Intro to Clinical Practice

MEDICAL EDUCATION ELECTIVE in “Intro to Clinical Practice” Course (MDCN 490/495)

(Last Updated February 2, 2022)

ELECTIVE OVERVIEW

Host: Dr. Anthony Seto and ICP Course Committee, University of Calgary

Eligibility

  • Resident
  • Approval from resident’s program director
  • Approval from ICP course chair

Course Description

Intro to Clinical Practice (ICP) (MDCN 490/495) is a two-week course (one week in June and one week in January). In ICP, medical students achieve preparedness for clinical rotations by learning and practicing knowledge, skills, and attitudes relevant to all specialties. Students are immersed in practical, hands-on sessions, where unique teaching methodologies such as simulation, role-playing, and gamification enhance student engagement and learning retention. ICP covers a broad scope of topics including acute care approaches, teamwork skills, patient safety, communication skills, and interpretation of diagnostic results. ICP is “practical, and practice for your practice”.

Elective Description

The ICP Medical Education Elective offers a 2-week Resident-As-Teacher opportunity for resident physicians. The Assignments component of the elective focuses on medical education theory and foundations, while the Teaching component focuses on active teaching and reflection.

Learning Objectives

  1. Discuss foundational knowledge and concepts in medical education: learning objectives, curriculum development, lesson planning, presentation skills, learning theories, memory and cognitive load theory, feedback, gamification and serious games, simulation facilitation
  2. Teach medical students in an online environment
  3. Reflect on own teaching in a medical student course to identify personal strengths, changes, learning points, and teaching goals.
  4. Prepare for and participate in a microteaching session
  5. Develop a teaching philosophy draft

Elective Dates

  • ICP Part 1: June 19 – June 30, 2023 (active teaching time is between June 21 to June 28)
  • ICP Part 2: January 1 – January 14, 2024 (active teaching time is between January 2 to January 5)

Elective Contact/Registration

Dr. Anthony Seto

anthony.seto@ucalgary.ca

ELECTIVE BREAKDOWN

Elective Completion Criteria

  • MED ED ASSIGNMENTS
    • 9 Theory/Foundations Assignments (due Friday of Week 2, 11:59pm)
    • 3 Direct Observation Field Notes (due Friday of Week 2, 11:59pm)
    • 3 Reflective Practice Assignments (due Friday of Week 2, 11:59pm)
    • Teaching Philosophy (due Sunday of Week 2, 11:59pm)
  • TEACHING EXPERIENCE
    • Teach 24+ hours of ICP (scheduled)
    • Microteaching Presentation (will be scheduled either Week 1 or Week 2)
    • Medical Student Mentorship Session (will be scheduled either Week 1 or Week 2)
    • Elective Debrief Session (will be scheduled Week 2)
    • Bonus sessions (there may be additional optional sessions to sign up for)

9 Theory/Foundations Assignments

  • A1: Learning Objectives (0.5h)
  • A2: Curriculum Development (1h)
  • A3: Lesson Planning (0.75h)
  • A4: Presentation Skills (0.75h)
  • A5: Learning Theories (0.75h)
  • A6: Memory and Cognitive Load Theory (0.75h)
  • A7: Feedback (0.75h)
  • A8: Gamification and Serious Games (0.75h)
  • A9: Simulation Facilitation (1h)

ELECTIVE LEARNING OBJECTIVES BY ITEM

Elective Item Learning Objectives

By the end of the ICP Medical Education Elective, a medical resident will be able to…
A1: Learning Objectives 1.    List the 6 levels of Bloom’s taxonomy, and give 1 example verb associated with each level2.    List the components of the ABCD method of writing learning objectives

3.    Using either an example case provided or a new educational idea, write 3 learning objectives
A2: Curriculum Development 1.    List and describe the 6 steps of Kern’s curriculum development model2.    Using either an example case provided or a new educational idea, write out a brief curriculum development plan by going through the 6 steps of Kern’s curriculum model
A3: Lesson Planning 1.    List and describe the components of the BOPPPS Model for lesson planning2.    Using either an example case provided or a new educational idea, write out a brief lesson plan by going through the BOPPPS Model for lesson planning
A4: Presentation Skills 1.    List the average retention rates for lecture, reading, audio-visual, demonstration, small group, practice, and teaching2.    Describe the implications of cognitive load theory

3.    Describe the 4S’s (i.e. SSSS mnemonic) of being a successful presenter

4.    Describe the mechanics of being a great presenter (i.e. PPPP mnemonic)

5.    Upgrade the aesthetic, style, and clarity of at least 2 electronic slides the medical resident has previously worked on, keeping in mind “Presentation Zen” principles
A5: Learning Theories 1.    Describe the following 7 learning theories:a.    Instrumental learning theoriesb.    Humanistic theoriesc.     Transformative learning theories

d.    Social theories of learning

e.    Motivational models

f.      Reflective models

g.    Constructivism

2.    Select 1 learning theory, and describe how it can be incorporated into the medical resident’s next educational project, lesson, or teaching approach
A6: Memory and Cognitive Load Theory 1.    Identify how many information elements working memory can hold at a time2.    Identify how many elements working memory can actively process (i.e. organize, compare and contrast) at any given moment

3.    Identify how long working memory can hold an information element before almost all information is lost, unless it is actively refreshed by rehearsal

4.    List and define the 3 types of cognitive load that impact working memory

5.    Describe instructional techniques that can: i) decrease extraneous load, ii) manage intrinsic load, and iii) optimize germane load

6.    Describe the difference between System1 and System 2 thinking
A7: Feedback 1.    List 8 general principles of effective feedback2.    Describe the Pendleton model of giving feedback

3.    Describe the Reflective Feedback Conversation approach

4.    Write an example dialogue/script of how the Pendleton model could look like, between a preceptor and a learner

5.    Write an example dialogue/script of how the Reflective Feedback Conversation approach could look like, between a preceptor and a learner

6.    Write a made-up, short example of an ITER for a medical student who is performing well on any knowledge, skills, and attitudes of the medial resident’s choosing

7.    Write a made-up, short example of an ITER for a medical student who is needs improvement on any knowledge, skills, and attitudes of the medial resident’s choosing
A8: Gamification and Serious Games 1.    Describe the difference between gamification and serious games2.    List at least 6 examples of game design elements

3.    List and define the 3 psychosocial needs of the self-determination theory for motivation

4.    Describe the difference between intrinsic motivation and extrinsic motivation

5.    List 3 key principles of gamification

6.    Describe game design strategies that can help meet the 3 psychosocial needs of the self-determination theory

7.    Describe the overjustification effect and strategies to avoid this

8.    Describe the negative effects of competition and strategies to avoid this

9.    Propose a gamified strategy or use of a serious game that can be used to teach a medical topic
A9: Simulation Facilitation 1.    Describe the difference between debriefing and feedback2.    List and describe the 4 phases of the PEARLS debriefing framework

3.    List 3 strategies a debriefer can use during the Analysis phase

4.    Describe 2 to 4 approaches to co-debriefing

5.    Describe 3 proactive co-debriefing mitigation strategies during pre-debriefing

6.    Describe 4 proactive co-debriefing mitigation strategies during debriefing

7.    Describe 2 reactive co-debriefing mitigation strategies during debriefing

8.    Describe 1 proactive co-debriefing mitigation strategies during post-debriefing

9.    Describe 1 reactive co-debriefing mitigation strategies during post-debriefing

10. Describe 7 strategies to use during a difficult debrief

11. Review Team Scheme (this is how UofC medical students learn about teamwork): https://blackbook.ucalgary.ca/team-scheme/

12. From the Team Scheme, identify 2 items that students may struggle with. Describe some strategies that students can use to work on these 2 teamwork challenges.
Microteaching Presentation 1.    Prepare a 10-minute lesson plan to teach on a topic of the medical resident’s choice, related to medical student success2.    Create clear and aesthetic presentation slides

3.    Practice presentation skills

4.    Give feedback to peers on their presentations (if applicable)
Medical Student Mentorship Session 1.    Facilitate a medical student mentorship session to prepare students for success on clinical electives2.    Answer medical students’ questions regarding preparedness for clinical electives and resident’s specialty
Teaching / 3 Direct Observations / Reflective Practice Assignments 1.    Teach medical students in a variety of sessions including simulations and workshops2.    Reflect on feedback from preceptors and medical students

3.    After teaching, reflect on strengths, areas needing improvement, learning points, and teaching goals
Teaching Philosophy 1.    Write a personal teaching philosophy

ASSIGNMENTS AND SESSION DESCRIPTIONS

Please submit assignments to anthony.seto@ucalgary.ca.

A1 – Learning Objectives

Tasks:

A2 – Curriculum Development

Tasks:

A3 – Lesson Planning

Tasks:

A4 – Presentation Skills

Tasks:

A5 – Learning Theories

Tasks:

  • Review “Learning Theories” paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458658/
  • List the 7 categories of adult learning theories and describe each category, making notes.
  • Select 1 learning theory that resonates with you, and describe how you can incorporate that in your next educational project, lesson, or teaching approach.

A6 – Memory and Cognitive Load Theory

Tasks:

  • Review the article, “Cognitive Load Theory: implications for medical education: AMEE Guide No. 86.”: https://www-tandfonline-com.ezproxy.lib.ucalgary.ca/doi/full/10.3109/0142159X.2014.889290
  • How many information elements can working memory hold at a time?
  • How many elements can working memory actively process (i.e. organize, compare and contrast) at any given moment?
  • How long can working memory hold an information element before almost all information is lost, unless it is actively refreshed by rehearsal?
  • List and define the 3 types of cognitive load that impact working memory
  • Describe instructional techniques that can: i) decrease extraneous load, ii) manage intrinsic load, and iii) optimize germane load
  • What is the difference between System1 and System 2 thinking?

A7 – Feedback

Tasks:

  • Review the article, “Giving feedback in clinical settings”: https://www-bmj-com.ezproxy.lib.ucalgary.ca/content/337/bmj.a1961.long
  • List 8 general principles of effective feedback
  • Describe the Pendleton model of giving feedback
  • Describe the Reflective Feedback Conversation approach
  • Write an example dialogue/script of how the Pendleton model could look like, between a preceptor and a learner
  • Write an example dialogue/script of how the Reflective Feedback Conversation approach could look like, between a preceptor and a learner
  • Review the article, “Twelve tips for completing quality in-training evaluation reports”: https://www-tandfonline-com.ezproxy.lib.ucalgary.ca/doi/full/10.3109/0142159X.2014.932897
  • List 12 tips for completing quality in-training evaluation reports
  • Write a made-up, short example of an ITER for a medical student who is performing well on any knowledge, skills, and attitudes that you would like to comment on
  • Write a made-up, short example of an ITER for a medical student who is needs improvement on any knowledge, skills, and attitudes that you would like to comment on

A8 – Gamification and Serious Games

Tasks:

  • Review article, “Gamification in Action: Theoretical and Practical Considerations for Medical Educators”: https://www-ncbi-nlm-nih-gov.ezproxy.lib.ucalgary.ca/pubmed/?term=Gamification+in+Action%3A+Theoretical+and+Practical+Considerations+for+Medical+Educators
  • Describe the difference between gamification and serious game
  • List at least 6 examples of game design elements
  • List and define the 3 psychosocial needs of the Self-Determination Theory for motivation
  • Describe the difference between intrinsic motivation and extrinsic motivation. According to the Self-Determination Theory, which one is more valuable?
  • List 3 key principles of gamification that are mentioned in the article. Which 1 need of the Self-Determination Theory does each of these 3 principles fulfill?
  • Describe game design strategies that can help meet the 3 psychosocial needs of the Self-Determination Theory.
  • Describe the overjustification effect. What are strategies to avoid this?
  • Describe the negative effects of competition. What are strategies to avoid this?
  • Propose a gamified strategy or use of a serious game that can be used to teach a medical topic of your choice. Keep the pitch brief.

A9 – Simulation Facilitation

Tasks:

  • Review article, “Promoting Excellence and Reflective Learning in Simulation (PEARLS)”: https://insights-ovid-com.ezproxy.lib.ucalgary.ca/pubmed?pmid=25710312
  • What is the difference between debriefing and feedback?
  • List and describe the 4 phases of the PEARLS debriefing framework
  • List 3 strategies a debriefer can use during the Analysis phase
  • Review article, “Co-debriefing for Simulation-based Education”: https://insights-ovid-com.ezproxy.lib.ucalgary.ca/pubmed?pmid=25710318
  • Describe 2 to 4 approaches to co-debriefing
  • Describe 3 proactive co-debriefing mitigation strategies during pre-debriefing
  • Describe 4 proactive co-debriefing mitigation strategies during debriefing
  • Describe 2 reactive co-debriefing mitigation strategies during debriefing
  • Describe 1 proactive co-debriefing mitigation strategies during post-debriefing
  • Describe 1 reactive co-debriefing mitigation strategies during post-debriefing
  • Review article, “Difficult debriefing situations: A toolbox for simulation educators”: https://www-tandfonline-com.ezproxy.lib.ucalgary.ca/doi/full/10.1080/0142159X.2018.1468558
  • Describe 7 strategies to use during a difficult debrief
  • Review Team Scheme (this is how UofC medical students learn about teamwork): https://blackbook.ucalgary.ca/about/team-scheme/
  • From the Team Scheme, identify 2 items that you think students often struggle with. What are some strategies you would say to students to help them improve on these 2 teamwork challenges

Microteaching Presentation

Tasks:

  • Prepare a 10-minute lesson plan to teach on a topic of the medical resident’s choice
  • Create clear and aesthetic presentation slides
  • Deliver the presentation

Medical Student Mentorship Session

Tasks:

  • Facilitate a medical student mentorship session to prepare students for success on clinical electives
  • Answer medical students’ questions regarding preparedness for clinical electives and resident’s specialty

Reflective Practice Assignments

Tasks:

  • Submit the following, for 3 teaching sessions:
    • at least 1 strength (e.g. things that went well, things you would continue to do)
    • at least 1 change (e.g. areas needing improvement, things you would like to do differently)
    • at least 1 learning point (e.g. what new insights you gained, what medical education concepts you applied)
    • at least 1 teaching goal (e.g. your action plan for future teaching, teaching goals and vision)

Direct Observation Field Note

Tasks:

  • Submit the following from a preceptor (for certain teaching sessions, you will be assigned a preceptor that will perform observation), for 3 teaching sessions:
    • at least 1 strength (e.g. things that went well, things resident should continue to do)
    • at least 1 change (e.g. areas needing improvement, things that may be approached differently)
    • at least 1 teaching point (e.g. insights and tips on teaching, application of medical education concepts)
    • other comments

Teaching Philosophy

Tasks:

(Please note that the teaching philosophy is just one part of a teaching dossier. For more information on teaching dossiers, please see page 22 of: https://taylorinstitute.ucalgary.ca/sites/default/files/Teaching%20Philosophies%20and%20Teaching%20Dossiers%20Guide.pdf. You are not required to submit a teaching dossier.)

End-of-elective Debrief

  • Meet with ICP course chair to reflect on elective experience
  • Discuss goals in teaching and medical education, and discuss strategies to achieve them
  • Fill out end-of-elective survey