Train the Teacher

The Hospitalist. 2007 January;2007(01):

January 1, 2007|The Hospitalist

If you work at a teaching institution, an important part of your career track may be teaching residents the work of hospitalists. “Within academia, there are two major tracks: research[er] and clinical educator,” says Sanjay Saint, MD, MPH, hospitalist and professor of internal medicine at the Ann Arbor Veterans Affairs Medical Center and the University of Michigan Medical School, Ann Arbor. “We’re promoted based on our clinical work and on education evaluations; it’s helpful when we’re being reviewed if we’re seen as good teachers by our students.”

How are your teaching skills? How much thought and effort do you put into how you train your students? Do you take steps to improve your methods?

“Most of us have to work at being good teachers,” admits Dr. Saint. “We watch excellent teachers and learn as we go.” What follows is the advice of one excellent teacher.

How to Fight Skills Decline

Dr. Wiese recommends the following to help students retain the skills and knowledge they must pick up so quickly.

Encourage students to use the knowledge frequently, or ensure that they do so;
Ask students to record the data so that it’s accessible later;
Teach methods and approaches, not facts; and
Re-dose: cover the information again.

Teachers: Champions for Hospital Medicine

Jeffrey Wiese, MD, FACP, is an SHM board member and associate professor of medicine at Tulane University Health Sciences Center in New Orleans, where he also serves as associate chairman of medicine, director of the Tulane Internal Medicine Residency Program, and associate director of student programs, internal medicine. “From an [SHM] board perspective, it’s been my agenda to better situate hospitalists as teachers,” he says.

One reason he’s committed to boosting the number of hospitalist-teachers is that Dr. Wiese believes the specialty is a perfect match for imparting knowledge. “Hospitalists are better instructors primarily because of their greater accessibility for supervision,” he says. “Because of the number of things they do and the consistent repetition with which they do them, they also have a better familiarity with what students need to know and how to do it.”

Another reason that hospitalists are excellent choices to train residents: “Hospitalists work at improving hospital systems and focus on quality of care,” says Dr. Wiese. “What better group of people to teach the systems of care and practice-based learning competencies?”

Attributes of Best Physician Leaders

What makes a good leader? According to a survey of 110 physician leaders, physician educators, and medical students, the following traits and activities are seen as most important in effective physician leadership:

Interpersonal and communication skills;
Professional ethics and social responsibility;
Influence used with peers to encourage the adoption of new approaches in medicine; and
Administrative responsibility in a healthcare organization.

Survey respondents also indicated that “coaching or mentoring from an experienced leader” and “on-job experience (e.g., a management position)” are the most effective methods for developing physician leadership competencies.

Source: McKenna MA, Gartland MP, Pugno PA. Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students. J Health Adm Educ. 2004 Summer;21(3):343-354.

Coaching Versus Teaching

The basis of Dr. Wiese’s theory of teaching is that you should think and act as a coach—not a teacher. “A teacher is responsible for disseminating knowledge to his pupils; a coach is responsible for the performance of his pupils,” explains Dr. Wiese. “With a coach, the success of the job is contingent on the performance of the player—in this case, the student or resident.”