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A Framework for Effective Clinical Teaching Skills. John (Jack) D. Buckley, MD, MPH Henry Ford Hospital April 9, 2005. GOALS. Review our Teaching Duty Introduce a validated Educational Framework designed to enhance effective teaching skills Framework Outline Seminars Personal Goal Setting

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a framework for effective clinical teaching skills

A Framework for Effective Clinical Teaching Skills

John (Jack) D. Buckley, MD, MPH

Henry Ford Hospital

April 9, 2005

goals
GOALS
  • Review our Teaching Duty
  • Introduce a validated Educational Framework designed to enhance effective teaching skills
    • Framework Outline
    • Seminars
    • Personal Goal Setting
  • Demonstration
are good teachers simply born
Are Good Teachers Simply Born?
  • Is it genetic and you either have it or you don’t?

OR

  • Can ineffective teachers become better?
  • Can you make a good teacher even more effective?
traditional teaching of clinical medicine
Traditional Teaching of Clinical Medicine
  • If you know the material, you can teach it.
  • See one, do one, teach one
  • I teach the same way as I was taught.
  • The ceiling effect
i m a good teacher the problem is they aren t very good learners

“I’m a good teacher. The problem is they aren’tvery good learners.”

-Anonymous faculty member

self pity and projected blame the recipe for a well lived life

“Self-pity and projected blame – the recipe for a well-lived life!”

-Parker, The Courage to Teach, 1998

train the trainer model
Train-the-Trainer Model

Stanford Faculty Development Center

Clinical Teaching

Program

Seminar Facilitators

Seminar Participants

(Faculty & Residents)

Learners

Institution

categories of effective teaching skills
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills1
Categories of Effective Teaching Skills
  • Learning Climate
    • The tone or atmosphere of the clinical teaching setting including whether it is stimulating and whether learners can comfortably identify and address their limitations.
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills2
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
    • The manner in which the teaching interaction is focused and paced as influenced by the teacher’s leadership style.
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills3
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
    • The establishment and explicit expression of a teacher’s and/or learner’s expectations for the learners.
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills4
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
    • This category describes approaches the teacher can use to:
      • Explain the content being taught
      • Have the learner meaningfully interact with that content, thus assisting the learner to understand and retain it.
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills5
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
    • The process by which the teacher assesses the learners’ knowledge, skills, and attitudes, based on criteria related to the educational goals.
  • Feedback
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills6
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
    • The process by which the teacher provides learners with information about their performance for the purpose of improving their performance.
  • Promoting Self-Directed Learning

Stanford Faculty Development Center

categories of effective teaching skills7
Categories of Effective Teaching Skills
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning
    • This form of learning is initiated by the individual learner’s needs, goals, and interests. This category deals with approaches the teacher can use to influence learner motivation and use of resources, thereby fostering self-directed learning.

Stanford Faculty Development Center

seminars the full package
Seminars: The Full Package
  • Eight sessions
    • One dedicated to each category
    • One for reviewing personal / institutional goal setting
    • Two-hours each
  • Components
    • Mini-lecture
    • Review and Analysis of video
    • Role Play
    • Goal Setting
seminar descriptions cont
Seminar Descriptions cont.
  • These seminars are NOT:
    • Rules
    • A proscriptive method for good teaching
  • They are intended to:
    • Increase your awareness of your own teaching skills.
    • Use the framework to analyze your teaching.
    • Use the framework to help identify options that may improve your teaching.
does this framework actually work
Does THIS framework actually work?
  • Clinical Teaching Program - 18 years old
  • 99 facilitators from over 60 academic medical centers.
  • Over 2000 participants
  • 76 peer-reviewed manuscripts
clinical teacher model assessment
Clinical Teacher Model: Assessment

Improving Clinical Teaching: Evaluation of a

National Dissemination Program.

-Skeff KM et al. Arch Intern Med 1992.

  • Faculty rated seminars as highly useful and would recommend to others.
  • Pre & Post Seminar Faculty Questionnaires
    • Rated teaching ability higher after seminars
  • Pre & Post seminar Housestaff (85%) and Medical Student (15%) Questionnaires
    • Rated teaching higher
clinical teacher model assessment1
Clinical Teacher Model: Assessment

Use of faculty development to improve ambulatory

care education. -Stratos GA et al. Med Teacher 1997.

  • 10 Facilitators: faculty development program: 64 ambulatory teachers: 11 western region VA institutions
  • Participants rated usefulness: 4.8 on a 5 pt Likert
  • Clinical teaching skills self assessments pre-post intervention: p<.001 improvement in all 7 domains
clinical teacher model applications
Clinical Teacher Model: Applications

Factorial Validation of a Widely Disseminated

Educational Framework for Evaluating Clinical

Teachers. -Litzelman DK et al. Acad Med 1998.

  • Reduced the 58 subcomponents to 25 items
  • Found overlap between descriptors of teacher knowledge and promotion of self directed learning
  • Provides evidence that the 7 category framework is a valid and useful way to analyze complex teaching activity
learning climate 1

LEARNING CLIMATE (1)

A. DEFINITION

B. EDUCATIONAL PURPOSE

C. TIMING (initial, ongoing)

D. KEY COMPONENTS

Stimulation

Learner Involvement

Respect/Comfort

Admission of Limitations

learning climate 2

LEARNING CLIMATE (2)

D. KEY COMPONENTS & SPECIFIC BEHAVIORS

1. STIMULATION

TEACHING BEHAVIORS:

• show enthusiasm for topic and for learners

• show interest through body language

• use animated voice

• provide conducive physical environment

2. LEARNER INVOLVEMENT

TEACHING BEHAVIORS:

• look at learners

• listen to learners

• encourage learners to participate

• avoid monopolizing discussion

learning climate 3

LEARNING CLIMATE (3)

D. KEY COMPONENTS & SPECIFIC BEHAVIORS

3. RESPECT/COMFORT

TEACHING BEHAVIORS:

• use learners' names

• acknowledge learners' problems/situation

• invite learners to express opinions

• state respect for divergent opinions

• avoid ridicule, intimidation, or interruption

4. ADMISSION OF LIMITATIONS

TEACHING BEHAVIORS:

• acknowledge learner limitations

• invite learners to bring up problems

• admit own errors or limitations

• avoid being dogmatic

demonstration learning climate
Demonstration: Learning Climate
  • Participants:
    • Attending Physician
    • Fellow
    • Resident
    • 4th-year Medical Student
  • Setting:
    • Morning Rounds in the Intensive Care Unit
personal goal setting specific teaching behaviors
STIMULATION

show enthusiasm for topic and for learners

show interest through body language

use animated voice

provide conducive physical environment

LEARNER INVOLVEMENT

look at learners

listen to learners

encourage learners to participate

avoid monopolizing discussion

RESPECT/COMFORT

use learners' names

acknowledge learners' problems/situation

invite learners to express opinions

state respect for divergent opinions

avoid ridicule, intimidation, or interruption

ADMISSION OF LIMITATIONS

acknowledge learner limitations

invite learners to bring up problems

admit own errors or limitations

avoid being dogmatic

Personal Goal Setting: Specific Teaching Behaviors
summary
Summary
  • Effective teaching is more than an art.
  • Teaching requires a conscious effort, practice, and self-assessment.
  • A framework can help you improve your teaching skills.