Teaching in the Clinical Arena

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Teaching in the Clinical Arena

• Vincent Chiang, MD
• OFD Medical Education Workshop
• March 27, 2007

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Outline

• Educational assumptions
• Reality
• Theory
• Implication
• Practical

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Educational assumptions

• No one wants to be a bad teacher
• Most people are not taught how to teach
• You can be a great teacher

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Educational reality

• Teaching does not always go the way we would like
  it to

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Features of successful educational institutions

• High, clear and shared expectations
• High academic engaged time
• Tightly coupled curriculum
• Frequent, appropriate assessment and feedback
• Powerful teaching

Hersh, RH. Declining by Degrees Higher
Education at Risk. Palgrave Macmillan. 2005
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Educational compact

• An educational compact is the agreement between
  learner and teacher
• There are four elements of every compact

Pratt D, Magill MK. Educational contracts a
basis for effective clinical teaching. J Med
Educ. 198358462-7
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Four elements

• Needs information, confirmation, direct
  assistance
• Expectations many, often unstated
• Roles
• Teacher model, expert, facilitator
• Learner (in)dependent, participant, competitor
• Content - involvement

Pratt D, Magill MK. Educational contracts a
basis for effective clinical teaching. J Med
Educ. 198358462-7
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Educational compact

• In medicine, the educational compact is often
• not negotiated
• not spoken
• not recognized

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Blooms Taxonomy
Bloom BS. Taxonomy of Educational
Objectives. Allyn and Bacon. 1984
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Learning Hierarchy
What actually happens in daily practice
Increasing Complexity
Ability to demonstrate specific clinical skills
Ability to apply factual knowledge
Ability to cite factual knowledge
Miller GE. The assessment of clinical
skills/competencies/performance. Acad Med 1990
65S63-7.
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Assessment Hierarchy
Performance
Increasing Complexity
Competence
Cognition
Rethans J-J, Norcini, J,Baron-Maldonado M, et al.
The relationship between competence and
performance Implications for assessing practice
performance. Medical Education 2002 36901-9
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Training Hierarchy
GME, CME
Increasing Complexity
UME, GME
UME
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Implication

• There is no such thing as a bad clinical teacher.

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How to do it

• Empower
• Role model
• Know your audience
• Imagery

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Seven simple secrets for successful supervision

• WDYT
• Three Mississippi
• Family Feud
• Birthing class
• Avoid the Heisman
• BLT
• Vogue

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