Sarah Augustine, MD
Medicine, VAMC
email Dr. Augustine
phone: 791-3800-3620

Goal: To improve the educational relationship between residents and medical students on the inpatient medical wards. This would involve introducing both residents and students to process tools that would help to create and define different types of teachable moments with the goal of improving both the quantity and quality of teaching.

Problem: In the current system, residents often feel deficient in their role as teacher. This deficiency stems from both a lack of confidence in being able to impart what they define as "useful knowledge" to their students as well as a perceived lack of time for useful teaching to take place. As a result of these misconceptions, potential teaching opportunities are often unrecognized and underutilized. In addition, medical students often have difficulty making the transition to an "in vivo" educational environment where the best learning opportunities are often not in the passive confines of conferences or Attending lectures. There is a tremendous potential learning interface within the resident-student team which cannot be duplicated by an Attending and which presents a significant opportunity for improving the learning value of the ward experience.

Proposal: This project targets the processes and skills necessary to take advantage of these learning opportunities. Residents and students would be divided into intervention and control groups on the basis random ward team assignments on the Medical Service at the VA. Residents in the intervention group will be provided with a toolbox for teaching that will include the One-Minute-Preceptor, evidence-based resources, and evaluation/feedback strategies. Students in the intervention group would be introduced to SNAPPS, an educational model that focuses on the role of the learner in driving the learning process (Synthesize, Narrow, Analyze, Probe, Plan, Self-directed learning). Control teams would be given a standard exhortation to teach, read, and learn based on the learning objectives for Residency and the Clerkship.

Evaluation:

A survey instrument administered at the beginning and end of the intervention month targeting fulfillment of learning expectations, quality and quantity of intra-team teaching, and overall satisfaction with the learning environment. Residents will need to comment specifically on their view of themselves as teachers and the impact of this role on the work of the team and their overall satisfaction with the ward experience.

Assessment by survey and possibly individual or team interviews of the impact of the targeted processes and tools in the intervention group. Might include reviews of the standard written evaluations looking for verbiage associated with these interventions.