Transitioning into Your Role as a Medical Educator
YOUNG PHYSICIANS SECTION
Jennifer McGowan, MD FAAEM FAWM
W
e spend three to four years of residency learning to become outstanding, competent clinicians. We graduate as newly minted attending emergency physicians, ready to treat patients, lead healthcare teams, and teach the next generation. But when do we learn how to teach effectively? Most of us model the methods by which we learned but have no formal education in what makes an effective educator. There were certainly teaching opportunities in residency, but was there ever formal instruction in how to teach? I hope so, but for many (me included), it was a trial-and-error method of finding your own style. Although medical education fellowships and graduate programs for education are great, many physicians cannot devote the time or resources to do these. This article is designed to give you a few quick tips to help you reframe your perspective as an educator.
Teaching is not about you. It is not about your knowledge, your skills, or how good of a physician you are. It is about the learner and their growth. This seems obvious, but if you listen to many people teach their residents, students, or ED colleagues, you will hear many declarations of knowledge from the teacher and not much feedback from the learner. Often, those of us in a teaching role look at teaching as a way to impart our knowledge on the captive audience. Instead, we should reframe teaching as an exercise to help our learners connect concepts between their existing knowledge, challenge them to grow their own theories, and actively participate in their learning instead of allowing them to zone out, smiling and nodding politely as we drone on endlessly.
Asking learners questions can be a big part of your teaching. Seems easy, but we all could probably improve
on this technique too. When you ask a question, wait and listen for the response. On average, educators only wait 0.7 to 1.5 seconds for a response to a question before giving the answer. Imagine being a learner, trying to retrieve an answer—it will take longer than one second! Let them take longer. Let them struggle to remember—this internal struggle to retrieve the information buried in their brain is when the learning occurs. Waiting just three to five seconds will allow your learners to formulate an answer and make your teaching more engaging. For more complex questions, allowing 10 to 15 seconds may be appropriate. On a busy ED
shift, try asking your learners a complex question, then go see a patient. Give them time to think, or to look things up if needed. Remember point one, it is not about you explaining what you know, it is about helping them remember all the things they know!
Make giving frequent, intentional feedback your homework as an educator. Feedback should be specific and directed, with clear goals of actions to continue or improve upon. Do not comment on personality traits, rather focus on relevant competencies. If you are having trouble visualizing this, think back to the milestones utilized in residency: patient care, medical knowledge, interpersonal and communication skills, etc. If you are in a role in which you give a written evaluation at the end of a rotation, try to think about feedback on each shift. I like to keep an ongoing notes tab on my phone, making it easy to jot things down in real time that might be forgotten in a few weeks. However, you do not need to wait until the end of the month, rotation, or year to give your feedback—feedback is best given within a short interval. Debrief with your resident after a resuscitation to discuss what went well and what could improve. Discuss with your student how they could have structured their consult more clearly for their consultant after they hang up the phone. Take five minutes at the end of a shift to talk about one to two things your learners did great on, and one to two goals to
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There were certainly teaching opportunities in residency, but was there ever formal instruction in how to teach? 58
COMMON SENSE MARCH/APRIL 2024