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Introduction Cognitive learning strategies are strategies that improve a learner's ability to process information more deeply, transfer and apply information to new situations, and result in enhanced and better-retained learning. Methods We developed an interactive workshop for a national conference of pediatric educators to teach five cognitive learning strategies. The specific strategies were (1) spaced retrieval practice, (2) interleaving, (3) elaboration, (4) generation, and (5) reflection. Each strategy was taught using an active learning exercise. We evaluated the effectiveness of the workshop through a commitment-to-change exercise in which we asked participants to commit to making a change in their teaching as it related to the workshop and then queried them 6 weeks later about their implementation successes and barriers. Results Of the 161 participants registered for the workshop, 52 completed the voluntary workshop evaluation. All 52 participants committed to making a change in their teaching as a result of the workshop. Of those 52 participants, 24 completed the 6-week follow-up survey. Eighty-two percent of those respondents (n = 18) reported implementing a change based on the workshop, with 77% of respondents implementing a change that they had committed to directly after the workshop and 55% implementing a change that they had not originally committed to at the end of the workshop. Discussion This workshop successfully led to behavioral change in the teaching of cognitive learning strategies. We anticipate that this will lead to improved learning among the trainees whom participants teach.

Introduction The medical education literature shows that residents spend at least 25% of their time teaching, enjoy teaching, consider it important, and agree that teaching improves their clinical knowledge and clinical skills. However, in today's busy training environments, there is limited time to formally train residents as teachers. Methods We developed a multidisciplinary, resident-as-teacher curriculum that includes a DVD series and accompanying self-study and facilitator guides to help program directors, medical educators, and residents take the first step in implementing cross-departmental teacher training. The entire curriculum was presented to all Beth Israel Deaconess Medical Center (BIDMC) residency program directors and at the Harvard Medical School's Resident-as-Teacher Curriculum Showcase. To date, the departments of medicine, obstetrics and gynecology, surgery, emergency medicine, dermatology, anesthesiology, neurology, and radiology have used the facilitator's guide to lead small-group resident-as-teacher sessions or have engaged their residents in self-study using the guide and videos. The DVD series may be used as part of a resident self-study program, as the basis of a facilitator-led teaching series for house staff, or as preparatory material for “flipped” classroom-type sessions. Results Eleven senior residents, from across departments, and three junior faculty members piloted and assessed the quality of the series. All found the series to be “Quite” or “Extremely Useful” in terms of introducing the skills of clinical teaching and all found the overall quality of the series to be “Excellent.” We also conducted an assessment of the effectiveness of presenting the series in AY2014 and 2015 as part of a “Fourth-Year Boot Camp” to senior Harvard Medical students (n = 22) who were about to start surgical or obstetrics and gynecology residencies. Pre− and post-evaluation of the large-group sessions using the DVD modules, PowerPoint, pocket guide, and facilitator's guide showed that the students perceived significant improvements in several areas in terms of their teaching comfort and confidence. Discussion We are currently conducting a multidisciplinary, clinical teaching observation study to determine the extent to which the series and accompanying guide have an impact on the residents' clinical teaching skills, regardless of department. Preliminary data from this study indicate that during the post-intervention observation, residents are more likely to ask students about their learning goals, encourage more student questions, inquire about the student's perspective on a case, encourage self-directed learning, and provide specific learner feedback.

Introduction As medical schools increasingly move toward student-centered, interactive learning approaches that promote active student engagement and critical thinking skills, there is a clear trend to employ teaching methods that emphasize collaborative, case-based instruction. Small-group teaching offer students the opportunity to build upon their existing knowledge by becoming active participants in the examination of a clinical topic or patient case. To be skilled at small group facilitation involves planning and design, managing learning during the discussion, and feedback and reflection after each session. Faculty training is essential for developing the skills necessary to be an effective small-group facilitator. Methods The teaching case and accompanying facilitator's guide included in this module provide a comprehensive set of skills and resources that can be readily used by those charged with leading a faculty development session about small-group facilitation. Participants of such a faculty development session work through the problem-based teaching case, and, by addressing common small-group discussion dilemmas, learn the skills needed to facilitate an effective discussion. The resources are intended to be used during a stand-alone, live, interactive training session. The case is structured using a problem-based learning format so that participants can experience small-group teaching in the role of the learner. The intended audience for the faculty development session is junior faculty or novice facilitators as well as senior faculty or facilitators, who will more than likely value the opportunity to share their own experiences in leading small-group discussions. Results This small-group teaching session and case has been presented 13 times at Boston Children's Hospital, as part of faculty development efforts at Harvard Medical School, at a national subspecialty conference, and at the national Harvard Medical School CME Course “Principles of Medical Education.” Group size has ranged from four to 40 and participants have included residents, fellows, physicians, and health care professionals from a wide variety of specialties. Discussion Through the experience of presenting this session on multiple occasions, we have learned that it is best to start by asking the audience members to assume the role of participant-observers; in other words, to participate in the exercise, but at the same time take a mental step back and observe the teaching strategies the facilitator models during the session. It is also helpful to mention that the facilitator will be modeling, and then stopping to point out, certain teaching behaviors, strategies, and nonverbal gestures/cues throughout the session.

This resource is a handbook designed to help individuals prepare for and conduct an effective teaching observation and feedback session. The handbook presents 10 steps that observers can follow to ensure they identify critical instructional moments during the teaching encounter and then engage in a mutual exchange of ideas with their colleagues at the conclusion of the session. It also suggests ways to avoid common peer observation pitfalls and describes the benefits of partaking in an observation pairing or buddy system. A number of references and sample peer observation of teaching forms are included at the end of the handbook. Creation of this resource originated from the need to translate the theory of peer observation into actual practice. While there have been recent calls from the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education for regularly scheduled feedback to medical education program faculty members about their clinical teaching abilities, there is little guidance on how that feedback should be collected and delivered. To provide individualized instructional development and feedback to the faculty members at our institution, we created the Peer Observation of Teaching Handbook for faculty members to follow in order to conduct effective teaching observations that would inform meaningful feedback to their peers. After each peer teaching observation, we send a brief feedback form to both the observer and the faculty member to collect comments and suggestions about the peer observation of teaching experience. Quantitative and qualitative feedback collected from the forms has been positive.

The success of a teaching session is dependent on multiple factors, including adequate instructor preparation, the balance of learners' needs with educational goals, active participant learning led by a skilled facilitator, and appropriate assessment of the session's educational outcomes. Medical educators are often asked to put together a session on a topic or to run a workshop on a particular subject, yet they may lack, or need to review, the necessary skills to present an educational, well-structured teaching session. This module presents a complete faculty development workshop with the aim of teaching medical educators how to use a practical instructional design framework to develop, implement, and assess a teaching session. By presenting principles of curriculum development and having the workshop participants practice using the “Who, Why, What, and How2” framework, the module helps medical educators easily determine teaching session content, identify appropriate teaching strategies, and engage their audience in meaningful learning experiences. Of the 30 participants who attended this 90-minute workshop, 73% evaluated the session immediately afterward. On a Likert scale of 1 to 5, with 1 being the highest score, attendees indicated that the objectives of the program had been clearly stated, with 91% providing a score of 1. Participants rated the organization of the program as excellent (1 from 91% of responders). Similarly, learners rated the presenters' abilities as high in knowledge (1 from 95% of responders), communication skills and offering specific skills (each with 1 from 86% of responders), and encouraging participation (1 from 100% of responders). Eighty-six percent of responders provided an overall teaching effectiveness score of 1 (excellent), with 14% providing a score of 2 (very good). Eighty-six percent of responders would highly recommend the program to a colleague. To help determine if our learners understood the session's objectives, we posed four knowledge questions based on the session content. Ninety-one percent of responders successfully distinguished between a learning objective and a goal, and 95% recognized an attitudinal objective. Most responders (95%) correctly identified the most effective strategy to teach patient communication skills. One month after the workshop, we asked participants to provide an anecdote to assess if they had the opportunity to apply the knowledge and skills they had learned from the session. One attendee shared that he had used the session's format to conceptualize a provider-director educational intervention and created educational objectives for an abstract submission based on session content. Given that opportunities to use materials within 30 days are limited, we plan to poll participants 6 months after the workshop to assess long-term impact.

Introduction The Accreditation Council for Graduate Medical Education defines systems-based practice as a residents' understanding of the health care system and their ability to efficiently and effectively utilize resources within this system. We developed this module to train medical residents in the delivery of optimal care to patients by helping them navigate the complex maze of health care resources and to make transitions of care more seamless. Methods We created an interactive, web-based 30-minute module based on the story of an older patient who presents to an emergency room with focal weakness after a recent hospital stay. The key curricular components of this training module are: (1) the basic elements of Medicare and Medicaid, (2) the various levels of post-acute hospital care for older patients, and (3) the role of provider-to-provider and provider-to-patient communication in patient transitions of care, including the critical elements of an effective discharge summary. The vignette has been tailored to be applicable to multidisciplinary trainees. Interactive questions are embedded within the case to emphasize key teaching points while continuing to engage the learners. Results We piloted this web-based module on trainees of the Harvard Geriatric Medicine Fellowship. Among the 10 fellows who participated, there was an average increase in score between pre- and posttests of 10.6% (from 79% to 90%). The module was well-received by the trainees, and we anticipate a greater improvement in performance among trainees who have never been trained in geriatric medicine. Discussion Systems-based practice is difficult to teach. By creating and piloting this web-based module we hope to offer residency directors an effective and entertaining interactive tool which may be used in either a didactic or an individual setting. Geriatric medicine offers an ideal forum for such teaching.