The opportunities to assess learners was a little more limited during the second half of residency since I was no longer a recitation leader and did not have any other APPE students. However, I was still able to asses learners during topic discussions, presentations, and when counseling patients. I was able to build on my assessment skills throughout this past year and have tried to focus on using that information to better myself and my teaching style. I still found it to be difficult to differentiate between poor, average, and good learners but was able to use past experiences as a guide.
Topic Discussions
I used patient cases and open ended questions to assess learners during topic discussions. The students are given the material beforehand so I am able to tell which students have prepared and which have not reviewed the material within the case. Those who have prepared are generally more willing to answer the questions and are able to elaborate more in their response. The ones who have not reviewed the cases tend to give short one-to-two word answers and are not able to provide the reasoning behind it. As the year progressed and the students were further along in their last year of pharmacy school I started to incorporate more difficult questions that were not provided on the handouts. I felt like this was a good way to determine if they had retained information from previous rotations and assess their ability to apply the knowledge. I also made evaluations for the students to fill out after each topic discussion and used their feedback to make adjustments going forward. There was still some difficulty getting students to participate without being called on but I think this was partly due to the virtual nature of the discussions. The virtual experience may make it more uncomfortable because they do not know if another student is about to answer. However, I did note more involvement by the end of the year as students were more confident in their clinical knowledge.
Presentations
Assessing learners during a presentation has been a little more challenging. However, with the use of audience response questions or case questions it makes it easier. The questions provide immediate feedback and let the presenter know if the audience is following along or if they need a more in depth explanation of the topic. I worked on incorporating questions based on the objectives when I taught a lecture at the College of Pharmacy so that the students knew where to focus when studying. When I presenting my Grand Rounds presentation, I tried to use more case based questions as this is what the pharmacists are use to in practice. I think tailoring the types of questions to the audience is a valuable tool. With presentations being mostly virtual, I had to use the speed and accuracy of responses since it was difficult to have group discussions. In the future I would like to incorporate more discussion time along with the audience response questions so that the learners are getting the information in a variety of ways.
Patient Counseling
Patient counseling is an important aspect of healthcare. As healthcare professionals, it is our goal to help patients understand what is going on with their care so that can become invested. Over the past year I have realized how impactful it can be to take a few more minutes to counsel patients. Starting off with a few open ended questions helps me get a better understanding of their current knowledge level. It gives me the opportunity to fill in the gaps in knowledge or to provide additional information as needed. I feel like this method also keeps me from giving the patient too much information initially. I then like to follow up the counseling session with asking them to repeat what they have learned. This helps me to gauge if they were able to retain the correct information and reiterate the most important take away points. This is an area that I will continually practice throughout my career and I feel like I am improving with each patient encounter.
Tools used to assess learners
Audience response questions
Patient cases with discussion questions
Asking open ended questions
Teach back method
During the second half of the year I was provided with multiple opportunities to give feedback to my peers. The residents presenting Grand Rounds and journal clubs and I completed an evaluation and provided written feedback for each one. In the beginning I struggled with giving feedback on areas for improvement because I did not want to offend any one. However, I realized that it is actually very valuable to the presenter and helps them know where they can practice so that they are more confident the next time around. I also know from personal experience that receiving feedback helped me strengthen my skills as a presenter and teacher and I want to help others do this as well. When providing the feedback I worked on using specific examples and referring to the material so that it was clear and concise.
I also provided feedback to each of my preceptors at the end of the rotation. I tried to really think about each experience and ways to improve the rotation. I had one rotation where I was able to incorporate a new way for the preceptor to review my notes which saved time and it made the edits more clear. I also tried to give feedback on what I thought was the most valuable component of the rotation so that the preceptor would be able to include it with future rotations. I think informative feedback needs to include examples so that there is no misinterpretation by the receiving party. My ability to provide informative and meaningful feedback increased throughout the past year and I feel like it was mainly due to the amount of opportunities I was presented with.
Strengths
Work ethic that pushes me to do by best
Ability to manage time effectively and efficiently
Receptive to feedback and willing to adapt in order to improve
Care for learner's education and learning experience
Weaknesses
Providing specific examples while giving feedback on areas for growth
Confidence when speaking in front of large groups
Engaging with the audience during large group presentations (eye contact)
Comfort level with using new teaching styles
Progress Toward Each Teaching Goal
For topic discussions the residents developed case based questions to help engage the students and provide real life examples. I would also ask questions to the students that they did not have access to ahead of time which allowed for more discussion. I feel like this helps learners retain the information because it puts the guidelines into practice. During journal club presentations I was able to promote critical thinking in the audience by picking articles that were relevant to the practice of pharmacy within the VA. When you are able to hear about a new drug or study and directly relate it to your practice it helps engage the audience. I was able to promote the engagement of learners during Grand Rounds by using audience response questions. Throughout the year I was able to practice developing appropriate questions for the audience that required critical thinking. Lastly, I was able to engage the learners during my therapeutics lecture by asking questions throughout the presentation and also leaving some information out of the slides. By not including all of the information, it required students to stay engaged in the lecture so that they were able to obtain all pertinent details.
One thing that I wish I would have done differently was to make the audience response questions anonymous. I fell like this would have sparked more participation from the group because they would have been less worried choosing a wrong answer. In the future I hope to incorporate this into my larger group presentations as well as some more interactive games to help stimulate critical thinking.
Activities completed to achieve goal
Monthly topic discussions x4
Journal club presentations x1
Pharmacy Grand Rounds
Therapeutics Lecture
I was presented with multiple different opportunities to improve my communication skills. The monthly topic discussions allowed for me to become comfortable leading a small group discussion. At first I was nervous that the learners would think I didn't know what I was talking about. However, as the year progressed and I gained confidence I was only worried about making sure I was providing information that would be valuable to the learners. I was able to take the focus off of myself and focus on what would make the discussion enjoyable which I think is a great accomplishment. I also presented journal clubs which helped me learn how to deliver clinical data to groups of professionals. During Grand Rounds I was able to practice presenting to large groups that included pharmacists and other pharmacy staff. I was extremely nervous before my first Grand Rounds but by the time I presented Spring Grand Rounds I knew how much I needed to practice in order to feel confident. Once I gained confidence in my ability to present it was much more natural and I even received the feedback that my Spring Grand Rounds was the best presentation I completed. Because I knew that I struggled with presentations I signed up to give a lecture at UAMS College of Pharmacy. Seeking out this opportunity gave me the chance to practice with the professor and receive additional feedback that I could put into practice. I was also able to develop effective communication within my rotations. I presented multiple different in-services to the medical teams which required me to think about how to get the information across in the most concise and efficient way possible. I plan to seek out opportunities that will allow me to continue to develop my presentation skills in the future.
Activities completed to achieve goal
Monthly topic discussions x4
Journal club presentations x1
Pharmacy Grand Rounds
Therapeutics Lecture
In-services
A majority of my experience giving feedback occurred during the first half of residency when I was leading recitation and precepting students. However, topic discussion occurred throughout the entire year and I noticed that it became easier to pick out the strengths of the students and provide feedback on the areas for growth. I found ways to provide specific examples so that the learners knew exactly what I was talking referring to. I feel like learners are much harder on themselves so it is best to give feedback that does not require their interpretation in order for them to understand. Another opportunity I had throughout the residency year to provide feedback was to my preceptors at the end of rotation. In this instance I found it more difficult to pick out areas for growth because most of the preceptors had been teaching for a few years and had developed effective method to teach. When I did notice areas that could improve the rotation I was able to speak up because I knew that the preceptors were happy to receive feedback. I know that feedback will always be a part of my career (both giving and receiving) and I plan to continue to work on providing constructive feedback in all instances.
Activities completed to achieve goal
Peer Evaluations
Topic Discussions x4