Geoff Stetson, MD Profile picture
Jun 15, 2021 14 tweets 9 min read Read on X
1/ Welcome back to #TweetorialTuesday with the #MedEdTwagTeam!

Today we will be summarizing what we have learned throughout the #EffectiveQuestions series.

Thanks for joining us, #MedTwitter, #MedEd, #Tweetatrician, & #MedStudentTwitter Friends!
2/ I have had an excellent time sharing with you all my approach to #EffectiveQuestions in the clinical setting.

Here is where we have been during this journey.
3/ In the intro we talked about ”pimping” and the psychologically dangerous environment it creates, as illustrated by these drawings in this fascinating study:

pubmed.ncbi.nlm.nih.gov/31084222/
4/ In the @MedEdTwagTeam’s quest to create #PsychologicallySafety in clinical learning environments, we do not condone the practice, nor the term itself.

”Pimping” has got to go!
5/ Inquiry, however, is a very valuable tool to promote learning in the clinical setting when used thoughtfully.

These are the 8 general rules I follow when asking questions. Check out the whole thread for details.
6/ We then detailed how even educators with the best of intentions can make a learning environment uncomfortable when they ask questions that are too specific.
7/ Our first specific purpose for asking questions was to perform a needs assessment of your learner(s), i.e. finding out what they know and don’t know, so you can fill in the gaps.
8/ We then cited the book #MakeItStick when discussing retrieval practice. Rather than asking learners to recall what they learned in their preclinical years, I ask them to recall what they learned while we worked together. This way, I know they have been exposed to the material.
9/ Next, we talked about using #BloomsTaxonomy as a framework for thinking about advancing a learner’s reasoning. Once you feel they have a good grasp of a concept at the remember/understand level, push them into the areas of higher cognitive effort/learning.
10/ We then overlayed the concept of Vygotsky’s Zone of Proximal Development or #ZPD. Identifying the bounds of a learner’s current abilities and supporting them in the #ZPD is key to promoting growth.
11/ Lastly, I cited the book #SmallTeaching when discussing prediction as a fun and effective way to prepare a learner’s mind for deeper learning. There are emotional and cognitive reasons why this tool is effective.
12/ But, prediction alone is not enough. After a prediction, it’s important to determine whether the prediction was accurate or not. Next, reflection is necessary to solidify reasoning that led to an accurate prediction, or correct thought processes that led to a misguided guess.
13/ Thank you all so much for joining me on this journey!

Hopefully you all picked up something you can use in your practice. Feel free to share any lessons learned.

The full threads can all be found here:
twitter.com/i/events/13982…
14/ Soon, @JenniferSpicer4 and I are going to introduce more advanced teaching topics. But first, we are going to return to the foundational skills of #PsychologicalSafety, as this is the time of year for foundational skills.

Gotta 🚶 before you can 🏃!

Tweet you next week!

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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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