Geoff Stetson, MD Profile picture
Apr 27, 2021 9 tweets 6 min read Read on X
1/ Welcome back to #TweetorialTuesday with the #MedEdTwagTeam!

Today begins our series on #EffectiveQuestions in the Clinical Learning Environment.

It’s an age-old practice that can conjure mixed emotions. This series will give you tools to use questions with purpose. Image
2/ I wanted to bring us back to the #HierarchyOfTeachingSkills that we have been using.

We previously covered the foundational skills that help create psychological safety & we just wrapped up our feedback series.

To see any of these previous threads, check out @MedEdTwagTeam. Image
3/ Here is where we are going over the next 7 weeks. Today is our intro.

This is one of my favorite topics in #MedEd!

Questions in the clinical setting are employed by all teachers & SEEM so simple to use.

However, effective questioning is a nuanced skill.

Let’s get into it! Image
4/ Questions, when used improperly, have the potential to cause learners to experience some serious psychological danger (opposite of safety).

Check out this fascinating study in which @egoebs asked pathology residents to draw a “pimping” encounter.

pubmed.ncbi.nlm.nih.gov/31084222/ Image
5/ The previous slide introduces the term “pimping”.

There has been much debate, but we agree with the authors of this paper, that the term itself is problematic, & the idea of using questions to humiliate or establish hierarchy is appalling.

pubmed.ncbi.nlm.nih.gov/25099239/ Image
6/ Today, we won’t get into the content, because I want to hear from you!

I would love to highlight some of your collective wisdom and experiences in the upcoming threads. Don’t be shy!
7/ TRAINEES (students, residents, fellows)! Reply with your thoughts to these ?s:
OF NOTE:
A “good question” is: one you think is fair and can lead to learning on your part.
A “bad question” is: one you think is UNfair and/or has little learning value. Image
8/ TEACHERS (residents, fellows, attendings)! Reply with your thoughts to these ?s:
OF NOTE:
A “good question” is: a question you think is fair and can lead to learning for trainees.
A “bad question” is: a question you think is UNfair and/or has little learning value. Image
9/ Alright my #MedTwitter, #MedEd, #MedStudentTwitter friends! I can’t wait to learn from you all!

We will see you back here next week to talk about general rules for asking #EffectiveQuestions in the clinical learning environment.

See you then! Image

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More from @GStetsonMD

May 17, 2022
1/ Attending: “Sam, what is the level of bilirubin at which scleral icterus is noticeable?”

Sam thinking: [1. I can make a guess, but 2. Who cares?]

Seem like a familiar scenario? Let’s help this attending ask a better question.
2/ Whether it is in the team room, or at the bedside, asking questions of learners is a skill that requires intention, preparation, and execution. These best practices were a topic I covered a while back, so this will be a refresher.
3/ These were all the topics that were covered in that series. Each individual thread can be found here:
twitter.com/i/events/13982…
Read 14 tweets
Apr 19, 2022
1/ You just admitted a patient with some really interesting pathology. You want to teach about it tomorrow on rounds. You know it is gonna be a busy day. What’s the plan?

Welcome back to #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!
2/ We are still in this “during rounds” section of our inpatient teaching block. Rounds are the CLASSIC time to drop pearls. But, doing it well takes thought and preparation.
3/ What does it mean to “drop pearls”? It refers to pearls of wisdom, and many of us think of some stately professor emeritus waxing poetic in a case conference.

But check out this definition here:
Read 11 tweets
Apr 5, 2022
1/ Welcome back to another edition of #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!

Over the last two weeks we have laid out the WHY and the WHAT of teaching communication. Today is the HOW. Let’s go!
2/ For refreshers on the WHY and WHAT, check out these previous threads from:
@JenniferSpicer4 (WHY) –
@GStetsonMD (WHAT) –
3/ And like the previous threads, much of this content comes from this book (Chapter 16 for this thread) by @DrCalvinChou & @LauraCooleyPhD of @ACHonline. It is a foundational book that is extremely readable and applicable. Well worth your time: CommunicationRx.org
Read 12 tweets
Mar 29, 2022
1/ We can’t always treat. We can’t always cure. But we can always support & care with good communication.

Welcome back to our #MedEd & #MedTwitter friends! Today we lay out some foundational skills of communication that you can help your learners to hone under your tutelage.
2/ As we continue to focus on inpatient teaching, we are still in the section that homes in on opportunities during rounds. Especially when rounds are done at the bedside this is a perfect time to practice communication skills.
3/ Last week, @JenniferSpicer4 helped us all to grasp WHY it is important to spend time teaching communication skills:
⬆️Health outcomes & patient experience
⬇️Cost of care
⬆️Clinician experience

Read 16 tweets
Nov 16, 2021
1/ It is near the end of your time on inpatient service and it has been BUSY!

Spirits are high, but folks are tired.
You want to make sure rounds are high-yield, but how to focus their energy?

Welcome back #MedTwitter & #MedEd for another #TweetorialTuesday from @MedEdTwagTeam!
2/ This week, I will share tips on how to use questions to get ”the wheels turning” for your learners before rounds.

In just a few minutes, this focuses energy, engages team members in the cases they may not be following, and enhances bedside learning for everyone.
3/ Today’s 🧵 harkens back to one I posted about ”prediction questions”.

Inspiration: #SmallLearning from @LangOnCourse. It is tremendous, with a lot of useful ideas that can be applied in the classroom or clinical setting. FYI - 2nd ed just came out.
Read 13 tweets
Sep 28, 2021
1/ Learning objectives? For serious?!? 🤔
Aren’t those for boring pre-clinical lectures?
Are they even necessary? I seem to get by just fine without them.

You may get by fine but knowing how to use learning objectives will take your game to a new level. Let's go!
2/ Welcome back, #MedEd and #MedTwitter friends, for another exciting week of learning from the @MedEdTwagTeam.

For orientation, we are still in our foundational skills section of #InpatientTeaching.
3/ Every resident who rotates with me leaves my team knowing why learning objectives (LOs) are important, how to make them, and how to apply them.

LOs provide structure to all didactic content, and IMHO, are the single most useful tool to power up your teaching.
Read 15 tweets

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