Excellence in Clinical Teaching

Your Name Here

Your Organization

Objectives• Recognized characteristics of an excellent

clinical teacher

• Identified barriers and solutions to achieving teaching excellence at our organization

• Performed a self-assessment of our clinical teaching abilities

• Explored peer-review methods as a tool for improving our clinical teaching abilities

• Discussed important issues specific to this group

Take-Home Points

• Clinical teaching is unique and demanding

• We have experienced both excellent and poor clinical teaching- Embrace the good

• Learner reviews, self-assessments, and peer-reviews can improve our clinical teaching

• Fostering a culture of honest and specific feedback is the key to improvement

Clinical Teaching

•How is it different?

Settings

Time constraints

Learners levels

Topics unpredictable

Patient care

Excellent Clinical Teachers• Activity One

• Think back to your medical school or residency experience

• In groups, discuss the characteristics of your best clinical teacher

• Write responses on your white board

Excellent Clinical Teachers• Accessible to their residents

• Enthusiastic about teaching

• Knowledgeable, good clinical skills

• Well organized

• Respectful

• Communicate clearly

• Present goals logically

• Set goals and provide feedback

Ineffective Clinical Teachers• Activity Two

• Think back to your medical school or residency experience

• In pairs, discuss the characteristics of your worst clinical teacher

• Write responses on your white board

Ineffective Clinical Teachers• Negative attitude, intimidating

• Poor feedback skills

• Inaccessible

• Limited knowledge

• Fail to recognize extra effort

• Poor communication skills

• Fail to adhere to schedule

Subjective Assessments

• Assessment of clinical teaching abilities often subjective

• Does excellent clinical teaching “rating” really matter?

Proven Outcomes

• Prospective cohort study

• 502 third-year medical students

• Good, mediocre and poor faculty

• Significantly higher USMLE scores for students of good clinical teachers

• Subjective assessment of clinical teaching correlates to outcome

Griffith, Charles H., Georgesen, John C., Wilson, John F.: Six-Year documentation of the association between excellent clinical teaching and improved student examination performance. Academic Medicine. 75:62-64, 2000

Self-Assessment

• Activity Three

• Achieving excellence in clinical teaching begins with you

• Reflect on your experience as a clinical teacher

• Complete the Faculty Self-Assessment

Barriers to Excellence• Activity Four

• What are some barriers to individual and collective excellence in clinical teaching at our organization?

• Discuss this question your group and list barriers on your white board.

Potential Barriers

• Limited feedback from learners and peers

• Vague or unhelpful feedback

• Ego or self-misperception

• Organization culture

Solutions to Barriers• Activity Five

• Now that we know a little more about our own strengths and weakness, lets turn our attention to those barriers

• Discuss potential solutions with your group and write them on your white board

Peer-Reviews• Tool to provide

additional information

• Ask for specific and actionable feedback

• Use feedback constructively

• General overview or event related

Objective Analysis

• Reviewing a peer may be difficult outside of the “heat of the moment”

• Consider an OSCE-like evaluation of your clinical teaching

• Some studies have attempted to identify specific objective metrics but failed

• May be used as a mentorship tool

Example FMIT Checklist1 Clerkship goals and expectations reviewed No Yes

2 Rounds were begun and ended on time No Yes

3 Literature searches or topic discussions were assigned No Yes

4 Students’ history and physicals were reviewed No Yes

5 Students were treated as team members Never Sometimes Always

6 A broad knowledge of clinical issues was demonstrated Never Sometimes Always

7 Education and patient management were balanced Never Sometimes Always

8 Students were encouraged to formulate their own A and P Never Sometimes Always

9 Students were encouraged to ask questions Never Sometimes Always

10 Constructive feedback was provided Never Sometimes Always

11 Physical findings were reviewed and demonstrated Never Sometimes Always

12 Clinical decisions (i.e. selection of tests) were explained Never Sometimes Always

13 Clinical findings (i.e. X-rays) were reviewed and demonstrated

Never Sometimes Always

14 Professional and ethical behavior were modeled Never Sometimes Always

15 Effective interpersonal and communication skills were modeled

Never Sometime Always

Integration Task

• Peer-reviews included in your handout

• Similar to your self-assessment

• Give to two colleagues over the next week

• Consider the OSCE-like evaluation during your next clinical teaching experience

Help Line

• Many of you posed great questions for discussion on the faculty LRNA

• Let’s form a circle and discuss some of these questions as a group

Our Concerns

• How do I get better at clinical teaching?

• How do I make time for teaching?

• Can active learning be combined with the 5-minute preceptor effectively?

Take-Home Points

• Clinical teaching is unique and demanding

• We have experienced both excellent and poor clinical teaching- Embrace the good

• Learner reviews, self-assessments, and peer-reviews can improve our clinical teaching

• Fostering a culture of honest and specific feedback is the key to improvement

Questions