Author: Salim Resaie

Editor: Rob Cooney

 

Sir William Osler, the father of beside teaching once said let the patient teach you.  His famous quote, “Medicine is learned at the bedside and not in the classroom…live in the ward,” rings true even in a busy emergency department.  Education on a busy clinical shift can help you solidify your ideas in patient care in a way that you can not only explain things more simply to learners, but also facilitate better decision making. The problem is, we are pulled in multiple directions during a busy shift. This creates barriers and difficulties in teaching everyday. Our goals as physician educators should be to provide excellent/compassionate patient care while teaching the art and science of medicine, despite these barriers. Teaching in a busy emergency department is possible, though not easy. Every shift in the ED is different and just like we adapt what we do everyday in patient care we should be able to do the same with teaching.

 

 

Salim Rezaie’s Clinical Education Hacks

 

Hack #1: Care for Your Learner

Create a Positive Learning Environment: Investing 5 minutes at the beginning of the shift makes a world of difference for learners.  Learning names adds a personal touch and makes learners feel more comfortable.  No one likes to be called med student or resident.  You can use this time to find out about them, inquire about their learning goals, and set expectations for the shift at hand.

Hack #2: Seize the Opportunity

The Teachable Moment:  This should really be called the learnable moment.  This allows you to discuss one targeted educational pearl.  In this scenario you can use the patients case to discuss one specific pertinent point.  The pro here is that it is fast and great for a busy shift, but the con is there is no real depth of exploration of knowledge.

Hack #3: Teach in Small Amounts

Teaching Scripts:  These are mini lectures that have been prepared ahead of time on a specific topic.  You can create a portfolio of these topics.  One way I have done this is by creating an Instagram page: https://www.instagram.com/rebelem2013/ .  This is a series of clinical pearls that I have acquired over the years.  This library will continue to grow with time and topics can be reused.  These are great for first thing in the morning or in the middle of a night shift if things are slow.

Hack #4: Use On Demand Learning

Teaching Procedures: There are so many great online resources now.  Start by asking the learner their knowledge base. Next you can direct them to an online video of how to perform a procedure.  One example of this is EM:RAP online procedure videos: https://www.youtube.com/user/EMRAPMEDICAL . The beauty of this is while you are performing other tasks, the learner is watching a video on how to perform a particular procedure. The con is make sure you have watched the video first, as not everything is filtered online. Another great resourse is the NEJM video library found here: http://www.nejm.org/multimedia/medical-videos .

Hack #5: Finish Strong

Closing the Shift Out:  Generally, at the end of a shift we have to give a learner feedback on the shift.  What went well and what didn’t go well.  This is a great time to ask them, to tell you three things they learned while on shift.  It helps solidify ideas for the learner, gives a spaced repetition component to their learning, and shows investment in their learning.

Conclusion:

Remember, as a physician educator you have to put effort into teaching on a busy shift.  Education does not just happen, but it also doesn’t have to be impossible. The goal of education is to close the gap between a learners current knowledge and the desired goal of better patient care.  Be the difference in your learners education, as one day, these will be the people caring for us and our loved ones.

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