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Twelve tips for teaching the informed consent conversation

Authors: Asha Anandalah & Laura Rock.
Med Teach. 2019; 41(4):465-70.

Obtaining informed consent is a complex and challenging process. In this article authors provide a roadmap, listed as 12 tips, for teaching the essential components of how to obtain informed consent:

  1. Choose a time and place for the consent conversation that emphasizes its value;
  2. Emphasize the importance of first making a connection and establishing trust;
  3. Counsel the trainee to assess for barriers to discussing informed consent;
  4. Reinforce principles of effective communication;
  5. Review the core elements of an informed consent conversation;
  6. Ensure the trainee is knowledgable about the procedure;
  7. Specify how to discuss risk;
  8. Teach the trainee to discuss the procedure in the context of the individual patient’s circumstances;
  9. Explain how to articulate an informed decision;
  10. Adapt your teaching to the clinical context;
  11. Discuss and review documentation; and
  12. Observe and debrief the experience afterwards.

You can find this article here.

* I have no financial interest to disclose (GP).

Interventions for undergraduate and postgraduate medical learners with academic difficulties: A BEME systematic review: BEME guide no. 56

Authors: Miriam Lacasse, Marie-Claude Audétat, Élisabeth Boileau, Nathalie Caire Fon, Marie-Hélène Dufour, Marie-Claude Laferrière, et al.
Medical Teacher 2019 Mar 12:1-21. doi: 10.1080/0142159X.2019.1596239. [Epub ahead of print]

In this systematic review, authors aim to identify interventions for undergraduate (UG) and postgraduate (PG) medical learners experiencing academic difficulties (“learners who do not meet the expectations of a training program because of a problem with knowledge, attitudes, or skill”), to link them to a theory-based conceptual framework, and to provide literature-based recommendations around their use.

The review provides a repertoire of literature-based interventions for teaching/learning, faculty development, and research purposes.

You can find this article here.

* I have no financial interest to disclose (GP).

Twelve tips for thriving in the face of clinical uncertainty

Authors: Galina Gheilman, Mark Johnson, Arabella L. Simpkin.
Medical Teacher 2019 Mar 26:1-7. doi: 10.1080/0142159X.2019.1579308. [Epub ahead of print]

“Effectively managing clinical uncertainty is increasingly recognized as a goal of medical education. Stress from uncertainty has been associated with depression and burnout in trainees and may also impact patient care.” In this article, authors identify strategies to help healthcare professionals thrive in the face of rising clinical certainty.
They grouped tips into three sections:

  1. Tips for self: Understand your gut reaction to uncertainty; diagnose the type of uncertainty; identify cognitive biases; plan for uncertainty using safety-netting and follow up; don’t worry alone by leaning on your colleagues.
  2. Tips to help guide students and trainees: Set the culture through role modeling while embracing the inherent uncertainty of clinical medicine; promote curiosity over certainty; be explicit about the level of uncertainty; formally integrate uncertainty into medical education curricula.
  3. Tips to implement with patients and in healthcare systems: Discuss uncertainty openly with patients; use patients as allies in shared decision-making; advocate for systems infrastructure to support the embracing of uncertainty.

You can find this article here.

* I have no financial interest to disclose (GP).

A Best Evidence in Medical Education systematic review to determine the most effective teaching methods that develop reflection in medical students: BEME Guide No. 51

Authors: Jane Uygur, Ellen Stuart, Muireann De Paor, Emma Wallace, Seamus Duffy, Marie O’Shea, et al.
Medical Teacher 2019, vol. 41, No. 1, 3-16.

Reflection is considered an essential skill for physicians. In this systematic review, Uygur et al. aim to determine which educational interventions are being used to develop reflection, how is reflection being assessed, and what are the most effective interventions. Twenty-eight studies were included, which had at least two of the following components related to reflection: introduction, trigger, writing, guidelines, small group discussion, tutor, and feedback. The strongest evidence they found was that guidelines for, and feedback on, reflective writing, improve student reflection:

You can find this article here.

* I have no financial interest to disclose (GP).

Twelve tips for teaching quality improvement in the clinical environment.

Authors: Maya Narayanan, Andrew A. White, Thomas H. Gallagher and Somnath Mookherjee
Medical Teacher 2018, vol. 40, No. 10, 1060-1066.

In this article, authors offer twelve tips to help physicians teach basic QI concepts in the clinical environment:

  1. Introduce the domains of health care quality and the centrality of the patient perspective
  2. Present the challenges of changing systems, culture, and behavior
  3. Teach process mapping
  4. Play follow the order
  5. Track patient care outcomes
  6. Identify potential errors in a process by using failure mode effect analysis (FMEA)
  7. Use an error to demonstrate the basics of root cause analysis (RCA)
  8. Teach assessment metrics
  9. Introduce driver diagrams
  10. Creating a SMART aim statement for a QI intervention
  11. Create a bedside checklist to decrease errors
  12. Discuss Plan-Do-Study-Act (PDSA) cycles

You can find this article here.

* I have no financial interest to disclose (GP).

Twelve tips for providing feedback to peers about their teaching

Authors: Lori R. Newman, David H. Roberts, Susan E. Frankl.
Medical Teacher 2018 Nov 26:1-6.

In this article, authors outline strategies to use before, during, and after teaching observations:

  1. Choose your words wisely
  2. Let the host determine the direction of the discussion
  3. Keep feedback confidential and formative
  4. Focus feedback on teaching skills, not the teacher as a person
  5. Get to know your colleague
  6. Check-in: be aware of self and other
  7. Pronouns play a powerful role in providing feedback
  8. Use questions to uncover teaching perspectives
  9. Be aware of common biases
  10. Establish credibility om the peer observation and feedback process
  11. Make teaching observations a win-win
  12. Conclude with an action plan

You can find this article here.

* I have no financial interest to disclose (GP).

Medical Teacher: Best Practice for Assessment

Authors: Ronald M. Harden & Pat Lilley.
Medical Teacher 2018. Vol. 40, issue 11.

This issue of Medical Teacher, features articles on a variety of assessment-related topics, such as: selection and recruitment, a framework for good assessment, key-feature questions for effective assessment of clinical reasoning, progress testing, work-place based assessments, etc.

You can find this article here.

* I have no financial interest to disclose (GP).

A Delphi study of medical professionalism in Arabian countries: The Four-Gates model

Authors: Mohamed M. Al-Eraky, Jeroen Donkers, Gohar Wajid, Jeroen J. G. van Merrienboer
Medical Teacher 2014. Vol. 36, pages S8-S16.

Medical profeesionalism has been described as a set of attributes and behaviors, yet the Western frameworks of medical professionalism may not resonate with the cultural values of non-Western countries. In this study authors aim to formulate a professionalism framework for healthcare providers as interpreted by local medical professionals in Arabian countries. They shortlisted eight professional traits and coupled them in four themes (Gates): dealing with self, dealing with tasks, dealing with others and dealing with God. Self-accountability and self-motivation were interpreted from a faithful viewpoint as “taqwa” and “ehtesab”, respectively, in Arabic. The authors discuss that the Four-Gates Model could help in better undestanding medical professionalism as grounded in the minds and culture of Arabs. The model may act as a genuine framework for teaching and learning of medical professionalism inArab medical schools.

You can find this article here.

* I have no financial interest to disclose (GP).

Surgical simulation: Current practices and future perspectives for technical skills training

Authors: Flemming Bjerrum, Ann Sofia Skou Thomsen, Leizl Joy Nayahangan, Lars Konge
Medical Teacher 2018. Vol. 40, pages 668-75.

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, authors use Kern’s framework for curriculum development to describe the current situation and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures.

You can find this article here.

* I have no financial interest to disclose (GP).

Twelve tips for the introduction of emotional intelligence in medical education

Authors: Christine G. Roth, Karen W. Eldin, Vijayalakshmi Padmanabhan, Ellen M. Firedman.
Medical Teacher 2018. Vol. 40, pages 633-638.

Abstract (as extracted from the paper):
Emotional intelligence (EI) is the ability to recognize, understand, and manage emotions in yourself and in others. EI has long been recognized as a critical component for individual and organizational success within the business realm, and there is emerging evidence that enhancing EI is equally important in the medical setting. EI can improve interpersonal communications, enable constructive conflict resolution, and promote a culture of professionalism. As healthcare becomes increasingly team-based, proficiency in EI will be required to build consensus among multidisciplinary stakeholders, and effect change in attitudes and behaviors that result in improved patient safety and clinical outcomes. Based on the existing literature and the authors’ experiences, these 12 tips provide practical suggestions on how to introduce EI into a medical curriculum. These tips have broad applicability, and can be implemented in courses on topics such as professionalism, leadership development, empathy, patient safety, or wellness.

You can find this article here.

* I have no financial interest to disclose (GP).