Yihan Yang Profile picture
Mar 15 16 tweets 8 min read
1/ Your student is trying to characterize the pt’s aortic stenosis murmur. The pt looks concerned. The rest of your team looks bored, waiting to examine the pt.

How to make PE teaching fruitful & engaging for EVERYONE?

#TweetorialTuesday #MedTwitter #MedEdTwagTeam #MedEd Image
2/ As a reminder, we are continuing our discussion about opportunities for inpatient teaching during rounds.

Today is the final installment on the physical exam. Image
3/ You’ve decided to teach exam skills. You’ve prepped WHAT you’d like to teach.

But with so many different levels of learners on a team, keeping all your learners & the pt engaged can be a challenge during exam teaching.
4/ For a general framework on HOW to teach the exam, starting from team prep work to debriefing, check out my prior bedside teaching schema tweetorial!

Image
5/ Several of the strategies in the prior schema can be helpful to engage ALL your learners. We will cover the following 6 strategies Image
6/ Expectations

✅Set & stick to time limits for exam teaching
✅Ask your learners what THEY want to learn from exam teaching
✅Tell learners (& patients) that you expect learners to say “I don’t know”
7/ Assign Roles - Give everyone on your team a task or ? to ponder while they’re waiting to examine the pt.

This is a great way to assign learner level / learner goal specific teaching points! Image
8/ Question Up - Learners sometimes feel intimidated when asked ?s @ the bedside.

🗝Consider asking ? to your most inexperienced learner 1st, moving up if they don’t know the answer

🗝AVOID asking junior learner a ? that a senior learner got wrong
9/ Predictions - @GStetsonMD previously posted a/b prediction ?s for teaching:

This skill is helpful when teaching:
🔥variations on a finding
🔥how exam changes w/ clinical progress/deterioration
🔥correlation w/ imaging Image
10/ See 1 vs Do 1 - Decide if you want to demo the skill first, or if you’d like your learners to jump right in.

Consider demo if:
🗝 the skill is advanced/commonly done wrong
🗝 it’s early in team formation & you’re unsure of your learners’ skill levels
11/ Coach & Redirect - Praise what learners are doing well while also providing gentle corrections when needed Image
12/ #MedTwitter, what other strategies do you use to engage learners when teaching at the bedside?

Did you pick up any new strategies for bedside exam teaching?
13/ But wait… what happened with the patient in all of this??

#MedTwitter previously identified several challenges with engaging pts while teaching at the bedside: Image
14/ Use the “PATIENTS” framework to engage patients while helping to protect their privacy and comfort.

For more details, check out my prior tweetorial: Image
15/ For a quick summary & takeaway reference, please check out my bedside teaching cheat sheet: drive.google.com/file/d/1-7ieQl… Image
16/ Stay tuned for next week’s intro thread on teaching communication at the bedside on rounds!

Make sure to follow @MedEdTwagTeam members @GStetsonMD @JenniferSpicer4 @ChrisDJacksonMD & @YihanYangMD so you don’t miss anything! Image

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More from @YihanYangMD

Oct 19, 2021
1/ “Let’s hear about this patient at the bedside.”

As an educator or learner, does this sentence make you tachycardic??

It’s another #TweetorialTuesday from the @MedEdTwagTeam! #MedTwitter #MedEd #MedStudentTwitter #Tweetorial #FacDev
2/ We are still covering the foundations of inpatient teaching.

This week, we will focus on general strategies to incorporate bedside teaching effectively into your inpatient teaching tool box!
3/ First, there are many benefits to teaching @ the bedside for learners, educators, & patients alike.

See articles:
⚡️@DanielRicottaMD TWDFNR @JHospMedicine: tiny.cc/RoundsTWDFNR

⚡️@OlleTenCate Review on Bedside Teaching / tinyurl.com/BedsideReview
Read 15 tweets
Oct 5, 2021
1/ You’ve got multiple learners on your inpatient team. How do you know if you’re teaching them what they need and want to learn?

It’s another #TweetorialTuesday from the @MedEdTwagTeam!

#MedTwitter #MedEd #MedEdTwagTeam #MedTweetorial #FacDev
2/ We are still covering the foundations of inpatient teaching.
 
If you missed these threads, catch up on:
🔥@JenniferSpicer4’s how to plan for teaching on rounds - tinyurl.com/roundsprep
🔥@GStetsonMD’s how to boost teaching with learning objectives - tinyurl.com/LObjectives
3/ This week, we cover how to use shared goal-setting to build upon teaching preparation & learning objectives.
Read 18 tweets
Jun 1, 2020
1/ #MedEdMethodsMonday this wk is on DEEP LISTENING.

2020 has been full of challenges & events revealing the divisiveness in our world.

#MedTwitter, as leaders in #MedEd we must practice to listen deeply to pts, colleagues, & learners.

What do I mean by “deep listening?”
2/ Good Listener, redefined

I’ve always thought I was a good listener. My friends and patients often told me so.

Then I took a leadership class @YaleSOM this spring for my #MedEd Masters & 🤯

Have you heard of the 3 levels of listening??
3/ Listening Levels
I never heard of levels of listening until my class when we were discussing #coaching.

The authors of “Coactive Coaching” describe 3 levels of listening. tiny.cc/CoActiveCoachi…

1. Internal listening
2. Focused listening
3. Global listening
Read 15 tweets
May 25, 2020
1/ #MedEdMethodsMonday #MorningReport edition ends this week with:

Tip 7-Abandon Objectives PRN
Tip 8-Consolidate Learning

#MedEd #MedTwitter #MedStudentTwitter #FacDev #MedEdPearls #ChiefResidents
2/ Tip 7 - Abandon Objectives

The chief resident has started on time, asked questions, engaged learners, embraced silence, managed faculty, modeled humility...

Then says:

“Okay. We have 5 minutes left. Let’s quickly talk about this slide...”

😱🤯
3/ Abandon Objectives - Ever fill a water balloon?

Ever try to get the water balloon super juicy by trying to squeeze in that last drop of water and then have the whole thing sadly explode?

Teaching is like that.

Try to cram in too much knowledge and you risk losing it all.
Read 12 tweets
May 18, 2020
1/ #MedEdMethodsMonday #MorningReport edition this wk:

Tips 5&6: Manage Faculty & Model Humility

See last 3 wks for: Start on ⏰ | Ask ? Effectively | Engage All Learners & Embrace Silence

#MedEd #ChiefResidents #MedEdPearls #FacDev #MedStudentTwitter #MedTweetorial Image
2/ Tip5 Manage Faculty | The Opinions

Seems like faculty attendance @ morning report is all over the map.

Interestingly, when @StephenHolt7 and I conducted our multi-institute stakeholder interviews, many more residents said faculty SHOULDN’T be @ report than #Medtwitter did Image
3/ Manage Faculty | Conflicted

In fact, the tension between why faculty should be present @ report & why faculty shouldn’t be present was often palpable within the SAME interview.

Why?
Read 16 tweets
May 11, 2020
1/ #MedEdMethodsMonday, wk 3 of #MorningReport theme!

Now that you've 1) Started on time & 2)Asked ?s effectively...

Tip 3 Engage All Learners & Tip 4 Embrace Silence

#ChiefTips #MedEd #MedTwitter #MedStudentTwitter #MedEdPearls #FacDev ImageImage
2/ Engage Learners - There are too many strategies to help engage all learners to cover them all. For this thread, I'll focus on:

⚡️Names
⚡️Microgroups
⚡️Deflection
3/ Engage Learners - Names

Use them!

Seems basic. How many reports have you been to where the facilitator did not use (or perhaps did not know) learners' names?

When I was a medical student, esp with a non-Western name, I can tell you it was near 100%
Read 21 tweets

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