Teaching strategies used by internal medicine residents on the wards

Abstract

Background: Residents serve as teachers to interns and students in most internal medicine residency programs. Aim: The purpose of our study is to explore what internal medicine residents perceive as effective teaching strategies in the inpatient setting and to formulate a guideline for preparing residents to lead their ward teams. Methods: Housestaff identified as excellent teaching residents were recruited from a large internal medicine residency program. Focus groups were formed and interviews were conducted using open-ended questions. Transcripts of the interviews were reviewed, analyzed, and compared for accuracy by two investigators. The transcripts were then coded to categorize data into similar subjects from which recurrent themes in resident teaching were identified. Results: Twenty-two residents participated in four focus group interviews held in 2008. We identified five principal themes for effective teaching by residents: (T)aking advantage of teaching opportunities, (E)mpowering learners, (A)ssuming the role of leader, (C)reating a learning environment, and (H)abituating the practice of teaching. Conclusion: Strategies for effective teaching by residents exist. The TEACH mnemonic is a resident-identified method of instruction. Use of this tool could enable residency programs to create instructional curricula to prepare their residents and interns to take on the roles of team leaders and teachers.

How can the training of medical residents be improved? Three suggestions

“…The interview responses reflect the results of the latest research on Finnish physicians, which indicate dissatisfaction with supporting teaching skills during PGME (Sumanen et al, 2015). However, effective teaching during residency is important for the successful operation of an inpatient service with regard to patient care, staff training and resident well-being (Smith and Kohlwes, 2011). While the residents might be well prepared for their role as physician, they might not have any preparation for their teaching role.…”

Developing and Implementing a Systems-Based Residents as Teachers Initiative

“…Based on the title and abstract review, we fully reviewed 14 additional articles on RaT of which 13 were relevant (Butani et al, 2013;Donato and Harris, 2013;Donovan, 2011;Keller et al, 2012;Lachman, Christensen, and Pawlina, 2013;Lakshmanan et al, 2014;Patocka, Meyers, and Delaney, 2011;Peyre et al, 2011;Ricciotti et al, 2012;Smith and Kohlwes, 2011;Snydman et al, 2013;Wachtel, Greenberg et al, 2013;Yuan et al, 2014). Current trends in the literature are that 1) RaT programs vary in content and design, with mostly discipline-specific, one-off deliveries; 2) program evaluations are not conducted aside from some assessments of resident teaching; and 3) a learner-centered approach should be incorporated into program development and implementation (Jarvis-Selinger et al, 2011).…”

Reflections on talent development in the professions.

“…Medical residents and first-year software engineers are not taking explicitly defined courses on a discipline's foundational topics. Instead, their PD transpires within their work milieu (McGee, 2014;Smith & Kohlwes, 2011). To truly foster talent, gatekeepers and mentors must know and apply adult learning principles (Dunst & Trivette, 2012;Garet, Porter, Desimone, Birman, & Yoon, 2001).…”