This Trick of the Trade focuses on teaching learners in the ED.
After a shift, we often review the day's case with our learners. We sometimes ask them to self-reflect.
I often used Demian's 'Plus/Delta' approach and ask 'What did you like /what would you change?'
This approach works well mostly. But, when the answer is 'I don't think I would change anything', it is hard to target teaching and feedback to the learner's need.
Trick of the Trade: What case did you like the least?
Recently, I started asking this question, 'What case did you like the least?'
I like it since the learner now clarifies their learning need. This sets the stage for a meaningful exchange suited to the specific learner. This ties in with the coaching theme that was reviewed previously.
Sometimes the answer would not be what I expected at all. For example, a star internal medicine resident expressed hesitancy about suturing, and an excellent emergency medicine resident wanted more independence. Without this probing question, I might not have picked up on those needs.
What other ways do you coax learning needs?
Great post and great idea Stella! I'm going to try that.
ReplyDeleteI've been working from the other end recently, asking residents and students to set learning goals at the beginning of the shift to make the learning a bit more deliberate as opposed to fortunate or opportunistic.
I find that when we set tenable goals ie: Improve my knee exam, or present a clear plan, we often reach them. On the other hand, I have also noticed that some residents seem a bit surprised when I pose this question at the beginning of the shift. When that happens, I explain my logic and goals, and propose we come together at the end of the first hour of the shift to agree on a goal for the remainder of the period.
Has anyone else tried this?
Demian
I will have to try this trick. Recently I've been telling the residents/students that my job is to teach them at least one thing every shift. We then both keep a lookout for topics to learn about. This also keeps the door open for them to ask me questions. Great idea, Stella.
ReplyDeleteThanks Demian and Michelle.
ReplyDeleteDemian, I use your technique as well. I sometimes have residents who say 'Wow, I have never thought of that. I usually just see whatever comes in.' I try very hard to make them think of something (anything!) to work on and yes, concrete goals are so much more attainable.