A multidisciplinary approach to teaching residents to teach.

Abstract

Ojective: Southern Illinois University (SIU) sponsors 300 residents in 17 different programs. In 1997 we introduced an institution-wide curriculum, Universal Issues in Medical Practice, and have delivered 11 sessions of it to date. This report focuses on one component of that curriculum, Residents as Teachers (RAT). Because all senior residents, regardless of specialty or program, are responsible for teaching students and interns, there was a need for training in teaching. Description: The RAT component is a ten-hour program consisting of an evening meeting followed by a highly interactive six-hour skills-development session that next day. We limit enrollment to 30 second-year residents and above. We offered the course twice in 1999, once for the surgical and again for the non-surgical specialties. An experienced facilitator/educator who has conducted such seminars internationally, primarily for surgical faculty, leads both programs. She is paired with a senior SIU faculty member interested in helping residents hone their teaching skills. The evening meeting is a relaxed “warm up” over dinner that provides an overview, sets expectations, and introduces the concept of the “resident as coach.” For the surgical group, the next day's session covers evaluating performance, teaching psychomotor skills, clinic teaching and questioning skills, effective feedback, bedside teaching, and leadership skills (for senior residents only). We omit the material psychomotor skills during the session for the nonsurgical specialties because we could not identify a psychomotor skill that was shared by pediatricians and psychiatrists, for example; we substitute material on planning and delivering lectures that “stick.” A ground rule for all sessions is that they are interruption-free. Pagers are shut off and the participating residents are signed out to colleagues or attendings. The seminar uses and reinforces the same teaching skills that we are trying to impart to the resident. Each participant receives a syllabus that also serves as a workbook. Each session uses a learner-centered rather than an instructor-centered approach. Participants are given realistic teaching scenarios, are involved in role-playing, and have ample opportunity to practice teaching skills in breakout sessions. Discussion: By offering the RAT course (and the other Universal Issues courses) across specialty lines we have ensured that all residents, even those from small training programs, have access to such sessions. Evaluations by participating residents in the RAT course have been collected. The course has been one of our most popular, with 47% of the residents rating the course extremely valuable, 47% very valuable, and 6% valuable; 83% rated the quality excellent, 17% very good. We are also trying to specifically measure the impact of the RAT seminars on the participating residents' teaching skills. We have developed a uniform evaluation instrument that specifically addresses the skills taught in the course. By surveying students and residents who have worked with the participants before and after they take the RAT course, we are evaluating whether we can detect a different in the participants' teaching skills and whether these skills improve or deteriorate.