Thread by @gretchemaben

Great keynote address at the @APCCMPD virtual conference this morning by Dr. Robert Arnold on "Teaching Fellows Communication Skills: How to Fit It in a Busy Practice." See the thread below for some tips! 1/

What does it take to learn?
1. Deliberate practice (and safe failure).
2. Repetitive retrieval
3. Spaced learning
2/

What have we learned about teachers?
1. Concern for learner experience ("I didn't want her to feel bad/diminished")
2. Want to give tools ("Here is a way to approach bad news")
3. Feel responsible to give feedback ("How will they improve otherwise?")
3/

Master teaching map:
1. Get learning goal.
- "What's challenging?" - Reframe challenge to goal.
2. Observe the learner in action.
- Take notes.
3. Assess what happened (feedback)
- What worked well?
- What do you wish had gone better?
- What could you do differently next time?
4/

Setting a learning goal:
- Engage the learner and ask them what is challenging.
- Reframe the challenge to a skill.
- Set expectations for feedback.
- Set a safety net for the learner.
5/

Observing the learner in action:
- Set the stage.
- Take notes.
- Intervene if necessary,
- Hand back to the learner if possible.
6/

Setting the stage:
- "We work collaboratively, so, as Dr. ___ explains things, I may add a point occasionally, or she/he may ask me to comment."
7/

How to decide whether to intervene:
- Is the patient being harmed?
- Is the learner emotionally overwhelmed?
- Is the learner aware things are not going well?
- Does the learner have the ability to get out of the situation?
- NOT just is you think you can do it better.
8/

How to intervene:
"Dr. _____, may I add something?"
9/

Hand back if possible.
How do you decide if/when to give the learner control back?
- The patient and learner are no longer at risk of being harmed.
"Dr. _____, may I ask you to finish this up by talking about the next steps?"
10/

Why is the hand back important?
- Keeps the learner at the center of the conversation.
- End on success.
11/

Assess what happened:
- How did it go?
- What did you do well? I loved how you...
- Anything you wish you would have done differently? Next time you might...
- What's your take home point?

Why? It build on what went well.
The model learning cycle: Goal -> Observe -> Assess.
12/

Feedback if you intervened:
- What happened before I stepped in?
- What did I say?
- What was the effect?
- What is your take home point?
13/

Feedback if you did not intervene:
- Do you have any ideas about how you might address that differently next time?
* Only add teacher ideas if needed.
- What is your take home point?
14/

Teaching challenge: What is they don't see something to improve? Point, then describe if necessary.
- Point: "Did you notice how they reacted when you said...
- Describe: "What I saw was that you said.... and then they did...."
15/

Thanks to Dr. Warner for the fantastic talk, and to @vitaltalk for creating such a meaningful curriculum! 16/16