Midpoint Reflection

Ability to accurately assess learners

I have had a multitude of teaching experiences so far through the teaching certificate program. Many of these experiences have included the opportunity to assess learners. This area is one I specifically wanted to work on and improve in as it is also a component of my teaching goals. In some situations (informal, individual or small group discussions) this has been very simple to do, where as in other instances I have found it extremely difficult (formal, large discussions or presentations).

A unique learning experience that I gained insight from was attending a Therapeutics II course exam item review session. This experience made me realize how each student in a class is at a different learning level and each may interpret questions differently, so it is important to be as clear, but concise as possible.

Other experiences I have had that enabled me to assess learners are Therapeutics II recitation, multiple topic discussions with P4 students, counseling patients on medications and disease states, and co-precepting students on Internal Medicine teaching and hospitalist rotations as well as a Pain/Palliative rotation.

Ability to differentiate between poor, average, and good learner performance:

Through all of these experiences I have better learned how to differentiate between learners and recognizing what sets them apart. Good learners are always prepared and complete required readings, cases, etc. ahead of time. Average students will do the work required of them, but will not go above and beyond required duties to complete tasks. Poor students are seldom prepared and most likely will not answer questions during topic discussion correctly. After differentiating between different levels of learners, the next step is realizing how to inspire or challenge these learners. With the good learners, I find this is the most difficult since they are very “gung-ho” and on top of tasks. It may be difficult to stay ahead of these learners and come up with new ideas to challenge them. Keeping good learners engaged may include inventing new tasks for them and allowing them to take on more responsibilities. I have learned that each learner needs reassurance, but some more than others. I have found that the average learner seeks assurance more than other types of learners. With average and poor learners I have realized that it is important to meet them where they are and not have high expectations of learners without first assessing what level they are at. Based on my experience with poor learners, I noticed that it is important to address any concerns early on and resolve them moving forward.

Tools used to measure learner performance:

  1. Evaluation forms provided to students at the end of topic discussions
  2. Providing the audience the opportunity to ask questions to clarify concepts
  3. Cases with questions and readings given before topic discussions

The above mentioned tools have been extremely helpful so far in my teaching experiences. However, an idea I have moving forward is to give students a “quiz” or evaluation before a topic discussion and again at the end to see their baseline knowledge level and how much they learned throughout the session. This would also help me further differentiate between good, average, and poor learners.

Ability to give meaningful feedback

I have had multiple teaching encounters that have allowed me to give feedback both individually and in a group setting. I have given feedback to a large number of students as well as to PGY1 and PGY2 residents and pharmacists. More specifically I have given feedback to my students in the Therapeutics II recitation course for written SOAP notes and verbal case presentations. I have also given midpoint and final feedback to three P4 students that I have co-precepted during their rotation. I have also given written feedback to students after topic discussion and to pharmacy residents and pharmacists after presentations. Giving more constructive, meaningful, and timely feedback in a variety of settings is an area that I want to greatly improve on as it is also one of my teaching goals.

Individualizing feedback to meet specific learners needs:

I have learned to give feedback one-on-one and in a group setting. I have also learned to adapt to the personality of the student and learn how they react to feedback and base my comments on how they will respond. In providing feedback, I also give specific feedback for how each learner can improve.

Examples of successful and unsuccessful attempts to provide feedback:

Successful attempts to provide feedback include giving P3 students feedback during recitation on written SOAP notes and case presentations and them incorporating that feedback into future presentations. I have had an unsuccessful attempt at feedback when performing a midpoint evaluation of a student I had on P4 rotation. The feedback I gave at midpoint was not specific and clear enough for the student, so he did not perform at the level I was expecting. I had to then be more clear with feedback given in the future.

Learners reaction to feedback:

I had one P4 student on rotation that was very sensitive to feedback. This situation was very difficult for me as I am trying to improve giving constructive feedback, but to not hurt any student’s feelings in doing so. In every other experience I’ve had giving feedback the student or presenter has been thankful for the feedback and incorporated some of that feedback into future presentations, writings, and on rotation.

Teaching-related strengths and weaknesses

Strengths

1. Building strong relationship with students and learners

2. Leading topic discussions

3. Creating a comfortable, non-judgmental learning environment for learners

4. Highlighting important concepts in discussion and presentations

5. Open-ended questions and utilizing the teach-back method during patient counseling

Weaknesses

1. Incorporating new techniques into learning opportunities

    • Plan to address this weakness: interactive games during topic discussions, quizzes during topic discussions

2. Allowing students to formulate their own thoughts and answers to questions before interjecting

    • Plan to address this weakness: allow at least 10 seconds before giving an answer to allow student to formulate a response, ask stepwise questions to allow students to come to an answer

3. Reliance on notes during large group presentations

    • Plan to address this weakness: practice presentations more in advance so there will not be as much need for notes, practice presentations in front of someone else first

Progress toward teaching goals

Teaching Goal #1

Provide specific and consistent feedback in a timely manner based on strengths and areas of improvement.

Before the teaching program began I was very uncomfortable with providing feedback, both positive and negative. I have actively sought out various opportunities to provide feedback since this is an area I specifically wanted to improve in. My plan for this goal was to provide feedback immediately after a presentation, etc. and provide both comments for improvement and comments of praise.

Activities completed related to this goal:

    • Therapeutics II Recitation Leader to P3 students (including SOAP note feedback and case presentation feedback)
    • Evaluated co-residents, pharmacists, and P4 students during topic discussions and other presentations (in-services, grand rounds, journal clubs)
    • Provided midpoint and final feedback to three P4 students on rotation

So far, through the various teaching opportunities I have encountered I have found that it is still challenging for me to give “negative” constructive feedback and to provide truly helpful comments. I saw this the most as I was co-precepting P4 students and in recitation. Although, I don’t have any more P4 students on rotation and I have completed recitation, I still plan to improve in this goal with the rest of the teaching opportunities I encounter throughout my residency such as topic discussions done with P4 students.

Future plans to strengthen this area:

    • Continue providing constructive feedback to students and co-residents after formal and informal presentations
    • Work on giving more timely feedback with students when applicable


Teaching Goal #2

Effectively incorporate different teaching modalities into presentations and discussions based on individualized student learning styles.

My plan for this goal prior to starting teaching activities was to incorporate a different learning style into each topic discussion that I led with students. I have found more and more that this is difficult to do as I had expected especially when some learners are participating through distant learning from other sites. So far, I have utilized each VARK learning style in some way. I have found that students respond best to visual and kinesthetic learning styles and are more likely to participate when these components are present.

Activities completed related to this goal:

    • Topic discussions with P4 students (HTN/HPLD, Anticoagulation, Bugs and Drugs)
    • Pain/palliative topic discussions with P4 student (Pain Management, Nausea & Vomiting, Agitation/Delirium, Palliative Sedation)
    • P4 students on Internal medicine teaching and hospitalist rotations and P4 student on Pain/Palliative rotation

Since I have noticed that visual and kinesthetic learning methods keep students more engaged and interested in discussion, I plan to continue to utilize these methods more so than I have previously. I will not have any more chances to serve as a co-preceptor this year, but I plan to incorporate this into patient counseling and in topic discussions with students.

Future plans to strengthen this area:

    • Incorporate more visual and kinesthetic learning into future topic discussion


Teaching Goal #3

Assess and adapt to knowledge base of the audience by asking open-ended and engaging questions.

This teaching goal has been the hardest to measure through my teaching experiences so far. In small, informal group settings it is easier to assess the level of learners and make questions easier/more challenging based on their knowledge base. During topic discussion, questions at the beginning of the discussion have helped me determine what level the students are at and I can adjust the discussion from there. In large, more formal group settings this task is more difficult as there is not as much time to ask questions and there is a larger variety of listeners in the audience. I have also found that during patient counseling, using open-ended questions and the teach-back method is very effective when communicating with patients during inhaler or warfarin counseling for example.

Activities completed related to this goal:

    • Topic discussions
    • P4 students on various rotations
    • Grand rounds presentation
    • Patient counseling

In the future, I hope to grow in this area during large group discussions/presentations and anticipate the knowledge base of the audience before speaking.

Future plans to strengthen this area:

    • Future topic discussions
    • Spring grand rounds presentation
    • Future journal club presentations