Presentation on theme: "Resident Educator Development"— Presentation transcript:
1Resident Educator Development The RED ProgramA Residents-as-Teachers CurriculumDeveloped by Heather A. Thompson, MD
2The RED Program Team Leadership How to Teach at the Bedside The Microskills Model: Teaching during Oral PresentationsHow to Teach EBMThe Ten Minute TalkEffective FeedbackProfessionalism
3Resident Educator Development (RED) Program Effective FeedbackResident Educator Development (RED) Program
4Take a moment and think of a time when you received USEFUL feedback Take a moment and think of a time when you received USEFUL feedback. What made it useful?Then take a moment and think of a time when you received UNHELPFUL feedback. Why was it not helpful?Have the residents jot down ideas on a piece of paper.
5Real Life Examples“I felt that the feedback was a little too ‘nice’. That is, it did not pinpoint and specifically target any of my weaknesses. Don't be afraid to be a little more blunt about weaknesses”.From our electronic evaluation system, “E*Value”.
6Real Life Examples“I received my evaluation at the end of the rotation and was shocked to find that I was rated as “below average” in medical knowledge, physical exam skills and on presentation. I have a problem with this.1) I had no idea that my performance was anything but satisfactory. I was never told that there was a problem. When I asked, I was told I was doing fine.2) Nobody EVER watched me perform a physical – how could I be rated on this?3) how am I supposed to change what I’m doing now that the rotation is over – what’s the point of telling me now?4) I don’t even know what I did that makes me below average.”Another E*Value example.
7ObjectivesDiscuss the important elements in the process of giving effective feedback, including the INSIGHT modelList the elements of the Pendleton RulesReview the “ORIME” methodPractice giving feedback using videotapeObjectives for our session.
8Real LifeE*value: In general, students rate our residents highly in terms of overall teaching skillsHowever, lower scores are consistently noted in the area of feedback; similar trends noted for attending physiciansStudents and interns will often ask you “How am I doing?”People need more than “Fine”Another way to point out that our feedback skills need improvement.
9Effective evaluation and feedback Set it up correctly (you can’t evaluate what you don’t observe)Watch and evaluateDebrief (INSIGHT, ORIME, Pendleton process)On a clinical rotation, we are doing #1 and #2 every day. It’s #3 that often gets overlooked and forgotten.
10HOW to give effective feedback Comfortable for all involved (consider timing, location)Elicit opinion of the person receiving the feedbackEstablish joint goals and boundariesNot too much feedback (2-3 suggestions at most)Relate to specific behaviors, not the person“When you come in late, it disrupts the flow of patient care” NOT“You’re always late. You’re lazy.”
11HOW to give effective feedback Make observations, not assumptionsGive reactions, not judgmentsUse specific examplesOffer suggestions for improvement; be constructiveUSE A SET ORDER OF DISCUSSION
12“INSIGHT” Approach Inquiry Needs Specific feedback Interchange Goals HelpTiming of follow-up session
13INQUIRY How does the learner think things are going? Listen to the learner’s needs in detail.Listening attentively and thoroughly before commenting may be all you need to do, especially for minor/temporary problems.?
14NEEDS What does the learner feel s/he needs during this rotation? Ask the learner to define own learning needs.Learners accept feedback better when they feel the teacher has first understood their perspectives.
15SPECIFIC FEEDBACKGive your constructive feedback as specifically as you can.Start with specific, positive feedback.Learner-centered is better.Feedback “sandwich”: Positive/Negative/PositiveVerify the learner’s understanding of the feedback you’ve given.
16INTERCHANGEHow can you best balance the learner’s needs with the team’s needs?You may need to “think outside the box” to reach a “win-win solution”.
17GOALSState any new goals you’ve just reached, or review existing goals.Verify that you both understand and agree on these goals.
18HELP Do any serious problems merit a “learning consultation”? Chief residentsAttending physicianProgram DirectorsClerkship DirectorsLearning specialistEmployee assistance programOthers
19TIMING OF FOLLOW-UP SESSION Any final questions or comments?When would you and the learner like to meet again to go over how things are going?
20Pendleton’s Rules 1. Subject gives positive aspects 2. Observer gives positive aspects3. Subject gives areas for improvement4. Observer gives areas for improvement“Positive/Positive, Negative/Negative”This is a simple, set order of discussion that works very well, allows for a productive discussion to occur, and lessens the stress surrounding verbal face to face feedback.
21Why Pendleton’s Rules Work 1. Subject speaks first gives the person being evaluated a feeling of control2. Positive comments first lessens anxiety3. Subject often identifies exact same issues!4. Conversely—if subject has no insight, outside help might be in order
22ORIME O: Observer (passive) R: Reporter (data gathering) I: Interpreter (differential diagnosis)M: Manager (formulates a treatment plan)E: Educator (reads up on a topic, teaches the team)Summarize where they are at, what it takes to get to the next levelAn alternative is to relate to the learner where they are at on this scale, and what it takes to get to the next level. ORIME is very intuitive and works for students, residents, even attendings!!
23Video Clip Watch the video: choose 1. The Rambling Med Student. This student gives a poorly organized oral presentation to the attending.2. The Intern Interview. This intern takes a history from the patient with a less than caring bedside manner.3. The Renegade Intern. This intern intubates a patient on call without discussing the case first with his supervising resident.After this exercise, open it up for discussion—how did it go? Which did they prefer, INSIGHT, Pendleton’s rules, or ORIME?
24Video Clip Split into pairs. One will play the role of the senior resident, one the role of the medical student or intern.Practice giving feedback: what would you say to this person to help improve the situation?Try using ORIME, or Pendleton’s Rules.After this exercise, open it up for discussion—how did it go? Which did they prefer, INSIGHT, Pendleton’s rules, or ORIME?
25ObjectivesDiscuss the important elements in the process of giving effective feedback (INSIGHT)List the elements of the Pendleton RulesReview the ORIME methodPractice giving feedbackSummarize by relating back to the objectives, and you’re done.