Geoff Stetson, MD Profile picture
May 18, 2021 15 tweets 9 min read Read on X
1/ Welcome back to #TweetorialTuesday with the #MedEdTwagTeam!

We are in our #EffectiveQuestions series.

Thanks for joining us, #MedTwitter, #MedEd, & #MedStudentTwitter Friends! Image
2/ This week we start talking about my favorite uses of questions in the clinical learning environment.

First up is, questions as a needs assessment. Image
3/ I was schooled in #MedEdScholarship by @posucsf, Dave Irby, and @bobrien_15 @UCSF.

Like most educators of #HPE, they framed curriculum development for me through the lens of “Kern’s Six Steps”. Image
4/ @jackpenner and @timdyster from @UCSF/@UCSFIMChiefs are doing some really cool work under the handle @MedEdModels.

If you haven’t heard of #Kern’s, or want a refresher, especially on the needs assessment, check out their awesome visual description:
5/ I mention this because Kern’s approach has rented a room in my brain. I use a modified version for all my teaching efforts. From a pearl on rounds, to a chalk talk, to a 4-hour workshop. The intensity of my approach increases in concordance with the intensity of the teaching. Image
6/ As you can see, the first step in all my teaching is identifying a learning need. What is a learning need?

Kern presents an equation that is helpful for me to think about, because I like math. 🤓 Image
7/ There are many ways to identify learning needs in the clinical setting. Here are some:
1⃣Listening to presentations – my favorite way
2⃣Learner-initiated questions – they identify the bounds of their knowledge
3⃣Teacher-initiated inquiry – you probe to find those bounds
8/ When asking questions as a needs assessment, your goal is to find the gap so that you can fill it in. You must state this as your intention & make clear that their responses will not be used as part of evaluation.

Remember back in the General Rules?
9/ The best way to perform a needs assessment is through BROAD & OPEN-ENDED inquiry.
💡Broad – An invitation for learners to share the knowledge they possess, ideally up to their limits.
💡Open-Ended – It would be difficult to answer the question with any single word.
10/ There are hundreds of questions that could fit these similar BROAD and OPEN-ENDED principles. Here are some examples in some specific categories: Image
11/ Notice the question words.

“How” and “why” are excellent, as they naturally lead to broad and open-ended questions.

“What” is good too, but you need to be careful that you are not looking for an answer that is too specific. Image
12/ Another key piece to a good needs assessment question is the word ”you”. Why?

Because you are assessing the needs of the specific learner. Your goal is to find out how they, specifically, think about & approach various clinical scenarios. Image
13/ What happens when we don't use "you"? Notice how some subtle changes can alter the intention of the question?

🔑Omitting the word “you” can imply a "right" answer.
🔑Using us/we/our language can lead the learner to guess what “we” are thinking. Image
14/ Today I presented some big ideas and some more subtle things that can make a big difference in identifying the needs of your learners, thus helping you to be a more targeted and effective teacher.

The main takeaways are: Image
15/ Thanks for joining us!

Please, join us again next week as we dive into questions to facilitate retrieval practice.

To not miss out, make sure to follow: @MedEdTwagTeam, @JenniferSpcier4, and me

Tweet 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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