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Skeff: Promoting Understanding and Retention


Incorporating established teaching practice for enhancing understanding and retention in the clinical environment is particularly challenging for the teacher. Learners retain lessons at a significantly higher rate when they are given regular opportunities to discuss and apply knowledge, attitudes, and skills, and when they receive constructive, thoughtful feedback. Patient-centered [as compared to learner-centered], the clinical environment is generally not structured for organized group or individual discussion, or repetitive exercises. The role of the teacher is to provide a framework for learning and share key points. The teacher should build on this by exposing the learner to external learning resources such as online modules, professional literature, and simulation technology, which allow the learner to develop self-directed learning skills. The teacher should create opportunities for context-specific conversations relevant to previously stated learning objectives that require the learner to do the work and demonstrate skill in the objectives to the teacher.

  • Integrate “synergistic learning experiences” – relevant literature recommendations, content-specific online modules – to boost the learner’s retention
  • Allot discussion time for particularly valuable lessons to reinforce learner understanding
    • set the expectation that you will spend 15 minutes at the start of daily rounds
  • Encourage the learner to “think aloud” (i.e., walk you through his or her thought process) when time permits, to offer contextual feedback
  • Model learning by talking through the rationale for particular “lessons”
  • Summarize teaching moments, including recommended resources and or external learning media
    • example: Now that we have reviewed the basic framework for approaching acute psychosis, please read about this in a reputable review article. Tomorrow summarize how you selected the particular article, and present up to 5 key learning points during morning rounds.

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The Seven-Component Framework to Enhance Teaching Effectiveness

 

Skeff, K. M. (1988). Enhancing teaching effectiveness and vitality in the ambulatory setting. Journal of General Internal Medicine, 3, S26-S33.