trainees and, second, providing workshops to improve trainees' confidence and skill. Psychiatry trainees surveyed in New South Wales welcomed the role of teacher and the opportunity to improve their teaching capacity. Further support from supervisors, health services and medical schools is needed to assist trainees in their teaching role. CONCLUSION The role that trainees play as clinical teachers should be acknowledged and supported. Further development of research and scholarship in medical education is needed to determine how best to teach trainees to teach.
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Affiliation(s)
- Catherine Hickie
- Conjoint Senior Lecturer, University of Newcastle and Senior Staff Specialist, HNET Psychiatry, Hunter New England Local Health District, Newcastle, NSW, Australia
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Mileder LP. Are medical schools hesitant to teach undergraduate students teaching skills? A medical student's critical view. MEDICAL EDUCATION ONLINE 2013; 18:22997. [PMID: 24229730 PMCID: PMC3828563 DOI: 10.3402/meo.v18i0.22997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 10/16/2013] [Indexed: 06/02/2023]
Abstract
Junior medical staff provides a large proportion of undergraduate student education. However, despite increasing numbers of resident-as-teacher training programs, junior doctors may still not be sufficiently prepared to teach medical students. Hence, medical schools should consider implementing formal teaching skills training into undergraduate curricula.
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Snydman L, Chandler D, Rencic J, Sung YC. Peer observation and feedback of resident teaching. CLINICAL TEACHER 2013; 10:9-14. [PMID: 23294737 DOI: 10.1111/j.1743-498x.2012.00591.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Resident doctors (residents) play a significant role in the education of medical students. Morning work rounds provide an optimal venue to assess resident teaching. The purpose of this study was to assess the feasibility of peer observation of resident work rounds, to evaluate resident perceptions of peer observation and to evaluate resident perceptions of peer feedback. METHODS Twenty-four internal medicine residents were simultaneously observed by an attending physician and a peer while teaching during work rounds (between August2008 and May 2009). At year-end, residents received a survey to characterise their attitudes towards peer observation and feedback. RESULTS Twenty-one residents (87.5%) completed the survey. Half (52.4%) felt that participating in the peer observation study stimulated their interest in teaching during work rounds. Prior to participation in the study, fewer than half (42.9%) felt comfortable being observed by their peers, compared with 71.4 percent after participation (p=0.02). The proportion of residents who felt comfortable giving feedback to peers increased from 26.3 to 65.0percent (p=0.004), and the proportion of residents who felt comfortable receiving feedback from peers increased from 76.2 to 95.2 percent (p=0.02). DISCUSSION Peer observation and feedback of resident teaching during work rounds is feasible and rewarding for the residents involved. Comfort with regards to being observed by peers, with receiving feedback from peers and with giving feedback to peers significantly increased after the study. Most residents reported changes in their teaching behaviour resulting from feedback. Residents felt that observing a peer teach on work rounds was one of the most useful activities to improve their own teaching on work rounds.
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Affiliation(s)
- Laura Snydman
- Department of Internal Medicine, Tufts Medical Center, Boston, Massachusetts 02111, USA.
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Butani L, Paterniti DA, Tancredi DJ, Li STT. Attributes of residents as teachers and role models - a mixed methods study of stakeholders. MEDICAL TEACHER 2013; 35:e1052-e1059. [PMID: 23137246 DOI: 10.3109/0142159x.2012.733457] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Residents are at the forefront of student education in the hospital, yet valid tools to assess their performance as teachers are lacking. AIMS To develop a valid evaluation tool for assessing resident performance as educators for clerkship students. METHOD A mixed-methods design was used. Focus groups of residents and medical students explored desired behaviors in resident educators. Using grounded theory, a list of behaviors was generated inductively through iterative review and categorized into themes. After thematic saturation, behaviors were rated on a Likert scale by stakeholders based on "importance" and "accuracy of measurement." Items which were both important and accurate were used in the final tool. RESULTS Eighty-five desirable behaviors for resident educators were identified and consolidated into a 14-item tool. Twenty met both "importance" and "accuracy" criteria and fell under themes of respect, safe environment, balancing supervision with autonomy, relevant teaching and feedback. Nineteen "important" behaviors deemed not accurately measurable fell under themes of professionalism, communication, management skills and leadership. CONCLUSIONS Evaluation of residents as teachers and development of resident-as-teacher curricula should emphasize aforementioned areas. Professionalism and organizational skills may not be measurable reliably by learners. Complementary tools to assess these aspects of resident performance are necessary.
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Affiliation(s)
- Lavjay Butani
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA95817, USA.
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Haghani F, Eghbali B, Memarzadeh M. Effects of "Teaching Method Workshop" on general surgery residents' teaching skills. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2012; 1:38. [PMID: 23555141 PMCID: PMC3577416 DOI: 10.4103/2277-9531.104808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Residents have an important role as teachers and need to know about teaching, teaching methods and skills. In developed countries, "resident-as-teacher" programs have been implemented progressively; but there is little information about this theme in developing countries such as Iran. This study aimed to determine effects of "teaching method" workshop on surgical residents' teaching skills in Isfahan University of Medical Sciences. MATERIALS AND METHODS In this quasi-experimental study, 18 residents in 1(st), 2(nd), and 3(rd) years of surgical residency in Isfahan University of Medical Sciences have attended in a 10-hour workshop. Two questionnaires (validity and reliability) was verified: Clinical teaching self-assessment and clinical teaching evaluation was completed before and after the intervention ("teaching method" workshop) by attending residents and rater interns, respectively. Paired-samples T-test was used to analyze collecting data. RESULTS After intervention, Self-assessment mean scores were increased in two categories: feedback from 3.34 to 3.94 (P = 0.011) and promoting self- directed learning from 3.53 to 4.02 (P = 0.009); whereas, there was no significant differences in evaluation mean scores. CONCLUSION Statistical results from self-assessment and evaluation scores show little improvement in residents' teaching skills after the intervention, but residents assessed the workshop as useful. Lack of motivation in interns and little reward for residents who attend in educational activities could be responsible for these results. So, to promote role of residents' as teachers, we offer revision in residency curriculum and residents' formal duties as well as designing educational programs in teaching theme based on our needs and resources.
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Affiliation(s)
- Fariba Haghani
- Medical Education Research Center, Department of Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Batool Eghbali
- Medical Education Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mehrdad Memarzadeh
- Department of Pediatrics Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Berger JS, Daneshpayeh N, Sherman M, Gaba N, Keller J, Perel L, Blatt B, Greenberg L. Anesthesiology Residents-as-Teachers Program: A Pilot Study. J Grad Med Educ 2012; 4:525-8. [PMID: 24294434 PMCID: PMC3546586 DOI: 10.4300/jgme-d-11-00300.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 03/21/2012] [Accepted: 04/01/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The role of residents as teachers has grown over time. Programs have been established within various specialties to formally develop these skills. Anesthesiology residents are frequently asked to provide supervision for novice learners and have numerous opportunities for teaching skills and clinical decision making. Yet, there are no educational programs described in the literature to train anesthesiology residents to teach novice learners. OBJECTIVE To explore whether a resident-as-teacher program would increase anesthesiology residents' self-reported teaching skills. METHODS An 8-session interactive Anesthesiology Residents-as-Teachers (ART) Program was developed to emphasize 6 key teaching skills. During a 2-year period, 14 anesthesiology residents attended the ART program. The primary outcome measure was resident self-assessment of their teaching skills across 14 teaching domains, before and 6 months after the ART program. Residents also evaluated the workshops for quality with a 9-item, postworkshop survey. Paired t testing was used for analysis. RESULTS Resident self-assessment led to a mean increase in teaching skills of 1.04 in a 5-point Likert scale (P < .001). Residents reported the greatest improvement in writing/using teaching objectives (+1.29, P < .001), teaching at the bedside (+1.57, P = .002), and leading case discussions (+1.64, P = .001). Residents rated the workshops 4.2 out of 5 (3.9-4.7). CONCLUSIONS Residents rated their teaching skills as significantly improved in 13 of 14 teaching domains after participation in the ART program. The educational program required few resources and was rated highly by residents.
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Carr J, Deal AM, Dehmer J, Amos KD, Farrell TM, Meyer AA, Meyers MO. Who teaches basic procedural skills: Student experience versus faculty opinion. J Surg Res 2012; 177:196-200. [DOI: 10.1016/j.jss.2012.05.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 05/09/2012] [Accepted: 05/30/2012] [Indexed: 10/28/2022]
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Pien LC, Taylor CA, Traboulsi E, Nielsen CA. A Pilot Study of a "Resident Educator And Life-long Learner" Program: Using a Faculty Train-the-Trainer Program. J Grad Med Educ 2011; 3:332-6. [PMID: 22942958 PMCID: PMC3179234 DOI: 10.4300/jgme-03-03-33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 09/21/2010] [Accepted: 03/08/2011] [Indexed: 11/06/2022] Open
Abstract
PURPOSE We sought to create a resident educator program using a Train-the-Trainer (TTT) approach with adaptable curricula at a large tertiary health care center with a medical school and 60 accredited residency programs. METHODS The Resident Educator And Life-long Learner (REALL) Program was designed as a 3-phase model. Phase 1 included centralized planning and development that led to the design of 7 teaching modules and evaluation tools for TTT and resident sessions. Phase 2 entailed the dissemination of the TTT modules (Learning Styles, Observational Skills, Giving Feedback, Communication Skills: The Angry Patient, Case-Based Teaching, Clinical Reasoning, Effective Presentations) to faculty trainers. In phase 3, specific modules were chosen and customized by the faculty trainers, and implemented for their residents. Evaluations from residents and faculty were collected throughout this process. RESULTS A total of 45 faculty trainers representing 27 residency programs participated in the TTT program, and 97% of trainers were confident in their ability to implement sessions for their residents. A total of 20 trainers from 11 residency programs implemented 33 modules to train 479 residents, and 97% of residents believed they would be able to apply the skills learned. Residents' comments revealed appreciation of discussion of their roles as teachers. CONCLUSION Use of an internal TTT program can be a strategy for dissemination of resident educator and life-long learner curricula in a large academic tertiary care center. The TTT model may be useful to other large academic centers.
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