ATLANTA—Clinicians are often expected to teach others and provide feedback to myriad learners in various settings. Yet in medical schools, residencies and fellowships, a paucity of formal training exists for these activities.
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Explore This IssueJanuary 2020
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In November, during the 2019 ACR/ARP Annual Meeting session, Doctors’ Toolbox: Learning to Communicate and Teach, presenters discussed methods that make for good teachers and educators in detail, and asked the audience to use these techniques in their daily practices.
Nathan Houchens, MD, FHM, FACP, an assistant professor of internal medicine and assistant program director for the internal medicine residency program at the University of Michigan, Ann Arbor, began the session. He discussed the research he and colleagues performed describing the habits of physicians identified by division chiefs and chairs as exemplary educators. Through interviews with these clinician educators, focus group discussions with their current and former learners, and direct observation of clinical teaching during inpatient rounds, the researchers identified the actions, approaches and behaviors these exemplary educators consistently employed.1
First, these educators foster positive relationships with all team members by building rapport with them, creating a safe and supportive learning environment. This technique includes using icebreaker and open-ended questions to get to know team members. These educators share information about themselves to demonstrate openness, vulnerability and trust, often employing humor or self-deprecation to connect with learners and create a comfortable atmosphere.
These educators also serve as positive role models for patient care by treating patients as partners in their own care. They use patient stories to highlight key teaching points that connect to broader concepts, and demonstrate excellent clinical exam skills and communication techniques to learners. Even seemingly small details, such as helping patients get more comfortable in their hospital beds or assisting patients in putting on their socks after an exam, were regarded as important actions by learners hoping to continue to mature as caring, humanistic physicians-in-training.
Additionally, these educators engaged in coaching and collaboration by facilitating discussions, using effective questioning strategies and tailoring their teaching styles to the different learning levels, strengths and weaknesses of individual learners. In this regard, one learner explained, “[The educators] gauge where your knowledge is and then sort of put themselves in your brain and lead you down the path. … They start slowly, and they leave a trail of bread crumbs for you to follow so that you’re making connections all along the way.”
Dr. Houchens also discussed how educators view their own strengths and weaknesses, as well as how such characteristics as ethnicity, gender and age play a role in how educators present themselves. Example: Although exemplary educators sometimes use self-deprecating humor to connect with learners, this habit may be challenging due to conscious and unconscious biases, which can undermine an educator’s credibility.