TEACHING STRATEGIES Clinical Setting Office of Medical Education

Faculty Goals Students leave your clinical rotation with a reasonable expectation that they have the core knowledge, skills and attitudes of a clinician in your area of expertise.

Learning “A long lasting change in behavior” Instructor success  can be measured in the student’s ability to learn and retain the knowledge, skills, and attitudes.

Reasonable Goals and Objectives Focus on the needs of the student with particular attention to the skills that are needed in the student’s role. Know the goals and objectives of the clinical rotation.

Instructor Resources LCME standards ACGME /RRC standards Prepare yourself, good resources are of little value without good faculty.

Students Should Have the Opportunity to Come Prepared To be effective, the syllabus must be provided to the students in advance of the rotation.

Know the Characteristics of Students Target your learning to the appropriate audience.

Learning Environment You create the emotional climate through your interaction with students. Your nonverbal behavior teaches more about your expectations for a clinician than what you say. Set a positive can-do atmosphere. –Students will succeed on Shelf Exams, USMLEs, Boards

Faculty The single most important variable in optimizing the student’s educational experience. Challenge your students to critically think, to practice skills and integrate new knowledge into their clinical behavior. Give effective feedback.

Lifelong Learning Everyone learns throughout life. Teaching is a planned experience that facilitates learning. Engage your students to become independent lifetime learners.

Learning is Continuous Begin at the student’s level of knowledge and relate new learning to information the student has already mastered and information the student’s needs.

Learning Must Make Sense Learning is purposeful and must make sense to the learner. The ultimate purpose is to improve the health of Texans by educating physicians.

Learning Involves as Many Senses as Possible Learners remember: –10% of what is read –20% of what is heard –30% of what is seen –50% of what is heard and seen –80% of what is heard, seen and done

Learning Activities Must Be Appropriate for the Situation Major goal is the education of humane and highly skilled physicians. Students must see, hear and do skills. Cut the lecture time. Focus on application of an integrated scientific knowledge base to the practice of medicine.

Learning Must Be Stimulating You can successfully complete this rotation. You too can be a board certified physician. We will meet your needs and interests.

Learning Must Result in the Ability to Perform Do not focus on memorization. Reinforce new information with practice application. Repeated practice in simulated situations will reinforce learning.

Learning is Affected By Emotions Elicit positive emotions. –Accomplishment –Satisfaction Minimize unpleasant emotions. –Frustration –Boredom –Fatigue –Fear

Learning is Affected By the Physical and Social Environment Recognize the effects of social exchange and social environment on learning. Provide positive feedback in public.

Learning Objectives Determine what learners should know and what they should be able to do with the information. Know and share the objectives with the learners.

Learning Objectives Cognitive Objectives Tell what information the learner must know and describe the level of knowledge that must be demonstrated. Evaluated with tests, questions and answers, discussion, scenario practice.

Learning Objectives Psychomotor Objectives –Tell what physical skills the students must be able to perform. –Evaluated with demonstration of skill using skills checklist. –All should participate fully in practice sessions.

Learning Objectives Affective Objectives Indicate the feelings and attitudes the learner will develop or demonstrate.

Motivation of the Medical Student or Resident Intrinsic –Help me be a better physician. –May be more curious and want to learn more Extrinsic –Required for boards –Want to learn only what they need to know.

Past Experience Negative learning experiences in undergraduate and basic science years may cause some adults to feel threatened to be in the role of learner.

Past Experience Evaluation of performance may be challenging or stressful and the learner may need reassurance about the entire evaluation process.

Past Experience Adults often define themselves by past experiences and may have strong opinions related to their perceptions of the experience.

Past Experience A warm, non- threatening learning climate can help participants evaluate new ideas that conflict with old ideas more objectively.

Past Experience Faculty may need to help students overcome resistance to new ideas. Faculty need to be open to new ideas.

Comfort and Reinforcement If students have learned a particular skill or technique earlier in their education they may have difficulty changing behaviors… Encourage. Ensure Success. Be accepting. Treat all with dignity.

Faculty Skills Knowledge of the Subject Matter The foundation ofThe foundation of every great instructor is knowledge of the subject matter.

Facilitator of Learner Participation Give participants the opportunity to practice and MASTER the core knowledge and skills of your area of expertise. Encourage. Ensure success. If you detect limitations, document and provide additional assistance.

Serve as a Model Have exemplary knowledge and skills. Do not be careless. Teach to standards of care - if your personal beliefs are contrary to standards of care – encourage research.

Effective Feedback Provide careful and consistent and immediate feedback. Be positive. Observe student performance during skills and patient interactions.

What to AVOID

Inconsistent Faculty Performance and Inadequate Student Skill Performance

Unrealistic Expectations Inappropriate rigidity on the part of faculty. Do not expect students to be superhuman.

Overreaction to Grades No one tends to fail – or even get an average grade. Assess impact of grade inflation. Students overreact to getting a low A. Focus on learning not grades.

What to Do?

Stay Student Focused Fear imperfection Fear responsibility Fear anxiety and guilt Fear failure

Encourage Learning/ Motivate Learners Real life practice-based scenarios –apply knowledge to patients. Core knowledge TESTED Motivational context – the students are important. Faculty are to focus on the students and change them from passive observers to active learners.

Watch-then-Practice Introduce hands-on skills. Participants are to watch closely. Utilize simulation. Skills build on one another.

Practice-Based Learning Utilize Practice-Based Learning –Approximate the student’s anticipated role in actual situation. –Guide students through scenarios that simulate reality to increase confidence when confronted with an actual situation. –Critically observe and mentor.

Evaluate Skills Written Examinations Oral Presentations Involve the student in self evaluation

The END Resource: AHA:BLS ACLS Instructor Manuals 2000

Post Test print page, take exam, send to Dr. Sandra Oliver Which is true of adult learners? A. Adult learners need grades, gold stars, and other incentives as motivation to learn B. Adult learners should be involved in evaluation of their own work C. Faculty need to direct adult learners learning behavior D. Adult learners need structured curriculum organized in carefully sequenced subject matter.

Question 2 2.Learning is affected by which of the following: A.Learning Environment B.Feedback C.Motivation of the Student D.All of the above

Question 3 3. Choose the correct statement:Learners remember: A. 10% of what is heard and done B.20% of what is seen C.50% of what is heard D.80% of what is heard, seen and done

Question 4 4. The single most important variable in optimizing the student’s educational experience is the A. Course material B. Faculty C. Environment D. Student incentives

Question 5 5.The concept of life long learning includes all of the following EXCEPT: A. Students are passive learners B. Learning is student focused C. Students are challenged to think critically C.Lectures are replaced with applications to clinical setting