Grounding your teaching

This past week I've been brainstorming about the CEEP teaching session, thinking about 
two things in particular:

1. What information will be high-yield for the clerks (including my classmates who will be 

starting residency in a few months), and

2. What is it that makes a teaching session good?

Over clerkship we've had countless clinical teaching sessions put on by residents, staff, and our own peers. When I think back to those presentations that really hit home (or even register more than once in my memory), a few key features come to mind:

1. Starting with a story

Countless medical lectures have taught us that having a patient in front of us sharing their unique story about how they became sick, and their experience with their illness is often far more impactful and motivating in furthering our own knowledge, than simply picking up a textbook and diving into a particular topic. A story can often situate you quickly into a particular environment, allowing you to build a an understanding of the clinical encounter, and begin to lay the foundation for your learning about a particular case. In fact, I've found it especially helpful when teachers periodically "zoom out" to reconnect to the initial case, ensuring that the group still understands the relevance of the Hx/Px/Invx to this patient's presentation.

2. Make it relevant (give the people what they want!)

Another good motivator is a known gap - for instance, knowing that you always wonder whether the patient you're admitting - who has diabetes - should have their medication adjusted. I remember a particularly useful review session on hypercalcemia, where the presenting resident messaged our cohort before the session, and asked everyone to send in specific questions they had about the topic. This not only helped to engage us as learners in the topic, but also made it especially relevant, creating space to answer those questions we had had overnight on-call, or address concepts we had failed to really get our heads around, despite prioir attempts. Similar to highlighting a patient story, it can be just as useful to frame the approach around common questions we as trainees pose to ourselves, colleagues, and supervisors when working through a given clinical problem. 

3. Provide clinical pearls

When working through comprehensive approaches, DDx, and management plans, it can be easy to get lost in the forest of information. To ensure you still get some use out of the session, many staff will anchor your attention in a few key clinical pearls about the case - when this is done well (and throughout a given presentation), it can also help learners further build their understanding around these key features. In addition to promoting gross understanding, identifying clinical pearls can also serve as an opportunity to review important patient safety items, which can increase the confidence of more junior trainees who may have reservations about particular clinical entities for fear of not being able to care for patients safely.

4. Connect to useful resources/situate in real clinical setting

The last item I'll discuss involves providing learners with tools to simulate engagement in their real clinical environment, with the aim of developing skills, and making it that much easier for trainees to situate themselves in their role that next time they have a patient with _x_.  Recently we had a seminar where we had the chance to practice filling out ODSP forms; this served to not only familiarize our cohort with the form itself, but allowed us to envision that particular clinical encounter, and what we would need to discuss with our patients to help address this important piece of their care. One of the topics I'm considering for my presentation involves in-hospital diabetes management, and over the weekend I found helpful flow sheets (published online) that I could see myself making use of on the wards, as an adjunct to my own management plan. Providing these tools in your session allows learners to walk away with a sense of how they might actually operationalize their plan for a given patient. 

Reflecting on these items has given me some food for thought about how I'll approach my own presentation this week - over the next few days, I'm looking forward to briefly scanning the literature for other tips and tricks, as well as checking in with my colleagues on what works to them, to try to make the session as worthwhile as possible for the third and fourth year clerks. 

-AS