Family Centered Rounds: Bedside Teaching on the General Pediatrics Wards
I spend the majority of my face to face time teaching students and residents in my role as a hospitalist during patient care on the general pediatrics wards. I usually have 1-2 weeks per month of clinical time. Our team consists of a senior resident, 1-2 interns and 1-2 junior medical students as well as the nurse, usually a pharmacist and other support staff as needed. We perform Family Centered Rounds each morning, which is a multidisciplinary team approach to providing patient and family centered care, held in the patient’s room with family input and the goal of clear communication to all parties. The feedback below includes input from junior medical students, interns and senior residents who worked with me for one of two recent weeks over a month long period, as well as from faculty who directly observed my teaching and facilitation of Family Centered Rounds.
Raw Hospitalist Faculty Feedback on Bedside Teaching Using PROPS Observation Form
I am a co-leader of a peer observation/mentoring project called “PROPS” (see Active Projects) within my hospitalist division that involves our directly observing each other in this setting. I have included this rich data as it mirrors and expands upon that desired by the peer and expert forms provided in this practicum.
Raw Hospitalist Faculty Feedback on Bedside Teaching Using Peer and Expert Forms
Additional Peer Evaluation of Family Centered Rounds Using Peer Forms
The first peer evaluator, Dr. K Fernandez, is an established medicine-pediatrics trained physician who has been practicing as a hospitalist in both divisions for 8 years. She is known to provide a thoughtful and engaging learning environment and creates an environment of clinical inquiry. She is our local expert on Evidenced Based Medicine and teaches this to the residents. The expert evaluator, Dr. B Mizuo, is an excellent pediatric hospitalist who has also been practicing for 8 years. I consider him an expert in education as he has completed a higher degree in medical education through the John A. Burns School of Medicine/University of Hawai`i Office of Medical Education and is known to receive positive evaluations from learners. He is the director for our sub-internship program at KMCWC. The second peer evaluator, Dr. R Salyer, is a pediatric hospitalist who completed his chief residency two years ago and has been a welcome addition to our group. Residents and students find his teaching style engaging and desirable.
Raw Student and Resident Wards Survey Monkey Feedback
Provided anonymously through a survey monkey tool sent to the two teams immediately following their learning experience on the wards. This survey was sent to a total of two senior residents, three interns and three medical students. Five total people (with unknown level of training) have completed this survey to date (63%).
Wards Resident Feedback 2012-2014
Collated feedback from all three levels of pediatric residents in our program over the past few years who have worked with me as an attending on the general pediatrics wards. I pride myself on the recurrent theme of learners feeling safe, supported, and in a positive learning environment.
Summary and Reflections on Bedside Teaching on the Wards
Here I have provided my thoughts about the feedback I received, and my growth as a clinician educator as a whole.
Inpatient Pediatric Asthma Lecture/Module
This is a basic lecture about asthma that I give to medical students and interns on the pediatric wards. I have revised this powerpoint presentation recently while in this course to reflect my current location in Hawai`i as well as to embed more questions and interactivity into the format. I hope for this talk to be adapted for use as a self-directed module as well, when learners are not able to attend an in-person lecture. It is broken into two parts which I have posted below. The video clip is me giving the Part 1 lecture to a medical student audience.
Link to a .pdf of Part 1 of my powerpoint slides: Inpatient Asthma I
Link to a .pdf Part 2 of my powerpoint slides: Inpatient Asthma II
My two talks in the powerpoint version are very interactive and include animations that allow for better audience participation (i.e. waiting for learners to answer questions that are posed); this is lost in the .pdf version.
Expert Evaluations of Asthma Lecture
Dr. Kyra Len is a respected pediatric hospitalist of nearly 10 years and is also our pediatric clerkship director as well as an academic leader at the medical school. She is one of our students’ and residents’ favorite teachers, and has also completed a higher degree in medical education through the John A. Burns School of Medicine/University of Hawai`i Office of Medical Education. Mrs. Nancy Fahner has over 40 years of experience in education as a secondary school teacher and now as the Executive Director of the Michigan Association for Supervision and Curriculum Development. She regularly provides consultation to educators looking to improve their content and delivery of material. Mr. Gerald Fahner was a secondary school teacher for over 33 years and is an avid lifelong learner and an amazing teacher.
Peer Evaluation of Asthma Talk Part 1 & 2
Dr. Coral Yap is one of our excellent pediatric chief residents this year, and is known for creating positive and fun learning environments. She attended both sessions of my live asthma talk in person and provided this helpful feedback.
Self-Evaluation Form Asthma Lecture
I-PASS Training Workshop
I have been part of the faculty facilitator pool for the I-PASS method of handoffs workshops that we have given to the JABSOM medical students over the past two years. This year I facilitated two small groups of 2-4 students each while working through patient cases and simulating a handoff environment so they could practice using the mnemonic and tools they had learned earlier in the workshop. The students completed this anonymous evaluation after we had interacted in this capacity.
I-PASS Website: This provides information about the I-PASS method of handoffs and includes the workshop materials that were used for the training workshops I helped to facilitate.
Medical Student Feedback on I-PASS Workshop Facilitation
Tablet Computers in Medical Education Grand Rounds
I have participated in many activities related to this topic over the past few years with my colleagues (see more under Products of Educational Scholarship) as our medical students and residents had all received tablet computers, and therefore our medical education team decided to further our expertise in this area, which led to many regional and national presentations. This clip was a segment of Grand Rounds that I gave along with the pediatric clerkship director and our pediatric program director. The quality of the video is suboptimal, and the majority of the time the focus is on the screen, but was still useful for self-reflection.
If the camera person had focused on me more, I would have had a better idea about my body language during Grand Rounds. In general, it seems that I could improve my eye contact with the audience and try not to use expressions that are nonessential (i.e. “umm”).
Faculty Development: Pediatric Hospitalist Retreat
Each year our division of 17 people takes time away from the hospital for a retreat, at which we regroup and embark upon Quality Improvement projects together. This past year, I led the session with our division head, Dr. Lora Bergert, setting the stage for the PROPS project (see Active Projects for more details). This pdf does not show the links to videos that we referenced during the retreat but in general the videos were examples from Cincinnati Children’s and DC Children’s physicians who were performing well on Family Centered Rounds. Our division members practiced scoring the people in these videos for specific elements of performance as part of the training on how to use the observational tool that we developed as part of this study. The retreat was a success. There is some information on the pre-surveys that is too sensitive to post online, however as I was using that as one of our assessments for this retreat, I will summarize in saying that the majority of division members found value in this topic of studying and improving our Family Centered Rounds and have participated regularly in study activities since this retreat.
Slides from Family Centered Rounds Retreat
All Resident Orientation Lecture: Sleep Deprivation and Fatigue
This is a mandatory lecture that I developed on sleep deprivation and fatigue. All residents must have exposure to this topic during residency; I gave this talk at the initial multiprogram orientation session hosted by our overarching residency program employer. The feedback I received was positive and was from the CEO of the orientation sponsor (Hawai`i Residency Programs). Also, not too many participants were sleeping at the end of my talk, which I took as good feedback given the audience was subjected to a full day of lecture after lecture in a large nondescript lecture hall.
Intern Orientation Session: Giving Meaning to the White Coat
This is a very popular “feel good” session that I have given during the last two years of intern orientations on the morning just after they have received their first long white coats. It is meant to be an inspirational and motivational talk on their newfound responsibility to their patients as young physicians. Evaluation data below from collated resident feedback includes a section for this talk.
Clips in this Prezi include from the TV shows Scrubs and Grey’s Anatomy as well as from the movie “House of God.”
Conference Evals 2013 Including Giving Meaning to White Coat Talk
Board Review Sessions: Examples
I have devoted quite a bit of time towards helping pediatric residents prepare for and successfully pass the General Pediatrics Certifying Examination (“the boards”). I facilitate and manage a monthly board review on a specific high yield topic recently covered in the Pediatrics in Review journal to encourage residents to keep up with their reading. The monthly sessions involves the entire resident group through friendly team competition.
This clip below is of me giving a monthly board review session to all of the residents at Academic Half Day on the topic of Neonatal Respiratory Distress.
Specific evaluations for this session:
Raw Resident Conference Evaluations for Respiratory Distress Board Review Session
Self-Evaluation for Respiratory Distress Board Review Session
General evaluations for my board review sessions:
Academic Half Day Evaluations 2013: resident evaluations on multiple board review sessions throughout year
Academic Half Day Evaluations 2014
I also have developed an intensive senior resident level board review for those about to graduate. Here is an example of my initial “pep talk” and orientation to senior board review series: Serious Senior Surfing Kickoff Slides. When surveyed, our graduates found this helpful and that it added to their successful preparation for the boards.
GraduateBoardReviewFeedback: general feedback data from graduates of our program when asked about board preparation
Faculty Development: Using the Pediatric Milestones in Resident Evaluations
I presented versions of this talk at both a faculty-wide meeting as well as at a smaller subspecialty group meeting in attempts to better educate faculty on using the milestones properly to assess residents. The exercise that was a handout provided for faculty to complete individually or in small groups was given at the conclusion of the talk, therefore the scores that people assigned to the learners would be reflective of their proper use of the milestones’ scales and possibly indicate their attention/my quality of presentation. Overall the faculty did quite well in rating these various levels and types of learners.
Faculty Development Presentation on Using Milestones in Resident Evaluations
Milestones Faculty Development Exercise