Educator Essential Series: Building the Foundation
Welcome to the first session of the Educator Essential Series, a monthly resource designed to enhance the educational skills of our faculty as they work with medical students and residents on our teaching service. In this inaugural session, we'll focus on laying the groundwork for an optimal learning environment through effective team-building, educational planning, and strategic management of clinical care and teaching responsibilities.
Step 1: Create a Safe and Inclusive Environment
Welcome Email
Set the tone with a welcoming email that outlines your expectations and establishes a collaborative, inclusive atmosphere. Customize the standard DHM template to reflect your personal style and preferences. You can find a link to my general template here.
Orientation
Start each block with a brief "time-out" orientation, allowing participants to get acquainted and feel comfortable in the learning environment.
Ice Breaker
Kick things off with a fun, engaging ice breaker activity to help team members connect and build rapport.
Step 2: Develop a Comprehensive Educational Blueprint
Targeted Pearls
Infuse your teaching with clinically relevant pearls delivered in real-time, ensuring the content is timely and impactful.
Journal Club
Implement a "rapid-fire" journal club, where each resident is assigned a weekly presentation to encourage active engagement with the latest medical literature.
Student Presentations
Assign each student a 5minute presentation, providing them with an opportunity to showcase their knowledge and develop their teaching skills. A brief guide can be found here.
Step 3: Strategic Planning for Effective Balance of Clinical Care
and Time-Efficient
Teaching
1 Respect Time
Use tools like silent alarms and calendar reminders to ensure your rounds and teaching sessions stay on track, respecting the time allocated for clinical care and educational activities.
Afternoon Check-in
Schedule a defined time each afternoon, around 2 pm, to review the patient list with your residents, fostering efficient communication and teamwork.
2 Allocate Presentation Time
3
Dedicate specific periods for medical student and resident presentations, ensuring a balanced schedule that allows for both learning and patient care.
Foundational Teaching Tips
Approachable
Establish an approachable, non-intimidating presence that encourages open communication and collaboration.
Lead by Example
Demonstrate excellent bedside manner and clinical skills, serving as a role model for your students and residents.
Respectful
Insist on respect for all team members, fostering a culture of professionalism and mutual support.
Enthusiasm
Bring enthusiasm and passion to your teaching, inspiring your learners and igniting their curiosity.
Foundational Teaching Tips
Thought Process
Share your clinical reasoning and decision-making process out loud, allowing learners to understand your approach.
Independent Thinking
Encourage independent decision-making, providing guidance and coaching to support your learners' growth.
Resident Leadership
Empower your residents to lead the team, while offering support and direction to foster their development as future educators.
Bringing it All Together
1
Safe Environment
Establish a welcoming, inclusive atmosphere that encourages active participation and risk-taking.
2
Comprehensive Blueprint
Develop a well-structured educational plan that balances clinical care and targeted teaching activities.
3
Effective Management
Strategize for efficient time management, ensuring a harmonious blend of patient care and teaching responsibilities.
Educator Essentials: Core Teaching Skills for Medical Educators (Installment
2)
This installment focuses on core teaching skills essential for medical educators. It covers key areas such as effective preparation, targeted questioning techniques, the importance of wait time, expert insights and quality and safety integration. These strategies aim to enhance the learning experience for medical students, residents, and healthcare trainees, ultimately improving patient care through better education.
by Eric Barna
The Power of Preparation in Medical Education
Preparation is the cornerstone of effective medical education. As an educator, thoroughly reviewing new admissions and identifying relevant teaching points sets the stage for productive learning sessions.
Creating a visual map is an invaluable tool in organizing your teaching rounds. This map should outline what will be discussed during rounds, potential assignments for team members, and opportunities to incorporate technology.
1
Review New Admissions
Carefully examine patient cases to identify key learning points and clinical pearls.
2
Create Visual Map
Outline discussion topics, assignments, and technology integration opportunities.
3 Implement Plan
Execute your prepared strategy during rounds, ensuring comprehensive coverage of topics and assign "look ups" when appropriate.
Targeted Questioning Techniques for Different Learner Levels
Recall (MS3)
"What are the key diagnostic criteria for TTP?"
Analysis (Interns)
"Why do you think the shortness of breath relates to heart failure?"
Tests foundational knowledge
Recent USMLE
Knowledge
Reinforces key concepts
Encourages critical thinking
Applies knowledge to clinical scenarios
Develops diagnostic reasoning
Application (Residents)
"Describe a multimodal approach to this patient's pain"
Integrates complex knowledge
Challenges advanced learners
Prepares for independent practice
Self Assessment (All Members)
"Can we debrief on our patient who went to the ICU overnight?"
Allows for high level review
Encourages open communication
Ensures that clinical debriefs are a part of learning
The Art of Waiting: Maximizing Learning Through Patience.
Wait 5 Seconds !
Silence is powerful
Allowing a brief pause after posing a question creates a supportive environment that encourages active participation and deeper thinking.
Active learning
The waiting period demonstrates respect for learners' cognitive processes and provides valuable insights into knowledge gaps.
Targeted Teaching
The waiting technique allows educators to adapt their teaching to address areas of uncertainty and enhance the overall learning experience.
Wait 5 Seconds
The rule of thumb is to wait until if feels just a bit awkward and then wait a little more.
Expert Insights: Dr. Michael Herscher's Guiding Principles
Dr. Michael Herscher, one of or beloved educators and winner of multiple teaching awards, emphasizes four key principles that form the foundation of his teaching philosophy. These guiding principles not only shape his approach to education but also reflect the core values of medical practice:
1 Bedrock of Medicine
Dr. Herscher stresses the importance of a thorough history and physical examination as the foundation of good medical practice.
3 Lifelong Learning
Recognizing the dynamic nature of medicine, Dr. Herscher emphasizes the importance of continuous learning and the power of acknowledging when one doesn't know something.
2 Evidence-Based Practice
He advocates for always having a reason for medical decisions, supported by evidence. This approach promotes critical thinking and ensures that medical interventions are justified and beneficial.
4 Compassionate Care
The golden rule of treating patients as one would want to be treated is central to Dr. Herscher's philosophy, highlighting the human aspect of medicine.
Practical Implementation of Dr. Herscher's Educational Principles
Dr. Herscher's approach to medical education goes beyond theoretical principles; he actively implements strategies to enhance the learning experience for his students and residents. By incorporating these practices into daily routines, he creates a rich, engaging educational environment that fosters continuous learning and professional growth.
Daily Learning
Bring educational material to rounds daily, keeping content fresh and relevant.
Evening Recap
Send follow-up emails with supplemental information to reinforce learning.
Chalk Talks
Conduct short and targeted lectures when time allows for in-depth exploration of topics.
Integrating Quality and Safety into Medical Education (ECG Analysis)
Incorporating quality and safety practices into medical education is crucial for developing well-rounded healthcare professionals. One effective strategy is implementing a "time out" for ECG analysis during rounds. This practice serves multiple purposes: it reinforces the importance of basic ECG interpretation skills, enhances the quality of patient care, and instills a culture of safety and thorough assessment.
Additional Support and Resources for Medical Educators
Recognizing that medical education is a complex and challenging field, additional support is available to help educators refine their skills and overcome obstacles. If you would like further development of any skillset please reach out to Eric Barna via email at Eric.Barna@Mountsinai.org
Personalized Coaching
45-minute sessions tailored to individual educator needs, focusing on specific areas for improvement or skill development.
Expert Guidance
Access to experienced mentors who can provide targeted advice, innovative teaching strategies, and solutions to common challenges in medical education.
Educator Essentials (Installment 3): Bedside Rounding and Teaching
This guide focuses on optimizing bedside rounding and teaching for medical educators. It covers the benefits of bedside rounds, strategies for improvement, and key teaching skills. Expert insights on addiction medicine education are also provided as part of featured experts corner.
by Eric Barna
The Magic of Bedside Rounding
Skill Development
Real-time physical exam and communication skill enhancement.
Patient-Centered Care
Improves patient care quality. Shifts medical culture towards a patient-centered model.
Team Building
Builds team mentality and strengthens overall performance. Provides opportunities for role modeling.
Direct Observation/Feedback
Provides trainees with real-time, actionable insights that enhance clinical skills and decision-making,
Optimizing the Bedside Rounding Experience
1 Set Expectations
Establish bedside rounds as a routine practice.
2 Review Logistics
Discuss timing, presentation format, and focus on highyield physical exam findings.
3 Pre-Encounter "Time Out"
Identify sensitive topics that may be better suited for a private conversation later in the day.
4 Introductions
Take a moment for team members to introduce themselves and their roles on the team
5
Practice is the Key to Success
Regularly practicing bedside rounds with your clinical team will lead to improved efficiency, smoother workflow, and more impactful interactions during rounds.
Key Teaching Skills at the Bedside
Streamlined H&P's
Model Exam Skills
Streamline patient presentations to focus on key details with minimal interruptions.
Demonstrate proper techniques with focused physical exams. Encourage trainees to participate.
Targeted Teaching
Identify 1-2 valuable teaching points related to the presented case.
Patient Centered
Patient engagement enhances the educational experience and fosters patient-centered communication.
Expert Corner: Addiction Medicine Education With Dr. Eric Kutscher
Partnership is Key
Understand the varied knowledge and experience around substance use both from the lens of patients and our trainees.
Precise Language
Differentiating between key terms such as intermittent use, at-risk use, and use disorders is essential for accurate diagnosis and effective management.
Harm Reduction
Take a few minutes to bring harm reduction supplies to the bedside to teach patients and trainees.
Stigmatization
Avoid using terms like “addict” and “substance abuse” which do not carry medical meaning, and can be perceived as stigmatizing.
Additional Support and Resources for Medical Educators
Recognizing that medical education is a complex and challenging field, additional support is available to help educators refine their skills and overcome obstacles. If you would like further development of any skillset please reach out to Eric Barna via email at Eric.Barna@Mountsinai.org
Personalized Coaching
45-minute sessions tailored to individual educator needs, focusing on specific areas for improvement or skill development.
Expert Guidance
Access to experienced mentors who can provide targeted advice, innovative teaching strategies, and solutions to common challenges in medical education.
Educator Essentials Installment 4
This installment of Educator Essentials explores three key areas for medical educators: strengthening your team, leveraging simple technology for optimizing teaching impact, and promoting safety and high-value care. It provides practical tips and strategies for enhancing the educational environment, engaging learners, and improving patient care.
by Eric Barna
Strengthening Your Team Unit
A strong educational environment starts with a strong team. To ensure a high-functioning team, it is important to strengthen the foundational elements.
Get To Know Your Trainees
Take the time to get to know your trainees. What is their life like outside of the hospital? What motivates them?
Check in on the The
Team Pulse
Routinely check in on the team's morale and energy. A day filled with unexpected emergencies and challenges may require a shift in expectations.
Set Goals and Celebrate
Set daily goals and celebrate successes regularly to keep the team motivated and engaged.
Provide Feedback
Routinely
Ensure that feedback is occurring at routine intervals to help trainees grow and develop.
Simple Technological Tools to Enhance Teaching Impact
Audience Polling Tools
Fill them with clinical questions in board review style- this will allow you to gauge knowledge gaps and have the teams actively pause and engage their devices
Web Based Infographics
Build an archive of high quality illustrative graphic that can easily be sourced from the web to target complex topics with improved visual impact
Team Email Threads
Initiating a back end team thread and encouraging all participants to share articles, guidelines related to active cases is a great way to engage all learners
YouTube Video Library
You will find an abundance of high impact, short video media to drive home clinical points (i.e. variceal bleed with an endoscopic view, 1 minute review of alcohol withdrawal physiology etc.)
Experts Corner: Educational Tips for Promoting Safety and High-Value Care With Dr. Vinh
Nguyen
1 Use a Safety Checklist
At the end of each presentation, ask residents and medical students to briefly review the indications for lines, tubes, and drains, daily lab work, and DVT prophylaxis. This takes just 30 seconds but significantly reinforces the importance of safe, high-value care.
2 Identify Waste
Teach trainees to be more intentional in their work by reviewing orders together during rounds. Highlight unnecessary lab tests, emphasizing both their financial costs and the potential risks from unnecessary procedures or misleading findings.
3 Incorporate Evidence-Based Medicine
Share relevant articles and literature that support a safety culture and high-value care. Encourage the team to review key studies, like the TRICC trial on transfusion goals, to show how our practices are grounded in evidence.
4 Review the Escalation Pathway
Trainees may not always recognize when a clinical situation needs the attention of a supervising attending. Clearly outline the specific scenarios when they should notify you, and review the escalation pathway with them in real-time.
5
Model Good Safety Practices
Trainees learn from observing attendings. Demonstrate best practices, such as washing your hands before and after patient interactions and using closed-loop communication, to reinforce these important behaviors.
Celebrating Our Outstanding MSH Educators: Exceptional Trainee Feedback from the Last Quarter!
"Goes above and beyond as an educator and finds ways to always teach throughout the day."
"I appreciate the time taken to actively discuss educational topics at relevant and appropriate times during rounds, while still being mindful of our timing and workflow."
"Fostered a welcoming environment, allowed residents to take the lead, and was always there for support."
"An incredible model for professionalism and cultural competency. One day, I hope to model the same behaviors I observed during our two weeks together."
"A great teacher who had amazing tips on physical exams and provided a very systematic approach to differential diagnosis buckets, always sharing new trials and research with the team."
"An exceptional attending who, amidst a sick list and with inexperienced interns, facilitated an excellent working and learning environment by setting clear expectations, maintaining open lines of communication, and empowering the team."
"The perfect balance of academic knowledge, care, and compassion for both patients and team members."
"Provided the right balance of supervision and independence for me to learn and grow as a resident."
"Created a comfortable, collegial, and professional atmosphere where I felt confident asking questions and expanding my medical knowledge."
