Resident as teacher: educating the educators

Abstract

Context and setting Residents teach students informally, by asking and answering questions, giving mini-lectures, and providing clinically relevant, on-time teaching, whereas attending doctors often have scheduled and more structured time with students as assigned preceptors or teaching attendings. Why the idea was necessary Due to the time demands and economic pressures of contemporary medical practice, talented and dedicated teaching faculty staff are becoming more difficult to find. Residents are often called upon to teach in their stead and, although they are eager to teach, the literature argues that residents need training in teaching skills if they are to be most effective. What was done We created a 1-month elective at our institution that offers senior residents the opportunity to learn about educational theory and practise teaching while free of the constraints imposed by the role of ward team leader. This elective focuses on additional skills (e.g. adult learning theory and feedback) not addressed in depth in the required Resident Teaching Development Programme (RTDP) offered to residents in all core clinical departments at our hospital.We piloted this elective with a chief resident (MAW) in the internal medicine and paediatrics residency, who served as a clinical preceptor for Year 3 medical students during the paediatric clerkship, reviewing student case presentations, discussing relevant topics and teaching physical diagnosis at the bedside. During the pilot, the teaching resident met bi-weekly with a faculty mentor to discuss required readings and debrief on individual teaching sessions. Each teaching encounter was also supervised by an experienced teacher who provided immediate feedback to the resident.Unlike teaching on the wards, where time is a constant pressure, as a clinical preceptor the resident has more time to focus on teaching the communication and physical examination skills needed to be an effective clinician (as the presentation of 1 patient may last as long as 90 minutes). Evaluation of results and impact The teaching resident felt that the experience was a useful way to consolidate and practise the teaching skills addressed during the RTDP. It also allowed the resident to focus on the most crucial teaching points and interesting aspects of a case rather than on the minutiae involved in managing an acutely ill patient.Student evaluations of the experience were positive. Both students and mentor commented that the teaching resident was a strong teacher and role model. One student noted that the resident Ô ... showed [them] just how big a role a [Year 3 student] can have on a team ... [the teaching resident] was a model for the type of resident I want to beÕ. Another student described the teaching resident as a strong teacher who was Ôvery thorough and detailedÕ. His faculty mentor described the resident as an Ôoutstanding preceptorÕ to whom the students Ôeagerly respondedÕ.As this elective is offered to more residents this year, we plan to assess the improvement in residents' teachin...

Quantification of bedside teaching by an academic hospitalist group

“…Many residencies have developed resident as educator programs in an attempt to create a future generation of attendings better able to teach. 13 Several limitations should be acknowledged when interpreting the results of this study. The study was limited to a hospitalist group at a single academic medical center and relied on resident recall.…”

“…The interrater reliability was 0.91. The average patient census on each team during this time period was 12 (range [6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Short-term outcomes and long-term impact of a programme in medical education for medical students

“…The challenges involved in the preparation of medical educators lie in identifying the critical content of such preparation and its appropriate location in the curriculum. Some residency programmes offer seminar‐type training in the 1‐minute preceptor model 8,9 and others offer short‐courses on concepts associated with good teaching 4,10–15 . Shorter courses provide an awareness of the challenges of teaching and exposure to specific tools that can be used to support instruction, but they do not allow for the level of conceptual integration and confidence‐building learners require to comprehensively apply these concepts 2 .…”

“…Some residency programmes offer seminar-type training in the 1-minute preceptor model 8,9 and others offer shortcourses on concepts associated with good teaching. 4,[10][11][12][13][14][15] Shorter courses provide an awareness of the challenges of teaching and exposure to specific tools that can be used to support instruction, but they do not allow for the level of conceptual integration and confidence-building learners require to comprehensively apply these concepts. 2 In a recent study, Smith et al 7 reported successful outcomes with a version of the 'Training Tomorrow's Teachers Today' programme.…”

A Novel Iterative-Learner Simulation Model: Fellows as Teachers

“…2 Common elements among resident-as-teacher programs include discussion of basic teaching principles, resident-led teaching sessions observed by instructors and followed by a thorough debriefing, and success assessment through participant surveys. [3][4][5][6][7][8] Inclusion of feedback strategies and leadership and communication skills help ensure a safe learning environment. 9 Objective,…”