Original Article

Teaching to Teach: An Effective and Feasible Teaching Curriculum for Internal Medicine Interns

Authors: Anna K. Donovan, MD, MS, David R. Linz, MD, Doris M. Rubio, PhD, Melissa A. McNeil, MD, MPH, Carla L. Spagnoletti, MD, MS

Abstract

Objectives: New competency requirements from the Accreditation Council for Graduate Medical Education have prompted greater emphasis on developing residents’ teaching skills. Many residents make their first foray into teaching during internship, making it an important yet underrecognized opportunity to develop basic teaching skills. In addition, in the current graduate medical education climate, residents’ tasks are compressed into an even shorter time, which has caused teaching opportunities and expectations to be balanced with the need for efficiency. After performing needs assessment surveys of medicine interns and medical students, we developed an interns-as-teachers curriculum to equip internal medicine interns with skills specific to their unique role as medical student teachers.

Methods: We conducted a workshop focused around four specific skills: role modeling, using teachable moments (ie, teaching on the fly), thinking out loud, and coaching. We evaluated the curriculum by comparing pre- and postcurricular teaching knowledge, attitudes, and self-reported teaching behaviors among 51 interns in the intervention group with 20 interns in the comparison group from the previous year’s class.

Results: Sixty-one interns participated in the curriculum, and 51 (84%) completed both surveys. Knowledge and several self-reported teaching behaviors improved significantly among the intervention group, but not in the comparison group.

Conclusions: Interns participating in a half-day interns-as-teachers workshop aimed at preparing them to teach medical students in clinical settings achieved significant improvement in teaching knowledge and in several core, self-reported teaching behaviors.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Accreditation Council for Graduate Medical Education. ACGME common program requirements. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2017-07-01.pdf. Published February 2017. Accessed July 20, 2017.
 
2. Hill AG, Yu TC, Barrow M, et al. A systematic review of resident-as-teacher programmes. Med Educ 2009;43:1129-1140.
 
3. Post RE, Quattlebaum RG, Benich JJ, 3rd. Residents-as-teachers curricula: a critical review. Acad Med 2009;84:374-380.
 
4. Accreditation Council for Graduate Medical Education Task Force on Quality Care and Professionalism. The ACGME 2011 duty hour standard: enhancing quality of care, supervision, and resident professional development. https://www.acgme.org/Portals/0/PDFs/jgme-monograph<1].pdf. Published 2011. Accessed September 24, 2018.
 
5. Barnard K, Elnicki DM, Lescisin DA, et al. Students’ perceptions of the effectiveness of interns’ teaching during the internal medicine clerkship. Acad Med 2001;76(suppl 10):S8-S10.
 
6. Al Achkar M, Hanauer M, Morrison EH, et al. Changing trends in residents-as-teachers across graduate medical education. Adv Med Educ Pract 2017;8:299-306.
 
7. Alliance for Academic Internal Medicine. Residents as teachers curriculum models. Recommended curriculum guidelines for family medicine residents. Residents as teachers and precepting in postgraduate practice. https://www.aafp.org/dam/AAFP/documents/medical_education_residency/program_directors/Reprint290B_Postgraduate.pdf. Accessed October 5, 2018.
 
8. Cruess SR, Cruess RL, Steinert Y. Role modelling-making the most of a powerful teaching strategy. BMJ 2008;336:718-721.
 
9. VitalTalk. Coach in real-time. 2017. http://vitaltalk.org/topics/coach-in-real-time. Accessed July 20, 2017.
 
10. Gaba ND, Blatt B, Macri CJ, et al. Improving teaching skills in obstetrics and gynecology residents: evaluation of a residents-as-teachers program. Am J Obstet Gynecol 2007;196:87.e1-e7.
 
11. Pangaro L. A new vocabulary and other innovations for improving descriptive in-training evaluations. Acad Med 1999;74:1203-1207.
 
12. Doran GT. There’ a S.M.A.R.T. way to write management’ goals and objectives. https://community.mis.temple.edu/mis0855002fall2015/files/2015/10/S.M.A.R.T-Way-Management-Review.pdf. Published November 1981. Accessed October 5, 2018.
 
13. Bree KK, Whicker SA, Fromme HB, et al. Residents-as-teachers publications: what can programs learn from the literature when starting a new or refining an established curriculum? J Grad Med Educ 2014;6:237-248.
 
14. Weiss V, Needlman R. To teach is to learn twice. Resident teachers learn more. Arch Pediatr Adolesc Med 1998;152:190-192.
 
15. Accreditation Council for Graduate Medical Education and American Board of Internal Medicine. The internal medicine milestone project. http://www.acgme.org/portals/0/pdfs/milestones/internalmedicinemilestones.pdf. Published July 2015. Accessed July 20, 2017.