Teaching for Teachers

Hina J. Shah, MD

Resident in Nuclear Medicine

Massachusetts General Hospital/Brigham and Women's Hospital 

PGY 8

11/13/2020 

Hina J. Shah, M.D. 

This was the first time I participated in the Centre of expertise course. This was a virtual session. It gave an amazing opportunity to meet so many co-trainees/colleagues from different specialty which is rare even though we are such a huge academic setting. I am a physician but that allows me to play multiple roles one of which is that of teacher. It was interesting to see that people face similar challenges as a teacher.

One must be innovative in these challenging times of virtual teaching where ‘teacher’ and ‘students’ are not always seeing each other. It is important to know about the various tools which are available to do this and make the teaching more effective. This course helped me to understand various methods which one can use to make teaching more effective and interactive. I have already employed some of these methods and I think it is helping me make my teaching more engaged.

I want to continue my career as a physician-teacher as I think at the end of the day what we all want is to know that we are making a positive difference to someone. And what way then a teacher to make that difference.

Having such courses help you meet people from different fields with similar challenges and one can come up with innovative solution to the problems. I think it would be great if these courses are incorporated in the curriculum, at least 1 to 2 lectures; this way one would know what interests them and the available opportunities. And the later courses could be optional and that way everyone who enters this institute knows what work COE does and how they use it for one’s maximum teaching.

I incorporated some of the tips from the course like quick audience feedback and it was wonderful to know areas of your strength and where you can improvise.

I am hoping to find a job soon in an academic setting where I can continue being a teacher-physician and utilize all the treasurable tips I got from this course.

This clinical teaching skills course by COE was an enlightening and a happy experience!

Pocket Talks: A hidden gem in time-limited teaching.

Kathleen Weiss, MD

Resident in Cardiothoracic Surgery

Brigham and Women's Hospital 

PGY 3

11/12/2020 

Kathleen Weiss, M.D. 

The COE CTS course was fantastic. The lectures highlighted important concepts in educational theory, and integrated those principles with day-to-day practical elements in teaching and learning. The presentation on situated cognition and constructivism was particularly relevant and incredibly useful; it underscored in my mind how little instruction we receive during our training on how to teach (as opposed to what to teach). The solidarity in discussing obstacles to teaching and learning stood out as a highlight of the program, and there was some consolation in the collective recognition that time (or lack thereof!) is a pervasive barrier to teaching and learning in the clinical realm. We discussed strategies for mitigating this challenge, with one being a suggestion for having “pocket talks” prepared in advance, i.e., brief, pre-planned lessons on important topics that you know will be relevant to your anticipated learning cohort. I have since prepared several of these “pocket talks” to have on hand to use when the opportunity arises. I practiced one with a med student and it was a tremendous success! This small victory encourages me to put this strategy into practice and capitalize on seemingly small opportunities to teach during brief (2-5 minute) chances to do so. There is a lot that can be learned from even a small amount of time! Preparing and executing my “pocket talk” also gave me newfound confidence in my own teaching potential, and cultivated a mindset of making this a regular part of my professional/academic endeavors moving forward.

Changing How I Learn

Kristina Thurin, MD

Fellow in Behavioral Neurology & Neuropsychiatry 

Brigham and Women's Hospital 

PGY 6

11/11/2020 

Kristina Thurin, M.D. 

The Clinical Teaching Course gave me the opportunity to closely examine the factors that improve how I learn from others as well as how I teach. The presentations outlining the cognitive science of teaching and learning resonated with me given my interest in neuropsychiatry. The course made me realize that most of my education has been based in a model that is not necessarily in line with how we learn, retain, and recall information. I will definitely be modifying how I study and how I teach moving forward.

The strong focus on examining our experience of giving and getting feedback was also exceptionally valuable, especially hearing other trainees’ experiences. These sessions have motivated me to put more thought into both seeking and giving directed feedback while still in training and moving forward in my career.

 

COE Course on Medical Education Implores Us to Think Harder About Our Learners.

Michael Stephen Kelly, MD

Resident in Internal Medicine and Pediatrics

Massachusetts General Hospital 

PGY 3

11/11/2020

Michael Stephen Kelly, M.D. 

As a trainee, so much of the job is to devote your time and energy to learn as much as we can. In caring for patients, we seek to grow from the guidance of our attendings, seek to better understand our patients and emulate our professional role models. So naturally, when trainees go to teach—whether it be our peers, medical students, or our patients—we seek to transfer that knowledge. This is the pitfall that trainees-as-teachers often fall into, focusing on the knowledge to be transferred and not on the recipient of that knowledge. The COE course on medical education was hugely helpful in giving me not only the learner perspective, but also evidence based practices that I could use to make sure I was teaching in a way that was effective for my learner. We need trainees to have more access to experiences like this.

 I can remember countless times when others have tried to teach me in the middle of a procedure, quizzing me about anatomy or complications. I remember in those moments wanting to focus on my attending, but also wanting to devote my focus to the task at hand, to do right by my patient. The COE course showed me that I wasn’t the only one, that trainees have a very hard time switching tasks from procedures to learning and back again—splitting their attention. I will certainly use the new strategies I learned during this course to change my practice away from interrupting the learner, to choosing moments for formative feedback at a time when the learner can focus on that learning.

 This course gave great opportunities to practice and hone or teaching skills, which is great to have low stakes time to workshop teaching. But, it also provided evidence for teaching techniques and theories. This is huge. We rarely have the opportunity as trainees to think in this way about teaching, often simply teaching in a way we feel like teachers we have liked did it. We must go further than this, seeking to teach in a way that is truly effective. This course helped push me along that path.

COE Helps us fight imposter syndrome in ourselves and future trainees.

Emily Jane Kivlehan, MD

Fellow in Pediatric Rehabilitation Medicine

Spaulding Rehabilitation Hospital 

PGY 5

11/13/2020

Emily Jane Kivlehan, M.D. 

Imposter syndrome is the sense of self-doubt and fear of being discovered as an intellectual fraud despite objective professional success¹. Initially found in groups of professional women, it has more recently been discovered to have a high prevalence throughout medical trainees^2,3.  In my personal experience, imposter syndrome “flares” especially in a new setting. Recently joining Harvard Medical School as a PGY-5 fellow in pediatric rehabilitation medicine, there have been new colleagues to meet, hospital cultures to adjust to and the ever-present struggle of finding the bathroom in a new building. Because of my passion for medical education, I signed up for the Center of Expertise Clinical Teaching Skills Course (and as above, of course thought maybe I wouldn’t be accepted and might be out of place if accepted). Upon a workshop session of reviewing the barriers trainees face to teaching, I noted “I don’t know enough” was common.

Trainees are sandwiched between engrossing ourselves in the learning environment to work toward our own autonomous practice and being responsible for adding to the medical education of trainees and medical students. As such, it may not be shocking that we wonder how we can teach others when we are not yet the experts. However, in our own word cloud, the most common listed qualities to describe our best teacher included “engaging,” “approachable,” “feedback,” “learning,” “supportive,” “patient” and “knowledgeable”. Despite our own self-doubts, the knowledge of our own teacher only listed ones out of the top 7 qualities.

I hope recognizing that we are not alone in our doubts – even those of us dedicated to signing up for an extra course on education – will be a first step toward fighting this component of imposter syndrome. Other tangible ways our group considered to combat this are to pick “bite-size” topics that we have prepared. This allows for flow into the busy workday and helps us build our own confidence by repeating certain topics. As we learn more, we can prepare more of these small topics. Second, if learners ask questions we do not immediately have an answer to, we can normalize the fact that we don’t all know it all quite yet. Beyond teaching clinical items, this helps us teach that we are not expected to know everything, hopefully fighting halting the development of imposter syndrome for those learners in the future!

1.         Clance PI, S. The imposter phenomenon in high achieving women: dynamics and therapeutic intervention. Psychotherapy: Theory, Research, and Practice. 1978;15(3):241-247.

2.         Legassie J, Zibrowski EM, Goldszmidt MA. Measuring resident well-being: impostorism and burnout syndrome in residency. J Gen Intern Med. 2008;23(7):1090-1094.

3.         Brown DW, Binney G, Gauthier Z, Blume ED. Fears and Stressors of Trainees Starting Fellowship in Pediatric Cardiology. Pediatr Cardiol. 2020;41(4):677-682.

 

Benefits of Clinical Teach Skills Course

Ryan M. Militana, DO

Fellow in Obstetric Anesthesiology 

Massachusetts General Hospital 

PGY 5

11/11/2020

Ryan M. Militana, DO

The partners Center of Excellence Clinical Teaching Skills Course was an invaluable experience as a healthcare provider at my level of training. The transition from resident to fellow is an experience that combines both clinical and supervisor roles that can be a challenge to balance at times. This course has offered a window into the various types of learning and how to optimize teaching in a variety of settings to help my own learning as well as teaching residents. The course also provided an opportunity learn more about the structure and support systems that the partners organization offers its members. The course allowed me to witness the presentation and learning styles of my colleagues as well as interact with individuals from other areas of medicine outside of my day to day interactions. I found the course to be incredibly valuable and I trust I will be utilizing its teachings as a I move forward in my own career.

 

Learning to Teach and Teaching to Learn.

Yun-Han (Hannah) Huang, MD. 

Resident in Internal Medicine

Brigham and Women's Hospital 

PGY 1

11/13/2020 

Yun-Han (Hannah) Huang, MD

In May, as medical schools in NYC prepared to restart clinical rotations amidst the COVID-19 pandemic, I was recruited to help organize a course on COVID-19. Newly graduated, I found it an exciting but challenging experience—one that increased my appreciation of the dedicated medical educators with whom I worked. Motivated to learn more, I applied to the COE Clinical Teaching Skills Course this fall.

 The most surprising part of the course, however, was that the concepts that we learned were applicable beyond clinical teaching. We learned, for example, about a 70/30 rule of information transfer. The concept is that experts, when explaining a procedure, only transmit 30% of the information necessary to replicate that procedure. Only 30%! Imagine the variety of scenarios where this could apply beyond clinical teaching:

-          Clinical and scientific presentations

-          Interactions with patients

-          Hand-offs between clinical team members

 Returning to my next clinical rotation, I found that this framework changed the way I asked and answered questions. After all, 30% information transfer means that the remaining 70% needs to be solicited. This concept (and others presented in the course) improved my interactions with colleagues and patients, and it made me not only a better teacher but also a better learner.