Early in this new academic year, interns are focused on, and likely feeling a little overwhelmed by, their new roles. Yet they are now undertaking another new role: instructors.
Teaching is part of the resident workload, and doing it effectively is going to require practice—just as with the clinical aspects of medicine. With a new set of medical students beginning training and a new set of residents seeing a shift in their roles—from being exclusively a leaner to a resident role that includes being the trainer as well as the trainee— here’s a refresher on the keys to providing effective feedback.
Andrew Olson, MD, is an associate professor of medicine and pediatrics in the division of general internal medicine at University of Minnesota Medical School (U of M). Having worked with both residents and students and with a background studying diagnosis and decision-making, he offered some tips for residents providing feedback to medical students.
The major topic in medicine has been a constant for months—the COVID-19 pandemic. For medical students, it kept them out of the clinical setting for a large chunk of time. At U of M where case numbers have reached more manageable numbers, medical students returned to the wards within the past month. The gravity of the situation may still weigh heavily on students, though.
“A resident’s biggest role is welcoming a student back and giving them feedback in the context of COVID,” Dr. Olson said. “The concept of cognitive load is important. Each of us has only so much space in our brain, and COVID is taking up a chunk. Residents and attendings have a key opportunity to say to students when they come back ‘let me know what’s going on in your life’ and ‘what are your concerns?’
“You have to let them know that you are here to help them feel safe.”
A pair of simple questions for any health professional, but particularly younger learners, can provide incredibly valuable information. What did you decide when it comes to diagnosis and treatment? What happened as a result of that decision?
Dr. Olson says students need to be aware of their “batting average” and know where they can adjust. “It is imperative that we know when we are right and when we are wrong so we know how to practice in the future.”
“We operate under the false assumption that if I missed something somebody will give me feedback,” Dr. Olson said. “We also think we are better at looking up cases than we are. We don’t go back and learn from cases in a standard way, and thus we miss a lot of learning opportunities. The way, in my view, to enhance expertise for all learners is that they are able to know the outcomes of their cases.”
Helping students get what they want out of a clinical rotation will help them as they map their career trajectory.
“The best feedback you can give is feedback aligned with a learner’s goals,” Dr. Olson said. “If you have a student come on the team, take a little time to talk and learn their goals. If they same something like “my physical exam needs work,” observe and give them direct feedback on that.”
As new residents, you have in the very recent past been in a similar position to the students you are working with. Because of that, you are uniquely qualified to offer feedback.
“Residents are often the most important teacher a medical student has,” Dr. Olson said. “If you’re just learning golf, you may want somebody who knows a little more than you rather than a golf pro.
“In teaching a resident or intern is in a unique position. They just learned many of these concepts, and they remember the steps they took to learn them.”
For residents looking to hone their teaching skills a one-minute preceptor teaching model, consisting of five steps that cover a supervisory encounter from start to finish, can be an asset.
While medical students or interns will be the ultimate beneficiaries, the model is designed to relay effective teaching methods to preceptors, who may feel overwhelmed trying to keep up with other residency tasks and with little time available.
The module, “Residents as Teachers,” is of the AMA GME Competency Education Program offerings, which include more than 25 courses that residents can access online, on their own schedule.