ALiEMJGME logo smLet’s talk journals, knowledge translation, and building our community of practice around scholarship hot topics specifically in medical education. This week we are piloting a cross-disciplinary discussion week, featuring and co-hosted by the Journal of Graduate Medical Education (JGME). We talk about the hot topic of the Resident As Teacher role in the JGME publication entitled “What Makes a Great Resident Teacher? A Multicenter Survey of Medical Students Attending an Internal Medicine Conference” by Melvin et al. using the Twitter hashtag #JGMEscholar.

Similar to the ALiEM-Annals Journal Club and Resident’s Perspective discussion weeks, a live Google Hangout will be held with the authors and selected experts. Ultimately, a curated summary from the various digital platforms (blog, Twitter, Google Hangout) will be published back in JGME. Some of the best tweets and blog comments will be featured.

Brief overview of the paper by first author Dr. Melvin

Google Hangout with Drs. Melvin, Sherbino, and Fromme (Jan 15, 2015)

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  • 00:00 Dr. Jonathan Sherbino (McMaster Univ, @Sherbino) introduces Dr. Lindsay Melvin (Univ of Toronto, @LMelvinMD) and Dr. Barrett Fromme (Univ of Chicago, @Doc_peds)
  • 01:40 Melvin: Discusses findings from her study
  • 03:10 Fromme: Reflects on the findings from the study and focuses on the topic of resident teacher quality
  • 05:39 Discussion about the term “feedback” and why it ranked so low in the survey results.
  • 11:23 How would you design the perfect Resident as Teacher curriculum? How do we balance the needs of the users (students) and learning theories?
  • 14:28 Are today’s learners and educators (millenials) intrinsically different than previous generations when trying to engage learners?
  • 16:10 Limitations of the study are discussed
  • 19:25 Melvin discusses the next research steps, using this paper as a springboard
  • 20:42 Fromme shares the news about an exciting new website being built to crowdsource a repository of resources to help teach the Resident as Teacher curriculum that will be applicable across health professions specialties. Each will be scored based on the Kirkpatrick level of evaluative rigor. Please contact us at ALiEM if you are interested in contributing to Dr. Barrett Fromme’s upcoming resource.
  • 24:58 Final take home messages

Resident as Teacher (RAT) References mentioned in the Google Hangout

  • Fromme HB, et al. Thequalities and skills of exemplary pediatric hospitalist educators: a qualitative study. Acad Med. 2010 Dec;85(12):1905-13. PMID: 20978425.
  • Kern, Thomas, Hughes. Curriculum Development in Medical Education. [Amazon]
  • Butani L, Paterniti DA, Tancredi DJ, Li ST. Attributes of residents as teachers and role models – a mixed methods study of stakeholders. Med Teach. 2013 Apr;35(4):e1052-9. PMID: 23137246.
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Citation

Melvin L, Kassam Z, Burke A, Neary J. What Makes a Great Resident Teacher? A Multicenter Survey of Medical Students Attending an Internal Medicine Conference. J Grad Med Educ. Dec 2014. [Open access article PDF] [su_spoiler title=”Abstract” style=”fancy” icon=”chevron”]

Background: Residents have a critical role in the education of medical students and have a unique teaching relationship because of their close proximity in professional development and opportunities for direct supervision. Although there is emerging literature on ways to prepare residents to be effective teachers, there is a paucity of data on what medical students believe are the attributes of successful resident teachers.

Objective: We sought to define the qualities and teaching techniques that learners interested in internal medicine value in resident teachers.

Methods: We created and administered a resident-as-teacher traits survey to senior medical students from 6 medical schools attending a resident-facilitated clinical conference at McMaster University. The survey collected data on student preferences of techniques employed by resident teachers and qualities of a successful resident teacher.

Results: Of 90 student participants, 80 (89%) responded. Respondents found the use of clinical examples (78%, 62 of 80) and repetition of core concepts (71%, 58 of 80) highly useful. In contrast, most respondents did not perceive giving feedback to residents, or receiving feedback from residents, was useful to their learning. With respect to resident qualities, respondents felt that a strong knowledge base (80%, 64 of 80) and tailoring teaching to the learner’s level (83%, 66 of 80) was highly important. In contrast, high expectations on the part of resident supervisors were not valued.

Conclusions: This multicenter survey provides insight into the perceptions of medical students interested in internal medicine on the techniques and qualities that characterize successful resident teachers. The findings may be useful in the future development of resident-as-teacher curricula.

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Senior medical student preferences for resident teaching techniques

Teaching Technique% who responded as “highly useful”
Using clinical examples78%
Repeating key points71%
Demonstration of techniques70%
Summarizing information70%
Illustrating points65%
Breakout sessions58%
Using powerpoint presentations, etc53%
Recommending resources45%
Providing feedback45%
Asking for feedback44%
Adapted from Figure 1

Senior medical student preferences for resident teacher qualities

Teacher Quality% who responded as “highly important”
Tailors teaching to learner’s level83%
Strong knowledge base80%
Approachable74%
Organized73%
Respectful73%
Enthusiastic71%
Friendly66%
Recognizes gaps in knowledge51%
Asks challenging probing questions48%
Professional45%
Has high expectations35%
Serious35%
Adapted from Figure 2
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Featured Questions

Four questions are featured here to spark discussion and reflection about the highlighted paper. If you have additional questions, feel free to pose them!

Q1: Feedback was NOT endorsed as an important element of learning. This finding conflicts with a substantial portion of the health professions education literature. What are the implications of this finding?

Q2: This study describes the perceived learning needs of medical students. What are the challenges of incorporating other perspectives (observed needs from teaching experts, institutional needs from training programs etc.) when designing a resident-as-teacher curriculum?

Q3: Let’s not reinvent the wheel. There are many curricular resources to teach residents how to be better teachers. In an effort to create a crowd-sourced repository to share with the educator community, please share useful resources that you know of.

Q4: This study used a post-course survey design. What are the major threats to the validity in survey studies? How might these threats to validity impact your ability to interpret or apply the authors’ results? What next-step study design and outcomes would build upon this work?

Please participate in the journal club by answering either on the ALiEM blog comments below or by tweeting us using the hashtag #JGMEscholar. Please denote the question you are responding to by starting your reply with Q1, Q2, Q3, or Q4.

Jonathan Sherbino, MD, MEd
Associate Professor, McMaster University
Clinician Educator,
Royal College of Physicians & Surgeons of Canada
Jonathan Sherbino, MD, MEd

@sherbino

Assistant Dean Health Professions Education Research, McMaster University || Past Chair, Emergency Medicine, Royal College of Physicians & Surgeons