Becoming a Resident Teacher Course: A Pritzker Innovation

1
Becoming a Resident Teacher Course A Pritzker
Innovation

• Krista M. Johnson MD
• Donald W. Scott MD
• James N. Woodruff MD
• Sandy Cook PhD
• David T. Rubin MD

2
Background- Needs Assessment

• Residents have a critical teaching role in
  current medical climate
• AAMC, ACGME, ABIM target resident teaching as a
  priority1
• Resident teaching enhances residents own
  learning and enthusiasm for teaching2

1 www.AAMC.org www.ACGME.org www.ABIM.org
accessed April 11, 2006 2Morrison E, Shapiro J,
Harthill M. Resident doctors understanding of
their roles as clinical teachers. Medical
Education 2005 39137-144.
3
Background- Needs Assessment

• A residents-as-teachers curriculum has been shown
  to significantly improve residents teaching
  skills1
• Most medical students enter residency with little
  experience or training in how to teach

1Morrison E, et al. The effect of a 13-hour
curriculum to improve residents teaching skills.
Ann Intern Med. 2004 141257-263.
4
Creation of New Course Becoming a Resident
Teacher (BART)

• Senior medical student elective since 2002
• 8 two-hour sessions in one month
• Goal
• Acquire teaching skills they will need to be
  effective resident teachers

5
Course Components

• Interactive teaching workshops with numerous
  faculty
• Supplemental reading materials
• Teaching portfolio assignment
• Observed Structured Teaching Exercise (OSTE)

6
BART Curriculum

• Introduction to Teaching and Role Modeling
• Teaching Portfolios
• Setting Goals
• Adult Learning Theory
• Feedback
• One-minute Preceptor Microskills of Teaching1
• Technology to Teach
• Promotion of Understanding and Retention
• OSTEs

1Neher JO, Gordon KC, Meyer B, Stevens N. A
five-step microskills model of clinical
teaching. J Am Board Fam Pract.19925419-424.
7
Observed Structured Teaching Exercise1 (OSTE)

• Used clinical teaching scenarios to teach using
  the one-minute preceptor (microskills)
• Each student played the role of teacher,
  standardized learner, and observer
• Allows practice and evaluation of teaching skills
• Direct observation
• Self-assessment
• Feedback
• Repeat

1 Morrison EH, Boker JR, Hollingshead J, Prislin
MD, Hitchcock MA, Litzelman DK. Reliability and
validity of an objective structured teaching
examination for generalist resident teachers.
Acad Med. 200277S29-32.
8
BART Course RatingsOverall, This Course was an
Outstanding Educational Experience
5-point scale with 5 strongly agree and 1
strongly disagree
9
Please rate the likelihood that
5-point scale with 5 definitely yes and 1
definitely not
10
Please rate the likelihood that
5-point scale with 5 definitely yes and 1
definitely not
11
Please Rate the Usefulness of the Class as a
Whole
5-point scale with 5 definitely yes and 1
definitely not
12
Please Rate the Usefulness of the Class as a
Whole
5-point scale with 5 definitely yes and 1
definitely not
13
Please rate your confidence before participating
in class (retro) and currently in
5-point scale used with 5 high confidence and
1 low confidence
14
Please rate your confidence before participating
in class (retro) and currently in
5-point scale used with 5 high confidence and
1 low confidence
15
Please rate your confidence before participating
in class (retro) and currently in
5-point scale used with 5 high confidence and
1 low confidence Increase in mean confidence
statistically significant in all domains using
the Wilcoxon Sign-Rank test
16
Improved confidence across all domains
17
Representative Written Comments

• The OSTE was great. Practice makes perfect. The
  general rules and facts taught here are necessary
  for adult, lifetime learners Many skills can be
  sporadically attained but to have it all written
  and structured for teaching ensures it is taught
  correctly. I will revisit the material taught
  from this class
• I believe the OSTE experience should be a
  requirement for all graduating MS IVs!
• The lectures were well selected. One of the most
  useful classes I took all year

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Key Lessons Learned

• The BART course is a unique curricular innovation
  that addresses the recognized need for residents
  as teachers
• Students report an increase in confidence in
  their clinical teaching skills across a variety
  of domains
• This well-received course offers students
  teaching skills for their future roles as
  outstanding educators

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Future Directions

• Continue the course 2007
• OSTEs
• Interactive modules
• Less theory
• Sharing our innovation
• Regionally
• Nationally
• Collaboration
• Research

20
Acknowledgements

• David Rubin, Jim Woodruff
• Don Scott
• Amy Szczudlak
• Sandy Cook, Andy Bowyer
• Instructors Diane Altkorn, Halina Brukner, Sandy
  Cook, Steven Davis, Kathlyn Fletcher, Eugene
  Geppert, Sarah Glavin, Stacy Gray, Julie Johnson,
  Sonia Kupfer, Alex Lickerman, David Liebovitz,
  Andelka Losavio, John McConville, Nuala Meyer,
  Michael Quinn, Jeff Teuteberg, Chad Whelan,
  Lawrence Wood
• Dezheng Huo
• Our STUDENTS!

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One-minute Preceptor (Microskills of Teaching)1

• 1. Get a commitment
• 2. Probe for supporting evidence
• 3. Teach the general rule
• 4. Reinforce what was done right
• 5. Correct mistakes

1Neher JO, Gordon KC, Meyer B, Stevens N. A
five-step microskills model of clinical
teaching. J Am Board Fam Pract.19925419-424.
22
Observed Structured Teaching Exercise (OSTE)


Students A1-4 Begin Here
Students B1-4 Begin Here
OSTE Station 1 Case A Students A1SL 1 A2SL
2 A3T A4O
OSTE Station 2 Case A Students B1SL 1 B2SL
2 B3T B4O

Start as the resident-teacher (30 Mins)
SL Standardized Learner O Observer T
Teacher
Students D1-4 Begin Here
Students C1-4 Begin Here
OSTE Station 3 Case B Students C1--T C2--O C3S
L 1 C4SL 2
OSTE Station 4 Case B Students D1--T D2--O D3SL
1 D4SL 2
Compliments of Don Scott, MD