As a physician in your first few years of practice, you are not only expected to provide exceptional patient care but also to educate the next generation. Applying adult learning principles to your teaching can significantly enhance your effectiveness as you foster a more engaging learning environment for medical students and residents. 

In this blog, we will discuss three major points to help you master the art of teaching: fostering active learning, providing constructive feedback, and tailoring education to individual needs.

1. Foster Active Learning and Hands-On Practice

Engage Learners through Active Participation

Adult learners benefit most from active engagement rather than passive reception. To effectively teach skills, it is crucial to incorporate interactive elements such as simulations, practical workshops, and hands-on practice sessions. 

Here are some tips to foster active learning:

• Simulations and Skills Labs: 

Utilize cadaver labs, simulators, or virtual reality platforms to provide hands-on practice. This allows learners to gain practical experience in a controlled environment. It is also a safe way to provide a setting that is ideal for constructive feedback. 

While formal, high-fidelity simulators are ideal, there are plenty of low fidelity options that you can consider for this purpose. If you are not familiar with these, consider using the following AI prompt: “List cheap and easy simulators for the education of residents/medical students to [carry out condition or skill]” examples include assess heart sounds, place an intravenous catheter, do cystoscopy…

These can be carried out as group boot camps during training or on an individual basis with pros and cons of each. 

• Case-Based Discussions: 

Conduct case-based discussions or role-playing scenarios that mimic real-life clinical situations. This helps bridge the gap between theoretical knowledge and practical application.

Implementing this often works best if you select common or critical clinical scenarios that will stimulate discussion and learning. Additional learning points include the use of:

• Diverse Scenarios: Consider changing up the indications, complications or patient demographics within the same scenario to highlight important points and foster additional learning. 
• Simulated Clinical Environment: Set up a simulated clinical environment that mimics real-life settings - this may include the use of mannequins, task trainers, or actors to represent patients.
• Scenario Script: Develop a script for the scenario, including patient presentation, history, and possible complications. This allows you to be consistent in teaching points, and to hand it off to a colleague to carry out. It also allows you to continually improve as you update your script over time.  

It is also useful to have a Structured Discussion Format that includes

• Introduction and Background: Start with a brief introduction to the case, providing relevant patient history and clinical findings.
• Guided Questions: Use open-ended questions to guide the discussion. Questions should encourage learners to think critically and explore different aspects of the case.
• Interactive Participation: Encourage active participation from all learners. Assign roles if necessary, such as lead physician, nurse, or patient, to facilitate engagement. 

Lastly, be sure to include a Debriefing Session. Ask the learner to give their answers first. They are often more critical of themselves than necessary and this gives you an opportunity to see where they may need your input most.. 

Important components of these include discussion of: 

• What went well
• What could be improved
• Key takeaways 
• Include constructive feedback and encourage reflection

• Interactive Lectures: To keep learners engaged and actively participating, I recommend that you incorporate interactive elements into your lectures, such as:
 

• Quizzes

• Polls

• Group discussions

In some of my lectures I include lots of pictures that require people to answer questions. If it is hard to engage people or you are not familiar with them yet, feel free to go around the room in order or call on those who are nodding off. It is also useful to understand the level of knowledge of your audience before you start. You may ask this ahead of time or survey the room formally (or with a show of hands) at the start of your talk. This will allow you to tailor your questions most appropriately. 

2. Provide Constructive Feedback and Reflective Learning Opportunities

Encourage Continuous Improvement through Feedback

Adult learners thrive on constructive feedback and the opportunity to reflect on their experiences. Therefore, providing regular, specific, and actionable feedback helps learners understand their strengths and areas for improvement. I encourage you to do this regularly so that learners do not feel that this is punitive or random. In an ideal system, you may have feedback forms after each procedure or with each patient type that have key points already enumerated and allow for people to see objective feedback. 

 Here are some strategies for effective feedback and reflection:

• Debriefing Sessions: After each practical session or surgical procedure, conduct debriefing sessions where you discuss what went well and what could be improved. 

I recommend that you always start with the positive. People have a habit of focusing on what they did not do well (negativity bias), but pull them back to thinking about the positives first. I also recommend that you revisit positives or add  some additional thoughts after giving any criticism. 

Encourage self-assessment and peer feedback as part of the learning process and let them know this will be part of ongoing education.

• Structured Feedback: It is very useful to use structured feedback tools such as checklists or rubrics to provide clear and objective feedback. This helps learners understand specific areas for improvement and helps emphasize areas in which they already have mastery. They can also be useful as initial teaching aids, allowing learners to focus on key components and tasks. 
• Reflective Practice: Encourage learners to engage in reflective practice by keeping journals or portfolios where they document their experiences, challenges, and lessons learned. This promotes continuous learning and self-improvement.

3. Tailor Learning to Individual Needs and Professional Goals

Customize Education to Enhance Motivation and Engagement

Adult learners have diverse backgrounds, experiences, and learning styles. Customizing your teaching approach to align with their individual needs and career aspirations can enhance their motivation and engagement. Here are some tips for tailoring education:

• Individual Learning Plans: Assess the baseline knowledge and skills of your learners and set personalized learning objectives. This ensures that each learner can progress at their own pace and focus on areas that are most relevant to their professional development.
• Variety of Teaching Methods: Incorporate a variety of teaching methods, such as lectures, hands-on practice, small group discussions, and one-on-one mentoring, to cater to different learning styles.
• Mentorship: Establish a mentorship program where experienced physicians can provide guidance and support to colleagues. This helps create a supportive learning environment and promotes professional growth. 

Summary

Teaching medical and surgical skills in academic medicine is a challenging but rewarding endeavor. By fostering active learning, providing constructive feedback, and tailoring education to individual needs, you can create an engaging and effective learning environment. Remember to continuously assess and adapt your teaching strategies to meet the evolving needs of your learners. By applying these adult learning principles, you can help shape the next generation of medical professionals and contribute to the advancement of academic medicine.

Tips for Teaching in the Operating Room:

1. Set Clear Expectations: Before each case, discuss learning objectives with your trainees. Clarify their roles and what you expect them to do or observe.

2. Use the "Think Aloud" Technique: Verbalize your thought process during procedures. This helps trainees understand your decision-making and problem-solving approaches.

3. Implement the "See One, Do One, Teach One" Method: Gradually increase trainee involvement. Start with observation, move to assisted performance, and eventually let them teach others under your supervision.

4. Provide Real-Time Feedback: Offer constructive feedback during the procedure when it's safe to do so. Be specific about what was done well and what could be improved.

5. Use Teachable Moments: When unexpected situations arise, use them as opportunities to discuss problem-solving and decision-making in real-time.

6. Engage in Post-Procedure Debriefing: After each case, take a few minutes to review key learning points, answer questions, and discuss areas for improvement.

7. Tailor Your Teaching Style: Adapt your approach based on the learner's level of experience and learning style. Some may need more hands-on guidance, while others may benefit from more independence.

8. Incorporate Technology: When appropriate, use surgical videos, simulations, or other technological aids to enhance learning before or after procedures.

9. Encourage Questions: Create an open environment where trainees feel comfortable asking questions. Remind them that there are no "stupid" questions in the learning process.

10. Model Professional Behavior: Demonstrate excellent communication with the surgical team, respect for all staff members, and a commitment to patient safety. These non-technical skills are crucial for trainees to observe and emulate.

SUMMARY:

Navigating the early years of academic medicine requires a strategic approach to career development, time management, and skill enhancement. By focusing on clear career goals, building strong mentorship relationships, and continuously improving your clinical, research, and teaching abilities, you can set a strong foundation for a successful career. Remember that becoming an effective educator, particularly in the operating room, is a skill that develops over time. By implementing these teaching tips and remaining committed to your own growth, you'll not only advance your career but also contribute significantly to the next generation of physicians. Stay adaptable, seek feedback, and don't forget to take care of yourself along the way.