Rethinking Shared Decision-Making: Delivery of Care Options in a Telehealth World.

Telehealth modalities have given patients options for delivery of care, and in some cases increased access to care. However, great effort needs to be made by providers and clinic staff to ensure patients are given choice in their delivery of care methods and technological support to work toward equity in care. We propose applying the BEACH model for shared decision-making to help providers support patients in choosing the best care delivery method, while also encouraging providers to seek further education on telehealth competencies. Lastly, we stress the importance of the clinical staff in ensuring patient autonomy, education, and support when choosing telehealth modalities of care.

Using the Skill of Noticing to Support Empathy for Third-Year Medical Students in Family Medicine.

BACKGROUND AND OBJECTIVES: Previous research has described a waning interest among third-year students to employ empathetic practice along with decreased opportunity to develop empathic communication skills. In this study we sought to address this decline using the skill of noticing (ie, the capacity to attune to specific aspects of practice and interactions) as an intervention for third-year medical students. METHODS: We designed a qualitative study to address the following research question: How can a focused noticing tool encourage empathetic moments during the patient interview for third-year medical students? Eight third-year medical students used the Social Emotional Noticing Tool (SENT) during their 4-week family medicine rotation, then joined a focus group to share their experiences with SENT and articulate barriers and opportunities toward practicing empathy during clerkship. RESULTS: Student participants (a) described using the tool, including barriers and opportunities; (b) made connections between the practice of noticing using SENT and enacting empathy; and (c) emphasized how enacting empathy in their third year is largely influenced by interactions with clinical faculty. CONCLUSIONS: The use of SENT helped students notice empathy or lack thereof. However, making connections between individual capacity for empathic interactions and the impact of positive or negative role models is necessary. Based on our findings, we encourage the need for shared responsibility among students, faculty and preceptors, and organizations.

Evaluating the DR-ED Listserv as a Medical Education Networking and Support Tool.

The listserv, although considered old technology by some, continues to show benefit for and growth in subscribers. We investigated the roles the DR-ED listserv plays within the medical education community. We asked, Who subscribes? Why do they subscribe? and How do they use the listserv? We conducted a mixed-methods evaluation of the DR-ED listserv based on message content analysis and user surveys. We found the DR-ED listserv fulfills medical educators' need to network collegially; keep current with issues and ideas in the field; share solutions to problems; share resources; and advertise development opportunities. We found two types of listserv engagement: a) one-way engagement by using it as a resource, or two-way engagement by using and sharing resources. Our findings also highlight the value users attribute to virtual resources and the role listservs can play as economical professional development in a time of constrained costs, and our analysis methods can be used to guide future listserv evaluations. We conclude the relatively easy access to a global medical education listserv is one strategy to create a community of practice for medical education practitioners.

Student Perceptions of Effective Simulation Instructor Teaching.

SUMMARY STATEMENT: Twenty-three focus groups were held with 183 first-year medical students to assess student perceptions of effective simulation instructors during preclinical training in a medical school. Qualitative descriptive analysis guided the interpretation of focus group data. Students identified 6 areas of knowledge (schedule, student learning goals, session scenario, tasks and checklists, technique, and session purpose); 5 effective instructor skill categories (setting up the learning environment, teaching at the appropriate level, teaching technique, providing deeper context, and giving effective feedback); and 8 positive instructor attributes (enthusiasm, engaged, prepared, knowledgeable, patient, relational, transparent, and calm) instructors should have. Each category of instructor attributes, skills, and knowledge was also described in detail providing illustrative examples of what effective instruction would look like in practice from the students' perspective. Recommendations for instructor faculty development methods and topics/goals are given.

Community, Coaching, and Action Research: Promoting Ambitious Teaching in Medical Education.

Ambitious teaching is an instructional approach enacted through central tasks of teaching that involves a fundamental shift in mindset and practice. In this approach, the teacher facilitates student learning in the context of authentic, interactive experiences by eliciting student thinking and adapting instruction accordingly. We designed the Medical Educator-Excellence in Teaching (MEET) program to promote ambitious teaching in medical education. Here, we describe the structure of MEET, the framework that informed our work, and program evaluation data. We propose MEET as a model of educator development that promotes ambitious teaching through development of educator community, focused coaching, and inquiry into practice.

12 tips for effective questioning in medical education.

Questioning is one of the most frequently used and powerful teaching strategies across levels and settings in medical education. Although the concept of asking questions may seem like a simple practice, many medical educators lack pedagogical training. When effectively executed, questioning can elicit positive outcomes in learner participation, concentration, and understanding of content. When used incorrectly, questioning can leave learners feeling singled out and not in a position to learn, or worse - threatened or humiliated. There is a lot of literature in medical education about what ineffective questioning looks like, but little about how to enact effective questioning, such as what kind of questions should be asked and how to design those questions to improve learning. The following twelve tips will help medical educators be purposeful and effective as they plan, ask, and analyze questions in classroom or clinical settings.

When did "teaching" become a taboo word for clinician educators?

In our recent work with clinician educators leading UME small groups, we noticed a phenomenon - many clinician educators are saying they don't teach, they just facilitate. Medical schools have moved to a new model of curriculum that integrates basic, clinical, and social science concepts. As curriculum shifts, so too must the definition and role of a teacher in medical education. The purpose of this article is to explore the work of current clinician educators and to encourage clinician educators to embrace their teaching role and seek educator development opportunities. In this article, we explore the history of how and why the word "teaching" became taboo for clinician educators. Then we explain the current state of the complex work of teaching for today's clinician educators and its implications for educator development.