Geoff Stetson, MD Profile picture
Nov 16, 2021 13 tweets 7 min read Read on X
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.
4/ @LangOnCourse provides a great analogy about the power of prediction: "[Predictive exercises] till the soil of your students minds and prepare a fertile ground for the learning that will follow."
5/ So, what is the science here?

Generating a prediction does a few things to improve learning from an emotional & cognitive standpoint:
6/ So how is it done? Here are some examples of scenarios and questions that can be asked about patients on a team that can prep your team for learning:
7/ What makes a good prediction question:
✅ It is posed as a fun activity to get people thinking
✅ It activates previous knowledge
✅ There is no ”right answer”. You all will discover the answer later when you see the patient, the consultant weighs in, or some result returns.
8/ This is a GREAT way to get all learners involved.
The primary provider has been thinking deeply about the patient, while others may not know much about them.
This helps focus all learners before meeting a new patient & prepares them to incorporate new information.
9/ After a prediction is made, however, it is important to discover the right answer ASAP.
One cannot let an incorrect prediction linger too long, as that risks cementing that prediction as “truth.”
10/ After you discover the truth, reflecting on your predictions is key to learning:
❓ Were you right? Wrong? Somewhere in between? Why?
❓ Did the patient’s presentation differ from a typical presentation? Why?
❓ Are there assumptions you made that must be challenged?
11/ This process is summed up with three key ideas:
🔑 Prediction (before rounds)
🔑 Exposure (getting the answer, during or after rounds)
🔑 Reflection (best as a group, during or after rounds)
12/ Are there other ways that you all get your learners ready to learn at the beginning of a clinical day?

Here’s a summary of how prediction questions can be used to prime learning and why it works.
13/ Thanks for joining us today!

The @MedEdTwagTeam is taking a break for a few weeks to spend some holiday QT with our families. For those who celebrate, we hope you are able to do the same!

Thanks #MedEd & #MedTwitter for all the support & engagement! Tweet you in 2022!

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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
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
Aug 31, 2021
1/ Merry #TweetorialTuesday to all our #MedEdTwagTeam, #MedEd, and #MedTwitter friends!

Today we will be chatting about how to fit in teaching when on an #InpatientTeaching service.
2/ As @JenniferSpicer4 outlined two weeks ago, we are going to structure our upcoming content in terms of different times when teaching can occur.

However, today is going to be an overview of structuring one’s day, and is part of our foundational skills section.
3/ And, as with all #MedEd, what I do will NOT translate directly to your practice, as learning contexts are so unique and specific. However, the big ideas and concepts are transferrable.
Read 14 tweets

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