Thank you for inviting Frank Stritter and me to join you today at Marshall

2. Thank you for inviting Frank Stritter and me to join you today at Marshall

3. Content of our Half-Day with you Theories of Learning Applied to Teaching. F. Stritter Improving Teaching and Learning in Different Settings. W. Herbert Instructional Options. F. Stritter Making the Most of Teaching and Learning Opportunities. W. Herbert

4. What We Hope Will Be the Outcome:You will….. focus more on teaching/learning appreciate specific methods of teaching and learning feel more confident in both your teaching and learning abilities have a good time this morning

5. Conduct of the Morning Interactive and lively Informal Discussion/Questions welcome

7. Improving Teaching and Learning in Different Settings Marshall University Wm. N. P. Herbert, MD University of Virginia

8. I have no financial conflicts to report. However, the 7th edition of our textbook Obstetrics and Gynecology (Beckmann and Ling) is coming out from LWW next year, and it’d be nice if you’d buy a copy.

9. Let’s start with a short puzzle…. When you know the answer, raise your hand, but make no sounds, please, or look around

10. Move one slanted or vertical bar to correct this equation: \/ = III + I + III

11. V = III + I + III to \/ I = II + I +III

12. What did you think about while trying to solve that puzzle?

13. “Please Prepare to Learn” Focus on teaching and learning Check your emails one more time, but not any more until we break Put cell phones on “airplane” mode and don’t look at them Put pagers on “vibrate” mode Sit back and think

14. OutlineImproving Teaching and Learning in Different Settings Introduction/Background Learning Settings: Clinical/Didactic Teaching in the Operating Room

15. Introduction and Background

16. What is teaching and learning anyhow? What are the differences among parenting, teaching, and coaching?

17. “They call it coaching, but it is teaching. You do not just tell them…..you show them the reasons.” Vince Lombardi

18. What are the characteristics of a good teacher? a good learner?

19. The single most important criterion for effective teaching and learning is ENTHUSIASMon the part of both the TEACHER and the LEARNER

20. Experience is a great teacher. Teaching is a skill, learned like performing surgery.Junior learners need very little, but they need the very little very much.

21. Regardless of setting, learning is more likely to occur when…. Instruction is problem-centered A supportive environment exists Instruction is experience-oriented Learners receive feedback

22. Learning Settings:ClinicalDidactic

23. Learning Settings Settings --- Clinical, Didactic Advantages and Disadvantages of each Opportunities to improve

24. Teaching in the Clinical Setting Advantages One on one time Direct observation Specific patient involvement Real life scenarios Limitations Pressures of “productivity” Variability of clinical situations Time with patients vs time with learners

25. Clinical Settings Resident Clinics Private Office/Faculty Clinics Operating Room Labor and Delivery Shift Turnover Bedside Rounds Teaching Rounds What’s good? What’s bad? How to improve?

26. Didactic Teaching and Learning Advantages Efficient in transmitting information Multiple contributors Limitations Can be boring as hell Little interaction; usually not “active” learning

27. Didactic Settings Grand Rounds Faculty Lectures Resident Lectures Journal Club Subspecialty Conferences Morbidity/Mortality Conferences In-training Exam Preparations What’s good? What’s bad? How to improve?

28. Teaching in the O.R.

29. Teaching in the Operating Room Who needs to be there? Who decides? Does the type of surgery matter? Prioritization of learners: Sr level, then Jr level, residents Medical, then non-medical students

30. B I D Method B riefing I ntraoperative D ebriefing

31. Prep and Briefing Who is learning? Background? Skills? Scrubsink Conversation: Overview of procedure/indications What do you want to learn today? Have you done this before? What are the danger points?

32. Intraoperative Teaching Assign a “teacher” to describe what’s going on Use a laser, camera Other potential topics to discuss Common complications Anatomy What if….

33. Debriefing As soon as possible after the case Reinforce what went right Correct mistakes. Next time…… Roberts NK et al. J Am Coll Surg. 2009;208(2):299-303

34. Take Away Points Teaching doesn’t just happen; it’s a process, and it takes work Enthusiasm for T/L is the most important factor Methods of teaching depend on the setting

36. Making the Most of Teaching and Learning Opportunities Marshall University Wm. N. P. Herbert, MDUniversity of Virginia

37. OutlineMaking the Most of Teaching and Learning Opportunities Teaching in the O.R. (First session) Teaching on Rounds Teaching in the Ambulatory Setting Evaluation and Feedback Value of “Lists” Teaching Patients

38. Teaching on Rounds Role modeling Meeting family members Physical exam findings Asking questions Looking for support

39. Effective Ambulatory Teaching Make learning active; ask questions Orient and focus Have objectives Coach; “blow the whistle,” give feedback Be positive role model Provide tips

40. One Minute Preceptor Assign a learner a task, usually to get a patient’s history, and to report his/her findings to you

41. The One Minute Preceptor Get a commitment: What do you think… Ask for supporting evidence: What makes you think that…. Teach general rules: When a patient has abnormal bleeding, the first thing… Reinforce what was right Correct mistakes Neher et al. J Am Board of Pract 1992;5: 419-424

42. The Educational Sequence

43. Teaching/Learning (T/L) is Like a Meal Say grace --- Prepare/Setting Appetizer --- Orient/Expecations/Whet appetite Entrée --- The main of T/L/The “experience” Dessert --- The wrap up/Debriefing Coffee --- Reflection/Feedback Leave the table --- Act

44. Before: Preparation and Setting Team Climate Orientation Expectations

45. Supportive Environment: Tips Recognize that expectations vary Clarify expectations, discuss goals Solicit their knowledge/experiences Listen with intensity Show enthusiasm and energy

46. Active (Engaged) Learning Ask lots of questions Let learners make decisions Set the stage for participation Involve everyone Hush! Give learners time Link new information to old Have learners summarize

47. During Role modeling One-minute preceptor

48. After Debriefing Feedback Evaluation

49. Feedback and Evaluation What’s the difference?

50. Evaluation is the process of making a value judgment about the adequacy of a learner’s performance. Evaluation is a grade.