Geoff Stetson, MD Profile picture
Jun 1, 2021 12 tweets 8 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, #Tweetatrician & #MedStudentTwitter Friends! Image
2/ Today we are touching on how to advance reasoning through inquiry. One of the best and most appropriate uses of questions in the clinical setting. Image
3/ Back when this series started, I asked y’all how you use questions in clinical teaching.

Two long-time friends of the @MedEdTwagTeam, @LiangRhea & @GIMaPreceptor left answers that perfectly set up this thread. Image
4/ They both are using a framework for advancing reasoning (#BloomsTaxonomy and/or RIME framework).

I learned Bloom’s as a tool for curriculum development, but it works just as well as a tool for formulating questions. Image
5/ A recent paper in @MedTeachJournal on the topic of questions in the clinical environment also endorses this idea. It is a great article and very much worth your time.

pubmed.ncbi.nlm.nih.gov/32297833/ Image
6/ Here is what they write on the topic of applying #BloomsTaxonomy to questions: Image
7/ Here is the table they reference with example questions. I would tweak a few of these to make them less “right or wrong” based on principles from previous threads. Overall, it gets the idea across. Image
8/ If you aren’t familiar with #BloomsTaxonomy, it is important that you become familiar.

Practice using it by writing learning objectives for small teaching you are planning, or by selecting verbs from the list for questions you will use in your clinical setting.
9/ Another important idea that @LiangRhea brought up is that of Vygotsky’s Zone of Proximal Development (ZPD).

This is the idea that to advance a learner’s understanding, you want to be helping them to operate in the ZPD. Image
10/ In the center circle, learners can already do the thing (too easy, little to learn). In the outer circle, the task is too difficult (the juice isn’t worth the squeeze). The sweet spot is when a task is just out of their range, but they can do it with help. Image
11/ Using the different categories of #BloomsTaxonomy, you can find where a learner starts to struggle. This is the ZPD for that learner for that specific topic/concept (H/T @GIMaPreceptor). Focusing your efforts there will advance their reasoning in the most efficient manner. Image
12/ Thanks for joining us!

Please, join us again next week as we dive into prediction questions and how they “prime the pump” for enhanced learning.

To not miss out, make sure to follow: @MedEdTwagTeam, @JenniferSpicer4, and me @GStetsonMD.

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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