February 2013: Tweeting Teachers

Twelve tips for using Twitter as a learning tool in medical education. Forgie SE, Duff JP, Ross S. Medical Teacher. 2013, January; 35L: 8-14. Available online.

We all know it, but it bears repeating: teaching is about the learner, not the teacher. And, learners can be tricky. Fortunately, there’s an app for that. Or, so say the authors of the article highlighted this month. 

In their “Twelve Tips” feature in Medical Teacher, Forgie et al. push Twitter (and Tweeting, Tweeple, Twittory, and Twit) into our apparently stodgy medical education vernacular.  Make no mistake, the article is first and foremost an embarrassingly helpful foray into social technology. Stepping back, though, the authors present a fresh solution to an old problem: how do we continue to make teaching about the learners? 

Presuming that your learners are comfortable with Twitter and the integration of technology, this article neatly highlights several opportunities for the adaptability of standard educational processes (evaluation, self-reflection, feedback, sharing literature) into Twitter. So, after reading this article, are you going to run to your computer (or mobile device), set up a Twitter account, and start counting your characters? Perhaps.

But what might be more likely – and more effective – is for you to use this article as an impetus to think proactively about opportunities to make your teaching more about your learners. Twitter is one way. There exist other technologies which can tap into such basic principles of adult learning, such as audience response systems, online learning sites, or sites to freshen up your presentations. Experiment with innovative teaching strategies. With all this opportunity, all that stands between you and learner-centered teaching is remembering your username and password.

Bottom Line:

140 characters can be the distance between you and your learners: how else can you bridge the gap? (98 characters)

January 2013: Innovations in Innovation Outcomes?

Educator perceptions of the relationship between education innovations and improved health.Friedman SR, Loh LC, Burdick WP. Medical Teacher. 2012, October; Early Online: e1-e8. Available online.

Innovation in health care education is in high demand. Institutions have innovations grants and innovations awards. Through formal and informal channels, we promote, cultivate, fund, and sustain innovative efforts. Indeed, medical education journals are riddled with descriptions of educational innovations¹, including innovations designed to cultivate innovation.^2,3 As editor of Academic Medicine, Steven Kanter even wrote an editorial helping us critically analyze our innovations for publication.⁴ His editorial, and the prevalence of innovative projects in the literature, shed light on the role and value of dissemination of educational innovations toward the improvement of practice.

This month, though, we use this article by Friedman and her colleagues up north to revisit the outcomes of our educational innovations and examine how they might extend beyond practice to public health.

After surveying faculty in Brazil and India, the authors generated a framework to understand how faculty believed their educational innovations contributed to health improvement. Mainly, the authors found that faculty believed the structure and process of their educational innovations improved the quality, quantity or relevance of health care education, which they then believed led to improved outcomes in public health.

Methodology in this article is not incredibly rigorous – a survey is distributed to an admittedly “relatively small and non-representative sample of faculty from two countries.”^{(p. e7)} However, the authors do explore that critical link between health care education and health. Beyond that, they suggest that we, as innovators in education, explore that critical link as well. They argue that the links between educational innovations and public health improvement “impact what types of education innovations are implemented, or even conceived.”^{(p. e7)} In other words, are we confident that we promote, cultivate, fund, and sustain educational innovations that are designed to improve public health? This article does not provide the answer, but it does encourage us to develop the question.

Bottom Line:

Innovations are critical to continued improvement in clinical education. Read this article, and those referenced below, to own your role as an innovator. The framework presented in this article suggests that your local innovation could have a broad impact. 

References

1. Anderson MB. A peer reviewed collection of reports on innovative approaches to medical education. Medical Education. 2012; 46(11): 1099-1100. Available here.

2. Armstrong EG, Barsion SJ. Creating “Innovator’s DNA” in Health Care Education. Academic Medicine. 2013; 88(3): 1-6. Available here.

3. Andolsek KM, Murphy G, Nagler A, Moore PR, Schlueter J, Weinerth JL, Cuffe MS, Dzau VJ. Fostering creativity: How the Duke graduate medical education quasi-endowment encourages innovation in GME. Academic Medicine. 2013; 88(2): 1-7. Available here.

4. Kanter SL. Toward Better Descriptions of Innovations, Academic Medicine. 2008; 83(8): 703-704. Available through the Health Sciences Library.

December 2012: Overcoming Adverse Events

Waking up the next morning: surgeons’ emotional reactions to adverse events. Luu S, Patel P, St-Martin L, Leung ASO, Regehr G, Murnaghan ML, Gallinger S, Moulton C. Med Educ. 2012; 46: 1179-1188. 

Adverse patient care events, defined in this article as injuries “caused by medical care rather than a disease process,” can profoundly affect practitioners, leading to many painful outcomes including “burnout, depression, guilt and shame.”^p.1180  

In this article, Luu and her colleagues present the results of interviews with surgeons in two phases; the first during which they spoke with surgeons about past events and the second during which they spoke with surgeons about recent adverse events. The results are powerful. 

As educators, we are responsible for teaching a lot of skills to residents and students in a short period of time. We teach through lecture, feedback, demonstration, and simulation. But we are not just teaching technical skills, communication tools, and professionalism. We are also teaching our learners about the profession of a doctor, a nurse, a therapist.

Baystate is continuously regarded as an exceptional teaching institution, valuing with equally high regard our current patients and our future patients. So, by giving our learners insight to our vulnerabilities – by sharing with them the ways that we navigate experiences in which we are uncertain – by doing our part to ensure that students and residents are not only mastering learning objectives but are maturing as caretakers – it is then that we also affirm our appreciation of our learners’ personal development and their emotional wellbeing.  The present article highlights the difficulty of navigating emotional responses to adverse events and, in doing so, presents a learning opportunity for students and teachers.

Bottom Line:

Adverse events can be intensely personal and emotionally troubling for practitioners. Use this article as a starting point for conversations on the difficulties associated with being the ‘second victim’ in an adverse event. Educational opportunities, including debriefing after adverse events, can provide a way for both teacher and student to navigate these times.