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CHAMP Teaching on Today’s Wards Session 1 – Improving the Process

CHAMP Teaching on Today’s Wards Session 1 – Improving the Process. Chad Whelan, MD Julie Johnson, PhD Paula Podrazik, MD. Today’s Agenda . 10:00 – 10:10 Overview of Teaching on Today’s Wards, Sessions 1-5 and Introduction to Session 1 10:10 – 10:30 Introduction to Mapping the Process

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CHAMP Teaching on Today’s Wards Session 1 – Improving the Process

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  1. CHAMPTeaching on Today’s WardsSession 1 – Improving the Process Chad Whelan, MD Julie Johnson, PhD Paula Podrazik,MD

  2. Today’s Agenda 10:00 – 10:10 Overview of Teaching on Today’s Wards, Sessions 1-5 and Introduction to Session 1 10:10 – 10:30 Introduction to Mapping the Process 10:30 – 11:15 Small Group Exercise 11:15 – 11:25 Break 11:25 – 11:45 Debriefing from Small Group Exercise 11:45 – 12:00 Take Home Points and Homework Assignment for Session 2

  3. Teaching on Today’s WardsOverall Objectives • Recognize teaching as a process • Review & affect barriers to teaching • Link to Clinical Teaching course • Link to ACGME competencies • Develop Strategies for • Improving teaching on today’s wards • Teaching ACGME competencies • Learn some new tools for applying these strategies

  4. Clinical Teaching CourseImproving Your Teaching • Learning Climate • Control of Session • Communication of Goals • Promoting Understanding and Retention • Evaluation • Feedback • Promoting Self-Directed Learning

  5. ACGME CompetenciesWhat are they? • Patient Care • Medical Knowledge • Practice-based Learning & Improvement • Interpersonal & Communication Skills • Professionalism • Systems-based Practice

  6. Teaching on Today’s WardsSession Outline Sessions #1-2 • Review your teaching process — successes and barriers • Recognize how your process influences the decisions you make Sessions #3-5 • Teaching systems-based learning • Teaching practice-based learning • Teaching lifelong learning

  7. Teaching On Today’s WardsSession #1 Objectives • Learn generalizable process mapping skills • Recognize teaching as a process • Map your teaching process • Link to communication • Link to professionalism • ID successes and problem areas

  8. Teaching on Today’s WardsSession #1 • Intro. –teaching process on the wards • Overview of the month-long process • Setting goals • Setting expectations • When can teaching occur? • Preventing burn-out

  9. Teaching on Today’s WardsSession #1 • Overview of the day on the wards • Setting goals • Setting expectations • ID the teachable moment • Incorporate the clinical trigger • Maintaining Balance!!!?!!!?

  10. What is your Primary Goal when on the Wards? • Achieving Excellence in Clinical Care and Teaching • Providing outstanding teaching and clinical care, getting your work done, getting residents home, and maintaining balance

  11. Teaching on Today’s WardsSession #1 • Intro. to mapping the teaching process • Demonstration of sample teaching maps • Link to teaching professionalism • Link to teaching communication • Small Group exercise

  12. Process Mapping • A process map or flowchart is a picture of the sequence of steps in a process • Useful for • Planning a project • Describing a process • Documenting a standard way for doing a job • Building consensus about the process (correct misunderstandings about the process)

  13. Process Mapping • Ovals are beginnings and endings • Boxes are steps or activities • Diamonds are questions • Arrows show sequence and chronology

  14. “The first step is to draw a flow diagram. Then everyone understands what his job is. If people do not see the process, they cannot improve it.” W.E. Deming, 1993

  15. Process Mapping • Can be “high-level” to get an overview of the process Bedside teaching? Team meets in work room Go to see patient Go to next patient Rounds complete No Yes Make teaching point

  16. Process Mapping • Can also be very detailed and “drilled down” to show the details and roles Team meets in work room Team has test results to review Team prioritizes order to see patients Team Discusses routine patients Team leaves work room

  17. Process Mapping • Detailed process maps are especially helpful to standardize and improve processes • For use as an improvement tool, it is important to map the current process, not the desired process

  18. Process Mapping • The teaching process • Sample maps in handout • Disclaimer before looking at maps • The evidence about how to teach/where to teach is mixed • There isn’t a wrong or right way – they are just different

  19. Process of TeachingPost Call Day – Case Study 1

  20. Process of TeachingPost Call Day – Case Study 2

  21. How Are These Processes Similar/Different? • What, if anything, surprises you about the maps? • What are some similarities between the maps? • What are some differences between the maps? • Where are links to communication and professionalism

  22. Small Group ExerciseMapping Your Process • The Goals of this exercise are to • Learn how to create a process map • Recognize teaching as a process • Recognize the differences in our teaching processes • Instructions • Form a dyad • Interview each other to create the first draft of the process map of your post call day

  23. Demonstration • Mapping Chad’s process (a hypothetical process for example purposes)

  24. Small Group ExerciseDebriefing • Re-group discussion session • What insights do you have about your teaching process? • Where in your process does teaching occur? • Where does teaching not happen because of clinical care needs?

  25. What are some of the barriers to teaching on the wards?

  26. Some of the barriers we came up with . . . • Time constraints • Misdiagnosis • Maintaining resident interest • Power struggles • When can I call it a day? • ???

  27. Take Home Points from Process Mapping • Everyone has his/her own style for teaching • Being explicit about your process for teaching will provide insight into how to improve the process / overcome some of the barriers • This type of exercise can be applied to any issue that you want to understand and improve – the method can be generalized

  28. Homework Assignment • Finalize your process map • Review your process teaching map • ID the successful portions of your map • ID the problem areas of your map • Link your process to the best places to teach communication and professionalism • Where does your process serve you well? • Where does your process start to interfere with the ultimate goal of achieving excellence in teaching? How will these teaching activities affect providing clinical care?

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