7 Organizing Tips to Jumpstart Your Medical Board Preparation

Successful board passage requires several things, among them—a strategic plan, a schedule, discipline, and motivation to stay on task, a comfortable and convenient place to study, and successful learning and test-taking skills. It also requires organizational skills that can increase your productivity. One place to begin is by organizing your study area to set the tone for a successful learning experience. Start by getting your office space, computer, smartphone, and resources ready to go. Office essentials include a desk, a chair (preferably ergonomic), and a lamp (preferably with cool LEDs). Here are seven tips that can position you for a successful learning adventure.

  1. Clear your desk (and office) of clutter. A desk that is too large can often invite clutter. Organize your desk to facilitate work by keeping only the basic office tools at hand. Optimize under-desk storage whenever you can. Most of us also find it easier to focus when our offices are also free of clutter—do what you can to eliminate (or move to another location) items that you’re not using.
  2. Add a timer to your computer menu bar. There are many free Apps for timers available, such as the Pomodoro Tracker or TomatoTimer. Timers are valuable because they can keep you focused and on track. Learn about the benefits of using the Pomodoro Technique.
  3. Add a folder on your computer desktop for important board-related material. The folder might include email correspondence from your professional society sponsoring the board exam and guidelines on what to take/not take with you to the testing center.
  4. Set a time each day for study-review and schedule it on your digital devices adding an alert feature. It has been said that this is THE most important thing you can do to prepare for boards.
  5. Gather all of your board review material together (e.g., key textbooks, review books, medical dictionary, board review lectures/videos) and place in a bookcase or cabinet in your office.
  6. Create a 3-ring notebook with tabs for board-related information (e.g., the content grid for the board exam, separate tabs for each topic area that contain specific learning issues, notes and other learning aids, and key resources).
  7. Subscribe to an online question bank. If your medical specialty does not have an online question bank, explore other options, like Board VitalsTRUELEARNThe PASSMACHINE. Ask your colleagues for advice on what question bank (and other resources) they found to be most helpful.

Getting yourself (and your office) organized is an important first step in preparing for a successful board review. Now you’re ready to tackle the next important step—actually starting your board review. Visit my blog for additional tips on how to successfully prepare for and pass your medical boards.
_____________

Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians for medical specialty boards (via phone or videoconference). Her academic appointments in allopathic and osteopathic medical schools and teaching hospitals give her a depth of understanding of the obstacles and pitfalls that physicians can encounter as they seek specialty board certification. Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful and more efficient, contact her for a 30-minute free consultation and download her 50 Tips for Successful Board Passage.

 

Coaching for Medical Specialty Boards

Coaching for Medical Specialty Boards

coachingToday, specialty board certification is an expected credential for physicians in clinical practice. However, each year hundreds of physicians across all medical specialties fail their national board examinations. The failure rate for initial certification has been as high as 15% to 30%, depending on the year and the medical specialty. Even worse, examinees that repeat their certification boards generally fail at a higher rate than first-time takers.

Preparing for medical boards is costly (ranging from $1,000 to $2,000 or more), time-consuming (it’s not unusual to spend three to six months or longer in preparation), and stressful (failing national boards can affect a physician’s ability to practice, for example, by losing hospital privileges).

In coaching physicians (at all levels and specialties) who are preparing for their national boards (first-timers and repeaters), I witness frustration and confusion over what they believe it takes to successfully pass the boards. Some have likened board preparation to a cognitive marathon. In fact, one physician shared with me that one of the first things he does to prepare for boards is to change his diet and start an exercise program–this helps accelerate his momentum.

Since content alone is not sufficient for passage, successful preparation requires a multi-faceted approach—a game plan, time management, best resources, and rebooting skills for successful learning and test taking.

Resources for board review include review books, review courses (live or online), and quality multiple-choice questions. While many medical specialty organizations offer board reviews, these programs do not necessarily result in successful passage. Effective review courses share three features—they include lectures and exercises specifically designed to improve metacognition, test-wiseness, and test-taking skills. In their book “How to Study for Standardized Tests”, Sefcik, Bice, and Prerost (2013) reveal that the result of over two decades of research on the impact of review courses on exam performance suggests the review courses do not significantly increase test scores for the majority of individuals who take them.

While it’s important to use a variety of study resources, physicians need to know how to efficiently and effectively use them. Because their time is limited, this is precisely where professional learning coaches can help–by providing strategies and resources to accelerate their work. Here are just a few ways professional learning coaches can turn board failure into successful board passage:

  1. Helping clients diversify their study skills and stay focused. For some individuals, it may mean learning to use metacognitive strategies to plan, monitor, and assess their understanding and performance or add other study skills to add variety and productivity to the review process.
  2. Preparing a “Game Plan” to manage the board preparation experience.  Studying for boards can be overwhelming, so learning how to manage it step-by-step can help reduce the stress.
  3. Increasing client’s efficiency and effectiveness. New ideas and strategies for board preparation, including time management, can increase motivation and improve productivity.
  4. Sharing the most effective tips, tools, and techniques to expand client’s knowledge seeking and test-taking skills. Learning coaches can help maximize your learning potential, provide just-in-time resources, offer aids to make your learning “stick”, and accelerate your review.
  5. Meeting regularly (weekly or bi-weekly) with clients to help them stay on track, not feel alone in the process, and reduce stress. Checking in regularly with your coach keeps you accountable and on task.
  6. Advocating a structured review process that includes specific tasks for each day and weekends. Knowing how to implement a structured review and modify your study as the exam date approaches are critical factors to your success.
  7. Monitoring client’s progress and offering options to increase client’s productivity. Your progress in preparing for boards can be measured in several ways, for example: (a) the number of multiple-choice questions completed; (b) test scores and their trend over time; (c) time spent studying; and (d) your assessment of your progress– identifying what went well or needs improvement and making appropriate changes. 

What explains the high failure rate on medical boards? In a July 2, 2013, blog, David Shaywitz, MD stated two possibilities for the declining pass rate: (1) the test is getting harder; or (2) millennials lack the study habits of their elders because they have become great “looker-uppers.” Obviously, knowing the content is critical for successful board passage, but other issues such as board preparation (by the individual and residency program), the time between residency completion and taking the examination, or resources used play a role. Consider contacting a professional learning coach to make the board preparation process more efficient, less stressful, and most of all, successful.

________
Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians for medical specialty boards (via phone or videoconference). Her academic appointments in allopathic and osteopathic medical schools and teaching hospitals give her a depth of understanding of the obstacles and pitfalls that physicians can encounter as they seek specialty board certification. Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful and more efficient, contact her for a 30-minute free consultation and download her 50 Tips for Successful Board Passage.

 

How to Make Your Board Review Manageable

How to Make Your Board Review Manageable

Screen Shot 2015-02-03 at 1.41.17 PMStaying energized and calm in the face of an impending critical deadline–such as a board exam–isn’t easy, however, there are steps you can take to minimize the feeling of being overwhelmed.

1.  Begin with the date you want to take the exam and work backward to create a review timeline.

2.  Develop a study plan with a schedule. Use the content grid of the board exam to identify and prioritize topics to study. Prepare a monthly calendar of topics to study, and aim to put in at least 2 hrs/night/3 nights per week.

3.  Assess your readiness for passing the exam by taking a recent board exam that your program might make available or that is online (check board review sites).  Identify your areas of weakness and strength and focus your attention on the areas of need.

4. Decide on how much time you need to devote to preparation–three to four months is quite normal, but it depends on your readiness and the amount of time you have available to prepare.

5.  Schedule a regular time to study.  This is THE most important thing to do to prepare for boards! Add these time blocks (e.g., 1 to 3 hours) in your daily schedule. The more specific your calendar entries, the more likely you will actually follow through. Set an alarm on your phone as a reminder. The study is more effective spread out over a longer period of time. Be realistic—don’t schedule more than you can actually accomplish. Be flexible—build in flexibility (i.e., one day off/week).

6.  Use a structured review process with repetitive cycles. Each day review the ‘weak’ topics from the day before. On weekends, spend 3 to 4 hours connecting your learning gaps and consolidating your learning over the past week.

7.  Overcome procrastination by organizing your study area. Put all of your resources together in one place in order to create a distraction-free environment. Work on bite-size tasks. Set a time. Use a reward system. Don’t multitask—it diverts your attention, a process known as switch tasking, which can result in processing inaccuracies and retrieval errors.

8.  Track your progress daily by including topics you’ve reviewed, resources utilized, and the percentage of correct multiple choice questions. Organize a 3-ring binder to record your results, stay on track, and keep you motivated.

9.  Stay energized by maintaining a balanced regimen. Schedule pleasurable activities as well as obligations (color code your schedule).

10. Keep fit and healthy. Break up your study by spending a few minutes every hour stretching, jogging in place, enjoying the fresh air to increase circulation and get revitalized.

Creating a study plan based on your needs and your schedule is a critical first step to easing your anxiety. Breaking the review into daily and weekend chunks create helpful repetitive cycles and repetition.

________

Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians in a virtual venue. Her academic appointments in allopathic and osteopathic medical schools and teaching hospitals give her a depth of understanding of the obstacles and pitfalls that physicians can encounter as they seek board certification. Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful and more efficient, contact her and download her 50 Tips for Successful Board Passage.

 

What is Scholarship in Medical Education?

What is Scholarship in Medical Education?

Over the last couple of decades, a new form of scholarship–“Scholarly Teaching”– has been promoted in medical education. Many educators are finding professional fulfillment and satisfaction as they research academic issues related to their teaching and their students’ learning. Scholarly teaching is based on the same criteria as other forms of research (i.e., clear goals, adequate preparation, appropriate methods, significant results, effective presentation, and reflective critique). Today’s piece describes five opportunities for doing scholarly work in medical education:

TEACHING. Demonstrating excellence as a teacher. Providing better feedback. Improving teaching skills. Conducting educational research–producing papers, publications, book chapters or presentations on health professions education.

CURRICULUM DEVELOPMENT. Developing new and innovative curriculum, courses, teaching modules. Designing innovative teaching methods. Designing assessment tools.

ADVISING AND MENTORING. Developing mentoring skills and programs related to developing expertise as a mentor with respect to career development, such as identifying core values, developing close collaborative relationships, skill development, and structured career planning (i.e., sponsoring, coaching, protection, challenging assignments, exposure, define overall professional expectations, setting time frames, breaking up large challenges into attainable goals).

EDUCATION LEADERSHIP AND ADMINISTRATION. Developing leadership skills related to health professions education. Administering an educational program. Organizing or leading faculty development activities. Improving the organizational climate which fosters teaching.

LEARNER ASSESSMENT. Demonstrating expertise and application in activities associated with measuring learners’ knowledge, skills, and attitudes, which would include at least one of four assessment activities:
(a) development–identifying and creating assessment processes and tools;
(b) implementation–collecting data using processes and tools;
(c) analysis–comparing data with correct answer key or performance standards; or
(d) synthesis and presentation–interpreting and reporting data to learners, faculty, and curriculum leaders.

While scholarly teaching can take many forms, the progression of educational activities to scholarship begins once you have chosen an area to research. Professional development programs can help faculty become seriously engaged in planned activities designed to improve their knowledge and skills in areas considered essential to their performance as a faculty member (i.e., teaching, research, writing, and administration–different from CME), and encourage and support their scholarly achievements.

Reference:

“Advancing Educators and Education: Defining the Components and Evidence of Educational Scholarship” (AAMC’s 2007 Summary Report & Findings on Educational Scholarship).

_________
Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing teaching enhancement and board preparation programs for physicians. Her background includes academic appointments in allopathic and osteopathic medical schools and teaching hospitals. Linda recently co-authored “Online Synchronous Faculty Learning Communities in Medical Education: It Can be Done Successfully”, published in the Learning Communities Journal. To find out how Dr. Carr can help you expand your teaching potential or make your board preparation successful as well as more efficient and effective, email: Carr@FacultyEdSolutions.org or visit her website.

 

Ten Tips for Supporting Problem Learners

Ten Tips for Supporting Problem Learners

Working with promising medical students is a unique privilege. Sometimes, however, we
encounmale resident looking stressed - shorter versionter learners who are annoying, difficult to deal with, stressed, or “just don’t get it.”  This is not an uncommon situation, and it happens in all areas of medical education. Learning difficulties can be due to affective, cognitive, structural or interpersonal challenges. As educators, our role is to provide support to learners in difficulty, but this can be a challenge due to the complexity and variety of possible causes. Today’s tip offers best practices for supporting learners in difficulty, which can help us meet our professional obligation as medical educators.

  1. Consider difficulties with the learning process, not just the lack of knowledge. In as much as certain study skills may have worked successfully in medical school, they may not compete with the high volume of reading and the time commitments of clinical education. It is not unusual for learners to be stressed in professional training programs, don’t assume that the problem is temporary.
  2. Identify the problem early and prevent the problem if possible. Students in difficulty often present in the following ways: failing an exam, poor attendance, unprofessional behavior, failure to complete work on time, not being prepared for sessions. Take time to investigate further—find out if their lack of performance is due to problems of a specific affective, cognitive, structural or interpersonal nature.
  3. Communicate with and provide feedback to the problem learner (i.e., conduct an educational assessment) in order to increase understanding of the problem. Meet with the student privately to explore the possible reasons for the difficulty. Does the learner understand the nature and severity of the problem? Did you outline a clear plan stipulating a timeline and concrete tasks to be mastered for addressing each of these problems? Does the learner have the opportunity and the resources available to work on these problems?
  4. Know when to seek outside help and know your limitations. Are the appropriate persons aware of your discussions and the proposed plan of action? Depending on the situation, a referral to a counselor, clerkship director, or program director may be in order.
  5. Think of students/residents with learning problems in the same way as you think of patients with illnesses—diagnosis, desired outcome, treatment options, treatment plan. This model provides a comprehensive approach that is effective and efficient.
  6. Work in collaboration with the student, emphasizing peer and self-evaluation. Expose the learner to the wide network (peers, staff, faculty, librarians, and counselors) of support available to them. Some learners may need the special services of a learning/academic specialist to help them acquire “new” (to them) learning strategies.
  7. Monitor progress and follow up through communication, regular feedback, formal and informal evaluations. Follow up with the learner and share this information with other medical school/clinical supervisors. Follow up is critical so that individuals don’t slip through the safety net.
  8. Remember there are many resources available to help resolve learner-related challenges. Resource information should be made available in writing during orientation and throughout the educational program. In addition, programs/institutions should provide opportunities to discuss issues (i.e., gripes), support groups, regular meetings with counselor/faculty advisor/ as well as classes in stress management, social get-togethers, and an annual retreat.
  9. Provide guidelines for remediation strategies. Choose a strategy that will match the category of problem. Be sure the learner helps develop and/or agrees to the plan. Provide resources. Implement the strategy. Evaluate and follow up.
  10. Document the entire process. Whatever action you take, put it in writing (i.e., date(s), the name of the learner, the problem(s), plan of action, resources, timeline, follow up, and outcomes).

There may be times during medical school when a learner experiences an academic challenge that is beyond his/her ability to solve. As clinical educators, our role is to recognize the need and meet with the learner to assess the situation (i.e., conduct an educational assessment) and identify the problem(s). Being adult learners, students, need to be involved in developing a plan that will help them advance to the desired target state and provide feedback to you on their progress.

Adapted from:

Vaughn, L. M., Baker, R. C., & DeWitt, T. G. (1998). The Problem Learner. Teaching and Learning in Medicine, 10(4), 217-222.

Evans, D. and Brown, J. (2010). Supporting Students in Difficulty. In P. Cantillon and D. Wood (Eds.), ABC of Learning and Teaching in Medicine (pp. 78-82). Malden, MA: Blackwell Publishing Ltd.

________
Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching for medical boards. Dr. Carr’s background includes academic appointments in allopathic and osteopathic medical schools and teaching hospitals. She has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful, efficient, and effective, email: Carr@FacultyEdSolutions.org or visit her website to get a head start by downloading her 50 Tips for Successful Board Passage.

Ten Strategies to Increase Your Reading Comprehension

Ten Strategies to Increase Your Reading Comprehension

stethoscope on a bookThere are several things you can do before you begin to read a journal article or a textbook that can increase your reading comprehension. Using this strategic approach for reading may take a little longer, but it will be well worth your time. Here are ten suggestions to optimize your learning while you read:

1.  Look at the objectives and/or the headings and ask yourself what you know about that content.

2.  Reflect on your prior knowledge … what do you already know about these topics? What do you not know? Spend time here … don’t rush.

3.  Look at the tables … what does each tell you? Read the captions. What questions do you have?

4.  Look at the figures … what do they tell you?

5.  Connect the information between the tables, figures, and diagrams. What do they tell you? Tie the tables, figures, and diagrams back to the text.

6.  Go to the end of the article (or textbook) and answer the quiz questions (if there are any). Cover the answers, guess what the distractors might be. Identify your learning issues.

7.  Ask yourself what’s missing – what is NOT in the material? Then, read the article (or book).

8.  Close the article (or book).

9.  Make a mind-map (or concept map) of all you remember. DO NOT REFER TO THE ARTICLE. Keep forcing yourself to use alternative memory techniques (visualization, photos, graphs, personal associations).

10.  Check through the material and fill in important information that you missed (use a different color of ink). Then, do another mind-map, from memory.

You can improve your reading comprehension by experimenting with these ten suggestions. If you practice reading in this step-by-step manner and make it a habit, your learning will be more meaningful and remembered longer. This method can definitely help make the content “stick”, and that’s the result we need.

________

Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians in a virtual venue. Her academic appointments in allopathic and osteopathic medical schools and teaching hospitals give her a depth of understanding of the obstacles and pitfalls that physicians can encounter as they seek board certification. Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful and more efficient, contact her and download her 50 Tips for Successful Board Passage.

 

Five Tips for Evaluating Learners

Throughout their medical education, students and residents depend on their engaged relationships with faculty and preceptors to provide inspiration, experiential learning, role modeling, and guidance. A critical role of medical educators is to identify learners’ gaps of knowledge and communicate this in a manner that will drive student learning both now and in the future. These five tips offer “best practices” to guide you in this process:

1.  “Feedback” and “Assessment” are not the same. Feedback seeks to shape, grow, and develop an individual. It is formative—spoken, based on three levels (what you saw the student do; your personal reaction; your prediction of the likely outcome of this behavior). Evaluation, on the other hand, seeks to summarize progress made over a set period of time or course of study. It is used for grades—written (i.e., using a rating scale and comments).

2.  Understand your role as a preceptor in the clerkship experience. Engage in comprehensive planning before, during, and at the end of the clerkship. Before clerkship, make sure you understand medical school expectations and review clerkship goals and objectives. Select clerkship dates that don’t conflict with your vacation or out of town conferences. Review the form you will use to evaluate students. During the clerkship, gather information from multiple sources, provide feedback, and use a systematic method of recording. At the end of the clerkship, prepare for the final evaluation, schedule and conduct the summary meeting, and complete and submit the final evaluation (within one week).

3.  Share a copy of the clerkship evaluation form with the student and discuss the areas that will be covered in the final evaluation. Ask your student to regularly evaluate his/her own skills, especially at the beginning and at the end of the clerkship, and ask for copies of patient profile sheets and case presentation slides/reports, and log books.

4.  Collect factual information and observations systematically over the course of the clerkship. Gather information (via observation, questioning, demonstration, review of patient notes/ records, self-assessment, input from staff and/or patients, presentations, patient logs, student projects) about your learner’s performance, noting both changes in behavior (improvement) and progress toward a goal. This information can guide planning for future educational experiences and for communicating summary information to other parties.

5. Use the information you collect to rate, rank, or assess the learner’s status at a given point. Evaluation should be conducted in an unhurried atmosphere that encourages an interactive discussion about performance (first ask the student to self-assess). Evaluation should be both verbal and written whenever possible and fulfill due process procedures. Written comments that address student understanding, skill, knowledge, attitude, or general comments (strengths and weaknesses) should include examples of challenges and improvements made over time.

Medical educators play an important role in assessing student learning and performance. Using a comprehensive plan before, during, and after the clerkship can improve efficiency and increase the learning<->teaching experience.

Source:   Society of Teachers of Family Medicine (2012). Preceptor Education Project, Second Edition: Facilitator’s Guide for Conducting PEP2 Workshops, Module 7 (Evaluation).

________
Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians. With a background in Higher Education, Learning and Teaching, and Medical Education, Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful and more efficient and effective, email: Carr@FacultyEdSolutions.org or visit her website to get a head start by downloading her 50 Tips for Successful Board Passage.

 

The Pomodoro Timer: A Tool to Energize and Focus Your Board Preparation

The Pomodoro Timer: A Tool to Energize and Focus Your Board Preparation

Using a tomato-shaped kitchen timer (now known as the Pomodoro Timer), Francesco Cirillo, a university
student,pomodoro timer discovered that his study habits improved. Cirillo found that when he broke tasks into 25-minute sessions (now known as Pomodoros) followed by a 5-minute break, and then took a long break after four Pomodoros, he was able to concentrate more fully on the tasks at hand and accomplish more work. Recently I suggested the Pomodoro Technique to a client, who was studying for her medical boards. Here’s what she had to say:

“I feel like the Pomodoro timer changed my life..! lol.. I always get SO distracted doing things, which is why the incessant planning and scheduling works great for me. The Pomodoro was the cherry on top-how to break down my time even more..! It was always so satisfying to achieve my 10 Pomodoros daily.”

Here is how to get started:

1. Choose the task to be accomplished (from your To-Do List or Board Review Game Plan). Minimize interruptions before you begin by turning off your phone and email/chat alerts.

2. Set the Pomodoro to 25 minutes (the Pomodoro is the timer). There are free apps for the Pomodoro timer that can be used with your iPhone or Android device as well as for your computer.

3. Commit to working on your task (and only that task) until the Pomodoro rings.

4.  Take a short break (5 minutes is OK). Check your phone for messages or return phone calls. Use this break to rest and “recharge your batteries.” Get away from your desk, stretch, and get a beverage.

5.  Continue your work sessions. After every 4 Pomodoros take a longer break (15 – 30 minutes). Go for a walk, eat a healthy snack, clear your mind.

If you have difficulty staying focused (or staying awake) while you study, try this strategy.  It’s easy. It can help you hyperfocus and power through distractions and get things accomplished in short bursts. It trains your brain to focus for short periods, and with time it can help improve your attention span and concentration. To learn more, visit the Pomodoro Technique website.

________

Linda L. Carr, Ph.D., is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching for medical boards in a virtual venue. Her academic appointments in allopathic and osteopathic medical schools and teaching hospitals give her a depth of understanding of the obstacles and pitfalls that physicians can encounter as they seek board certification. Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test-taking skills. To find out how Linda can help make your board preparation successful as well as more efficient, contact her and download her 50 Tips for Successful Board Passage.

 

Feedback in Medical Education:  Challenges in Giving and Receiving

Feedback in Medical Education: Challenges in Giving and Receiving

Image of a woman practicing how to give and receive feedback medical education“Feedback involves both the giving and receiving,
by teachers and learners,
and there can be gulfs between these.”
– Hattie & Timperley, (2007)

Feedback in medical education is challenging, both to the receiver as well as to the one giving it. The purpose of feedback is to improve performance and achievement, not to criticize or judge. Yet, providing feedback in today’s busy and complex healthcare environment is challenging. Moreover, medical educators generally receive little preparation for it.

However, research shows that providing specific, relevant and timely feedback in a constructive manner can markedly improve learning and performance. Today we examine critical issues associated with giving and receiving feedback in medical education.

Why is there such a Gap between Giving and Receiving Feedback? 

Medical educators are often unaware of the positive influence which feedback can have on learners and their performance. Because feedback is often seen as being ‘negative’, this can be uncomfortable to the giver and the receiver, so there is avoidance or postponement of this activity. Many believe that they lack the skills or resources to deal effectively with learners receiving negative feedback who may need additional support.

Why Make the Effort to Provide Constructive Feedback?

While it takes effort to give specific, constructive feedback, learners need feedback on their learning and clinical performance from someone more senior to know what they are doing well and what they need to do to improve. The Praise-Criticism-Praise feedback dialogue has been replaced by a new and improved Ask-Tell-Ask feedback model. Begin the conversation by ASKING learners to assess their own performance. Encourage learners to be specific and to not use generalities. Then, react to the learner’s observations by TELLING (providing) both reinforcing and corrective elements. Finally, ASK (again) by engaging them in reflective problem-solving about how they might improve and commit to monitoring improvement together.

What are the Challenges associated with Receiving Feedback? 

Students report that they rarely receive feedback, and when they do, they say it is frequently too late or incomplete to be helpful. They also say that they do not always recognize feedback when it is provided. To correct this situation, tell them you are going to give them feedback before you have the feedback conversation, and recognize that receiving feedback can be emotional. As an example, begin your comments by saying, “To give you some feedback, I ……”.  This may help.

Can a Shared Definition of Feedback Help?

In clinical education, feedback provides specific information by comparing a trainee’s observed performance against a standard, and is given with the intent to improve trainee’s performance. Three important points from this definition can serve as a guide: (1) provide specific information, not generalizations; (2) feedback should be a comparison between a trainee’s observed performance and a standard; and (3) feedback is given with the intent to improve trainees’ performance, rather than to criticize or judge.

How Can We Create a ‘Culture of Improvement’?

The goal is to create a culture within the clinical workplace where sharing feedback is the norm, improvement is expected and feedback to guide that improvement is required. The idea is to make giving feedback a routine aspect of work and learning. This means that practitioners and supervisors also need to ask for and attend to feedback from their learners and colleagues, and model this process for learners. Intentionally inform learners that you expect them to ask for feedback and make the giving and asking for feedback a routine learning activity by scheduling a few minutes each day, and document the dialogue using a daily feedback form.  

The ultimate goals for feedback providers are to: (1) increase their own comfort and skill in providing constructive feedback, and (2) to increase in their learners the comfort and skill in seeking, receiving and using feedback. By developing the daily habit of giving and receiving feedback, we inch closer to creating a culture of improvement in our clinical workplaces. Start today by using the “Ask-Tell-Ask” feedback model with learners, and don’t forget to let them know when you are providing feedback.

Adapted from:

Sargeant, J. & Mann, K.  (2010).  Feedback in Medical Education:  Skills for Improving Learner Performance, in P. Cantillon & D. Woods (Eds.), ABC of Learning & Teaching in Medicine (pp. 29-32).  Hoboken, NJ:  Blackwell Publishing Ltd.

________
Linda L. Carr, PhD, is CEO and Founder of Faculty Ed Solutions, LLC, a firm providing professional development programs and individual coaching to physicians. With a background in Higher Education, Learning and Teaching, and Medical Education, Dr. Carr helps faculty and residents explore new ideas to enrich their teaching and their scholarly development. To find out how you can enhance your teaching practice and/or make board preparation more efficient and effective, email her at: Carr@FacultyEdSolutions.org.

Assessing Your Emotional Intelligence in Your Teaching

Assessing Your Emotional Intelligence in Your Teaching

female physician at her computer

 

 

Our attitude and abilities that we use in approaching life and our teaching (i.e., our emotional intelligence) are not hard-wired.  We do have the ability to change and make improvements. By talking about issues related to teaching and learning in medicine with colleagues is one way to become introduced to ideas and strategies that can increase our efficiency and effectiveness as a teacher (and enhance our student’s learning experience). However, reading, listening and talking about ideas is not enough. We need to move beyond the talking stage to implementation. Are you part of the ‘solution’ that is open to change or do you prefer the ‘comfort zone’ of no change? This post invites you to assess your thinking and your actions by assessing your emotional intelligence (EI) with respect to your teaching practice.

  • Attend to the impact of your mood and behaviors. Our emotional states drive our performance, and can influence the emotions of people around us. How would you describe the learning<->teaching climate of your office? An upbeat environment fosters mental efficiency, aids communication, and flexibility in thinking. In their 2001 book, Now, Discover Your Strengths, Buckingham & Clifton define talents as “those recurring patterns of thought, feeling, or behavior that you can productively apply.” What would your students / colleagues / staff identify as YOUR talents related to teaching that are enduring and unique?

  •  Our emotional skills—attitude and abilities with which we approach life and work—are not genetically hardwired, however, they are deeply embedded in our neurology. Research suggests that by our mid-20s our range of emotional skills is relatively set and ingrained in our brain circuitry. An emotionally intelligent person can monitor his or her moods through self-awareness, change them, understand their impact, and act in ways that boost others’ moods through relationship management. Do you need to adopt a new plan or change an individual behavior? How willing are you to do this? When will you start?

  •  Identify the gap between WHAT YOU ARE DOING NOW and WHAT YOU CAN DO to facilitate teaching collaboratively to help students connect the dots—it’s all about enhancing student learning. Will this require learning a new skill, becoming better acquainted with a teaching colleague or clinician, experimenting with a new teaching approach? Begin the mental preparation (i.e., visualization) to replace an old habit with a better one. Make a learning agenda to help you reach your goal. When we prepare to overcome a habitual response, the prefrontal cortex becomes activated—giving us the brainpower to change.

  • Apply four components of emotional intelligence to galvanize your teacher performance from ‘Good’ to ‘Great’. These are:
    Self-awareness: the ability to read your own emotions, strengths and limitations, and feel confident about your self-worth;
    Self-management: the ability to control your emotions and act with honesty and integrity in reliable and adaptable ways;
    Social awareness: by being socially aware, we not only sense other people’s emotions, we show that we care;
    Relationship management: the abilities to communicate clearly and convincingly, solve disagreements, and build strong personal bonds.

By activating our emotional intelligence (EI), we can advance our teaching performance. Like electricity running through wires, EI can flow through your emotional skills to transform your outcomes from ‘good’ to ‘great’.

Adapted from: Goleman, D., Boyatzis, R., & McKee, A. (2001). Primal leadership: the hidden driver of great performance. In Harvard Business Review on Breakthrough Leadership Boston: Harvard Business School Publishing Corporation.

________
Linda L. Carr, PhD, is CEO and Founder of Faculty Ed Solutions, LLC, a consulting firm providing professional development programs and individual coaching to physicians. With a background in Higher Education, Learning and Teaching, and Medical Education, Dr. Carr has developed a unique board preparation program to help physicians develop a “Game Plan”, diversify their study skills, and enhance their test taking skills. To find out how Linda can help make your board preparation successful and more efficient and effective, email: Carr@FacultyEdSolutions.org or visit her website to get a head start by downloading her 50 Tips for Successful Board Passage.