Jennifer Spicer, MD, MPH Profile picture
Oct 12, 2021 15 tweets 8 min read Read on X
1/ You are standing in front of your team, getting ready to teach about diabetic foot infections.

HOW will you get them interested in this topic?

And how are you going to teach so that EVERYONE learns, from student all the way up to the fellow?!

#MedEd #MedTwitter: HELP!
2/ This week, I will share tips on teaching to multiple learner levels AND interests to help you effectively engage your entire team during inpatient teaching sessions.

It's another #TweetorialTuesday from the @MedEdTwagTeam for our #MedTwitter & #MedEd friends.
3/ You have a team of learners and a patient to discuss.

How will you make the teaching both INTERESTING & RELEVANT for your learners?

I mean, you're teaching about diabetic foot infection. Everyone's going to 😴💤 as soon as you start teaching. How can you keep them engaged?!
4/ There are endless things you can teach:

Therefore, to keep all learners engaged, try to pick something that aligns with content that they either NEED or WANT to know to help them now (on rotations/exams) or in the future (for their careers).
5/ Now, the problem is, many of us have difficulty remembering WHAT content is appropriate for each learner level.

I usually look at:
1⃣Rotation/clerkship objectives for that learner
2⃣Review books or questions specific for that learner level (e.g., MKSAP for IM residents)
6/ And then I get to know my learners and their goals in order to tailor teaching specifically to them.

Check out @YihanYangMD's tweetorial on "shared goal-setting" if you missed it last week for details on how to do that effectively!

7/ Here are examples of teaching points for this patient taking into account my learners' current knowledge & interests.
8/ Clearly every teaching point can’t be relevant to all learners. Instead, I try to ensure that at least one teaching point per day is targeted to each learner.

And I try to match it to their career goals - it increases motivation and shows them I care about their interests.
9/ Once I decide WHAT to teach, I consider HOW to teach it.

I've found 3 methods that help me engage all learners, regardless of their level:
1⃣ Learners serving as teachers
2⃣ Group discussion about a case/question
3⃣ Targeted questions/points for each learner
10/ Learners can serve as near peer teachers to the rest of the team. Teaching helps them learn the material better AND engages them in the session even if they know the information.

I use this method when I have a learner who is high-performing or has a unique interest/skill.
11/ Having learners work through a case or question together results in peer teaching AND allows you, as the teacher, to see potential knowledge gaps. This serves as a needs assessment for your own teaching!
12/ Finally, ask questions that are fair & appropriate for each learner.

I've found this table from this article in @MedTeachJournal to be helpful in thinking about questions that promote multi-level inpatient teaching.

tandfonline.com/doi/full/10.31…
13/ Here’s an example of teaching strategies I could use to engage all learners during a discussion of this patient.

Clearly this takes time. And you don’t need to ask all these questions. Just remember to engage all learners in the discussion!
14/ So, in summary, consider how you can engage ALL learners on your team during teaching, regardless of their current learner level, prior experiences, and future interests.

It seems tough, but it's actually easier than you think!
15/ What are some things YOU do to involve all learners on your teams?

Don’t forget to join us next week when @YihanYangMD will provide some general bedside teaching tips.

And follow @GStetsonMD & @YihanYangMD so you don't miss anything from @MedEdTwagTeam!

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More from @JenniferSpicer4

Mar 17, 2023
Kicking off BST Mode ⁦@emoryimchiefs⁩ Grady campus on #MatchDay2023

@gradydoctorImage
Do you want a 4-step process for questions to ask when you get a page next year when you’re alone on nightfloat or ICU call?

Check out this framework! Image
And now, do you wanna remember who the heck to order DEXA scans for in clinic?

Thankfully Miko De Bruyn comes to the rescue. Image
Read 16 tweets
Mar 7, 2023
1/ You're seeing a new consult with your team, and you want to teach the primary team too.

But WHEN is the best time to teach them?

On the phone?
At the bedside?
In their team room?

And in the morning?
Or maybe the afternoon?

This week: Image
2/ Last week @VarunPhadke2 described all of the individuals whom we can teach during the day.



But when should we teach them?

Often we default to teaching on the phone when receiving the consult or giving recommendations, but there are other options too.
3/ This week we will discuss the pros & cons of those options.

With one caveat.

Often the best time to teach is the one most convenient to your team & the primary team, which depends on your local institution's workflow.

But let's explore some general principles to consider.
Read 15 tweets
Feb 21, 2023
1/ You're finishing your last consult of the day.

It's late.
And it's been a long day.

You intended to find the primary team to teach them, but you have a million other things on your "to do" list.

Here are 8 reasons why you should still find time to teach the primary team. Image
2/ Reason #1: They want to learn

The primary team called with a question.
They are invested in the answer.

It's all about finding out what they want to know and targeting your teaching accordingly.
3/ Reason #2: It empowers them

Often the primary team has an idea of what to do but wants reinforcement that their plan is correct.

Teach them general rules that they can re-use. Image
Read 12 tweets
Jan 31, 2023
1/ Your team just saw a patient with syphilis, and you're ready to teach, but:

Resident #1: on week 2 of their rotation
👉 Has already seen 2 patients w/ syphilis

Resident #2: started today
👉 Hasn't seen a single patient with syphilis

What should you do now? Image
2/ Unfortunately, learners on our team may miss teaching that occurs during the rotation for multiple reasons. Image
3/ As @VarunPhadke2 previously pointed out, all learners on the team are usually not present all day, every day for the entire time we are on clinical services.

Image
Read 16 tweets
Jan 24, 2023
1/ A member of your consult team presents a patient w/ suspected neurosyphilis.

Your team:
⭐️ 3rd year medical student
⭐️ IM intern
⭐️ 2nd year IM resident
⭐️ 1st year ID fellow

How can you possibly provide valuable teaching to all of them?

This week: Multi-level teaching Image
2/ Teaching multi-level learners is hard.

Their range in baseline knowledge means a single teaching point is often not effective for everyone.

So how can you support everyone's learning without taking too long and/or boring others?
3/ A prior thread discussed the importance of clarifying learners' needs & interests at the beginning of the rotation.

This is one 🗝️ for effective multi-level teaching.

Know what materials is RELEVANT and INTERESTING for each learner level.

Read 14 tweets
Jan 10, 2023
1/ *Re-consult 📞*

You: What did the last consult note say?

Them: I don't know how to interpret it...

*reading the ✍️ yourself*
#Sepsis
- send tick serologies
- start broad-spectrum antibiotics
- we will follow up OSH data

You: 🤦 I feel you... We'll see the patient again. Image
2/ You wonder...

💭 What tick serologies were we referring to?
💭 What antibiotics were we wanting to start?
💭 And which OSH has prior records?

And you're not the only one wondering...

How can we ✍️ more effective notes?
3/ Clinical notes are used for many purposes, as previously highlighted by @YihanYangMD

Read 15 tweets

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