Jennifer Spicer, MD, MPH Profile picture
Nov 2, 2021 14 tweets 8 min read Read on X
1/ You're on the inpatient service,
and you want to teach...

but HOW are you supposed to FIND TIME ⏲️while also
✅ caring for patients
✅ writing notes
✅ completing other administrative work

Not to mention managing your personal life!

This week: tips on teaching BEFORE rounds Image
2/ This week, I will share practical tips on how to integrate teaching into your daily routine BEFORE rounds.

It's another #TweetorialTuesday from the @MedEdTwagTeam for our #MedTwitter & #MedEd friends! Image
When do you typically teach?
4/ As mentioned previously, I like to schedule teaching BEFORE rounds.

I do this because it:
*⃣ shows I PRIORITIZE teaching
*⃣ ensures we have TIME for teaching
*⃣ allows me to teach when learners are FRESH

Plus, it sets the tone for rounds as a time for teaching & learning. Image
5/ When teaching before rounds, it's critical to pay attention to⏰

Keep it short or learners start worrying about how teaching is impacting their workflow.

Primary teams tend to have busier mornings than consult teams, so 5-10 minutes of teaching before rounds works best.
6/ There are many strategies that can be used for short, focused teaching sessions.

Here are 3 strategies that we have used/seen that are effective teaching methods.

(Alternatively, you can use the pre-round teaching time to get to know your team members!) Image
7/ Here are examples of peer teaching.

If you create a central repository to store the teaching points & learning resources, learners can reference it in the future!

Example: @ricapitt creates a Google slideshow & has learners add a slide w/ their teaching point each day. Image
8/ Peer teaching benefits everyone.

1. Teaching is a powerful way to learn a concept better.
2. Peers' cognitive congruence with each other results in content being taught at the appropriate level.
3. It takes pressure off the attending.

Read more here:
tandfonline.com/doi/abs/10.108…
9/ Retrieval practice refers to the process of having learners "retrieve" information from inside their head, usually by answering questions.

This is a great way to teach, and it requires very little prep from the teacher.

Here is how I use it for inpatient teaching. Image
10/ If the concept of retrieval practice is new for you, use one of these excellent resources that summarize how to use it effectively:

An infographic:
learningscientists.org/retrieval-prac…

A video:


A website:
retrievalpractice.org
11/ Bite-sized teaching sessions allow you to teach content in a short amount of time.

The key is to limit what is taught in a single session; however, the same topic can be covered over multiple sessions allowing more comprehensive coverage of a single topic, if desired. Image
12/ Developing chalk talks will be covered in a future tweetorial.

For now, you can adapt others' chalk talks for your teaching. Examples:
*⃣@teachIM_org, teachim.org
*⃣@CPSolvers, clinicalproblemsolving.com

More about bite-sized teaching: bmcmededuc.biomedcentral.com/articles/10.11…
13/ So, in summary, try to incorporate short 5-10 minute teaching sessions before rounds using:

*⃣ peer teaching
*⃣ retrieval practice
*⃣ bite-sized teaching sessions

Doing it at the beginning of rounds ensures that it happens, but make sure that you don't lose track of time! Image
14/ Are there other ways that you incorporate teaching before rounds? If so, please share!

Next week, stay tuned for @GStetsonMD who will discuss using questions for "priming".

See you then #MedTwitter #MedEd! Image

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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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