CINECResidents as Educators
Narayana Medical College
Introduction
One of the primary goals of the postgraduate medical education is to impart teaching the specific clinical theory and appropriately recommended clinical skills training to undergraduate medical students. Clinical residents are a crucial part of this process and are expected to participate in medical student teaching in the preclinical and clinical years. During their clinical years, on most months, third- and fourth-year medical students will rotate on the designated outpatient department, clinical inpatient wards, operation theatres, ancillary units such as physiotherapy, family welfare, mobile ophthalmology unit, neonatal care unit etc.
However, typically minimal instruction on effective teaching is incorporated into educational programs. By making teaching a more intuitive process, ultimately resident education is enhanced, resulting in improved patient care. The resident is expected to treat students professionally and also provide teaching for them. Students should be allowed to follow patients and write notes. It is the resident’s responsibility to ensure that the medical student’s notes are co-signed. The senior resident should assign patients to the students. Residents are expected to take an active role in educating medical students rotating on service. Each resident will be provided with the undergraduate medical curriculum guidelines for the specific subject clinical posting. The resident should familiarize him/herself with these guidelines as he/she will play an essential role in the education of medical students during the clinical posting.
The physical exam is probably the hardest thing for residents to teach since most residents feel like they need to work on their physical diagnosis skills rather than engaging the students in teaching. Undergraduate students are generally knowledgeable about the theoretical part of clinical examination and are grateful for someone to observe their practical examination technique and to get feedback on it.
Residents should remember that even when they think they are not teaching, the student is watching them very closely and learning verbal and non-verbal behaviours. So the resident should be careful to model professional behaviour and explicitly tell the student what to observe about his/her behaviour.
The following curricula, created by the Narayana Medical College faculty and Medical Education Unit for Tomorrow health care Task Force, can be used for didactic presentations to enhance residents’ teaching skills. Each curriculum module includes a PowerPoint presentation, facilitator’s guide, and a quiz.
Aim of the course
To train the institutional residents with the necessary skills to become more effective teachers, thus improving resident and student education and ultimately patient care.
Intervention Program
Residents in the second year of their postgraduation course received a 15-hour mandatory training course. The course consists of 5 modules of 15 interactive sessions developed to instruct residents how to teach within the constraints of a busy workday. The content emphasizes applying teaching principles to everyday occurrences in an inpatient setting, such as oral presentations, working up a new patient, and performing physical examinations. These sessions have minimal didactic content and interactive discussions and role play.
Module 1: Teaching
Residents are required to teach medical students and other residents. This curriculum can be used to equip residents with the necessary skills to become effective teachers, improving resident and student education and, ultimately, patient care. Topics covered include adult learning theory, general teaching tips, common pitfalls, and teaching techniques.
Course content: Dr S P Rao
Lesson 1: 2.2.2021
- Define teaching versus learning
- Explain the basic tenets of adult learning theory
Lesson 2: Dr V Mahidhar Reddy 3.2.2021
- Examine how learning generally develops among students & residents
- Follow the BOPE development for the medical students(B=Bystander; O=Observer; P=Participant; E=Editor/ Synthesizer)
- Describe specific types of case-based teaching techniques
- Integration of clinical reasoning with imparting clinical examination skills
Lesson 3: Dr Lavanya 4.2.2021
- Standard clinical teaching methods and their merits and demerits
- Teaching Plan
- Probing techniques for supporting evidence
- Preparing teaching script as a teaching guide
- General Rules of teaching including Bloom’s Taxonomy of Learning Domains
Lesson 4: Dr Biju Ravindran 5.2.2021
- Bedside teaching manners and learning in hospital
- Medical Procedural teaching
- What is Professionalism
- Learning to be professional
Lesson 5 & 6: Dr V Mahidhar Reddy 6.2.2021 & 8.2.2021
- Teaching clinical reasoning skills (exhaustive method, hypothesis generation, pattern recognition and metacognition)
- Diagnostic reasoning and Working through a clinical problem-solving case
- Decision tree and doctoring clinical reasoning
- Strategies to practice with the learners
Module 2: Feedback
Giving (and receiving) feedback is an essential and continual part of teaching and learning. This curriculum covers the definition of feedback, characteristics of effective feedback, strategies for delivering effective feedback, and scenarios for active application of feedback strategies.
Course Content:
Lesson 7: Dr Sowjanya 9.2.2021
- Define feedback
- Discuss the importance of giving and receiving feedback
- Describe the characteristics of effective feedback
- Describe strategies for delivering feedback
Lesson 8: Dr SP Rao 10.2.2021
- Fostering Reflection and Providing Feedback
- Apply feedback strategies to scenarios
- Correcting mistakes and reinforcing correct procedures
Module 3: Social and Emotional Learning
Evidence about the impact of learning environments on the quality of learning continues to mount. Social and Emotional Learning (SEL) is a theory and associated methods aimed at improving the social and emotional components of learning environments. This curriculum exposes residents to SEL and introduces best practices for incorporating SEL into teaching in residency.
Course content: Dr Satish 11.2.2021
Lesson 9:
- Describe the 5 domains of SEL(self-management; self-awareness; relationship skills; social awareness and responsible decision making)
- Apply these domains to the everyday work of being a resident-teacher
- Assess the value of integrating SEL into teaching in a residency
- The heart and science of social & emotional learning
- Developing Socio-Emotional Intelligence in Higher Education
Lesson 10: Dr Sashikala 12.2.2021
- What is mentoring
- How to prepare to be a mentoring coach
- Mentoring opportunities
- How to encourage professional development
Module 4: Effective Presentations
Presenting at conferences and giving didactic lectures to colleagues, medical students, and others is an essential part of teaching in residency. This curriculum introduces methods for creating and delivering effective presentations.
Lesson 11:
- Describe some of the basics of effective presentations in didactics and conferences
- Describe the different dynamics involved in small versus large group teaching
- Describe techniques for effectively teaching a large group
- Describe techniques for effectively teaching a small group
Lesson 12: Dr Anand Reddy 15.2.2021
- Construct an effective presentation or outline thereof
- Appraise the work of peers and receive feedback
Module 5: Evaluation in Learning
Medical students, residents and faculty are evaluated in multiple ways throughout their careers. This curriculum briefly describes evaluation rationales and structures in medical education and how to effectively evaluate medical learners.
Lesson 13 & 14: 16 & 17 th Feb 2021
- Measurements in Assessment
- How to choose the best instrument and avoid measurement errors
- Measuring Skills and Attitude
- Explain the role of the NMC CBME competencies, milestones, and EPAs in evaluation in the education of future physicians
- Describe shared-mental models and how to define levels of performance
- Describe the value of comments and specificity
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Lesson 15: Dr Raghu 18.2.2021
- Assessment for student improvement
- Optimizing success for underperformers
- Evaluation of documents and case notes
- Assessment & Grading without bias
Lesson 16: Final Assessment of the course 22.2.2021
