As I reach the midpoint of the teaching certificate program (TCP), I look back on the opportunities that I have had over the last six months to experience teaching and grow as an educator. Through the University of Arkansas for Medical Sciences (UAMS), the TCP has provided an abundance of occasions in which I was able to interact with learners in different environments. Due to the UAMS TCP and my first-year residency at Arkansas Children’s Hospital, these experiences have provided much-needed lessons on my strengths and weaknesses as a teacher. I will use the knowledge that I have gathered over this time and continue to gather through the program’s conclusion to better myself as an educator.

One of the main methods that I wanted to establish early in the TCP curriculum was to adapt to the learners that I am interacting with each day. Not all people, and indeed not all learners, are the same. Due to this, I want to be fluid in delivering my teaching to allow for learners from all walks of life to grow under my direction. I aim to place learners in the optimal environment for their education and provide numerous teaching methods to reach each individual. I have found that it is essential to remember the difference in each individual’s learning style to maximize the amount of information they can learn from me. Recognition of the need to adapt my teaching and implement adaptive teaching has helped me achieve many of the goals that I set for myself as an educator. Being adaptable allows me to help change as I teach to allow learners to grasp the lecture's objectives. Utilizing formative feedback, I understand what the learners are gaining from the teaching session and what the learner and I need to improve during the encounter and future encounters. Finally, practicing adapting my teaching methods during the TCP will help me grow as an adaptable teacher throughout my continued academic career.

I was able to display my ability to adapt best during a topic discussion with an Advanced Pharmacy Practice Experience (APPE) fourth-year student during a topic discussion. During the discussion, we talked about the cardiac action potential and how different medications would affect different stages of that action potential. Before the topic discussion, I asked the student if they knew if they were a visual, auditory, reading, or kinesthetic learner. They expressed that they learned best by visualizing concepts, so I drew out each portion of the action potential on a whiteboard and made changes as the medications would. During this, the student looked confused and did not seem to be grasping the concept well. We took a moment to discuss the topic, and I asked for quick feedback on how they thought they were retaining the information. After some discussion, the student and I concluded that they were not learning the concept well, so I suggested having the student try to draw the changes. This change in the delivery method would allow them to see the action and involve some kinesthetic learning. Following this change, the student began to grasp the concept and gave feedback that it was a change they needed to understand the material.

Unfortunately, adapting to learners is not always as easy as the first example was. While teaching in UAMS’s Therapeutics II case-based class, recitation, I attempted to implement similar strategies while teaching students. I asked students their best learning methods and then would ask for feedback as I gave them feedback on their case presentation. One student told me multiple times that things were going well, and they had no comments on the lecture or how they were learning, but often still struggled with the material. Finally, during one of the last feedback sessions, I told them to be completely honest because I was trying to make sure they received everything from the lecture that they wanted to. The student finally admitted that they were struggling because they learned from reading material. However, because the class was online and presentation-based, there was not much reading material during that specific section. I asked the student why they had not brought this to me earlier, as I would have attempted to write summary notes over the cases and what had transpired during the class. The student informed me that by the end of class, they just wanted to be out of lecture and did not feel like having discussions about what was going on in class. This lesson was vital for me to learn. It is important to seek feedback from learners, but it is more important to make sure to place learners in a position to provide the most formative feedback to help them as their teacher.

The triumphs I achieved over the first sixth months of TCP were primarily due to my strengths as a teacher, and I would attribute many of the challenges faced to my teaching weaknesses. Due to a large clinical load at the beginning of my residency, aside from teaching Therapeutics II recitation, my teaching involvement was mainly outside of a traditional classroom. On different occasions, I spoke with patient caregivers on different hospital units about what was going on with their child’s medication and what they would need to do at home to help their child get healthy. My first significant experiences were conversational style teaching. I believe this style of teaching feels the most natural to me. Teaching can be a discussion and active rather than just a lecture to a learner. I want my teaching to be adaptive, informative, and beneficial to those who experience it. While delivering this teaching style, I realized the strengths I have that I need to continue to expand upon and the weaknesses I need to overcome in teaching.

My greatest strength as a teacher is my sense of empathy and ability to relate to those around me. One of my learners kindly said that I could meet someone for the first time and make it seem like I had known them for a lifetime. This connection is an intentional action I try to make with every person I interact with, whether a stranger, colleague, or learner. By relating with those I speak with, I build trust with the learner to lead them to get as much from the experience as I am trying to give. I understand that teaching is a two-way street and that there should be some back and forth between the teacher and the learner to facilitate an optimal learning environment. While trying to relate to learners, I also identified my ability to change teaching methods as a new strength. One goal of mine was to develop the ability to adapt, but I was unaware of how well I could already do this during an interaction. I believe this strength developed as a learner when I tried to understand concepts on many different levels before tests or other assessments.

The major hindrance of my teaching experiences has been my confidence in myself. Early on during my residency, I was hesitant to speak to patients or their caregivers about what was going on or what they would need to know about their medications because I lacked confidence. Instead, I would let my preceptors do most of the talking since they were more experienced than I am, and I would observe. As time passed, and I began to gain more confidence in my clinical abilities, I also began to gain further confidence in myself as a teacher. I started seeking opportunities to talk to as many individuals as I could to help them learn. As I progress through the TCP, I hope to gain further confidence in myself and have no hesitations when it comes to teaching opportunities. I would not say that I have overcome this weakness as of midpoint, but I believe that I am taking the appropriate steps to grow in confidence. I have made sure to involve myself in the delivery of didactic material in addition to my clinical duties so that I further my experiences teaching and can continue to gain confidence.

During the TCP, I have had opportunities to formally and informally assess my learners and provide different feedback levels depending upon the learning atmosphere. While teaching caregivers, I informally assessed the level of knowledge they had retained to determine if it was safe to send them home with their child's medication. During the Therapeutics II recitation, I had the opportunity to formally assess the students and provide a grade based upon a rubric and skills checklist. I was then able to provide feedback on what were the deficits in their knowledge and skill application. Because appropriate formative feedback was a goal I was striving towards during the program, I made sure to seek feedback from students on my assessment and the feedback I was giving them. I looked to improve my ability to assess the learners and give feedback with each educational session I provided. During the first half of the TCP, I focused on being fair in my assessments and listening to learners during feedback to grow from the interaction.

It was essential for the learners and some of my teaching mentors to evaluate my ability to assess and give feedback. The recitation class was the first time a mentor was able to evaluate my assessment and feedback skills. During this time, my mentor noted that I did not have the best time management skills during the course and would sometimes let sessions run just over time. One of the students also gave this feedback to me towards the end of the semester. I believe that I improved my time management during classes, and I understand the importance of maintaining an appropriate amount of time within the learning experience. There must be a time in the end for learners to address questions and for me to be able to discuss what I taught during the session. I took these lessons that I learned in the classroom and implemented them within my clinical teaching. I believe that optimizing the amount of time I spent discussing with caregivers about their child's medications allowed for a more efficient teaching process and gave the learner many opportunities to ask questions for clarity and adjust my teaching for learning deficits.

As stated earlier, teaching was most natural when it was a discussion rather than just as a lecture. This sentiment holds for my feedback as well. During feedback sessions, when there was a lot of back and forth between the learner and myself, I felt that they understood and would grow from the encounter rather than only listen to my feedback. In a topic discussion about a new potential long-term immunization for RSV, I spoke with specialty nurses, physicians, and residents about a research article on the new monoclonal antibody's efficacy and safety. At the end of the discussion, I talked about the journal article as if it was just a conversation, but I was using it as a time to assess what they had gathered from the talk. This conversation helped me determine what they had learned without making it seem like I was testing them. This strategy also allowed me to notice that one medical resident did not clearly understand how to compare medication binding affinities or extrapolate data. We spoke more about these topics, and it helped them understand more about the essential information and what we can learn from pharmaceutical research articles. This method of feedback and assessment is not something that I can take credit for on my own. It is a method that I was comfortable receiving as a student and early on during my residency. Many of my preceptors have made feedback and assessment a discussion rather than a lecture. I felt I could have several timely feedback sessions without feeling like I was in trouble or must drastically improve on something. This feedback method also gave me opportunities to discuss with the preceptor what my expectations were for my rotation. I will try to continue to implement these strategies and grow as I progress through the TCP.

I will use the goals I set this year as a motivator to improve as an educator and mold myself into the kind of teacher I would like to be. My goals focus on guiding learners through each experience by having clear, measurable objectives, providing quality verbal and written feedback, and adapting to each learner's needs within each learning session and throughout various learning sessions if there is a longitudinal experience. To reach these goals, I developed specific plans in which I would attempt to address these goals, improve upon them, and retry with a different experience. As the year progresses, I anticipate that I will grow towards my goal and introduce unexpected opportunities to achieve these goals. Throughout the first half of my residency, I effectively implemented the plan I had theorized about initially. I do not believe I need to alter the strategy, but to seek as many opportunities as possible to test my methods of achieving my teaching goals.

With each experience, I tried to set the expectations early with the learner and challenge the learner to see how close they could get to those expectations early in the encounter. For patients, I would ask them what they already knew about the medication or devices they would use at home. I presented similar techniques to students and fellow pharmacists by probing their knowledge of specific topics such as disease states or classes of medications. This method required me to have informal or formal learning objectives that I would sometimes share with the learner or keep to myself as expectations of the interaction. From this initial challenge, I would provide formative feedback and see how the learner felt about their current learning. Finally, I would adjust my teaching methods and the encounter's overall expectations based upon those initial interactions. This method forced me to be adaptable throughout the learning experience. With longitudinal experiences, I would present these challenges multiple times throughout the entire encounter, adjusting my expectations each time and preparing to adjust as the learners become more advanced in their newfound craft.

Overall, the methods that I implemented to reach my teaching goals have been successful thus far, but I still believe that I have room to improve and test myself further. Adapting to the learning methods of learners has been difficult as the number of learners increases. I have found that the more players involved in an encounter, the more I struggle with making sure that my base preparation of material is adequate for all learners. Some of the information may be too advanced for some of the learners but too basic for others. Because of this, I spoke to experienced educators about things that I should do moving forward. To address this possible issue, I will make sure I am covering material to provide crucial information and precisely what I want each learner to gather from the encounter. I must also prepare to describe the material differently and answer various questions from each level of learners, thus teaching the material to the learner's standard.