Dr. Chris Smith (@ccsmith269) kicked off our first afternoon with an exciting talk on clinical teaching. During his talk, he told us that patients, teachers, and learners, like clinical teaching, but there are a lot of barriers and challenges to teaching at the bedside. One of the biggest barriers is TIME! One way to overcome the TIME challenge is to prepare! He modeled some retrieval by reminding us about feedback (what Dr. Atkins talked about a bit earlier) and showed us the ideal praise-to-criticism ratio (5 positive comments for every 1 negative comment) from the Harvard Business Review (https://hbr.org/2013/03/the-ideal-praise-to-criticism#:~:text=And%20the%20optimal%20ratio%20is,their%20place%20and%20their%20time.)
He also talked about the microskills of teaching (something every educator should know!):
Get a commitment
Probe for supporting evidence
Teach general rules
Reinforce what was right
Correct mistakes
He left us with the power and importance of role modelling at the bedside! You all are powerful role models – model communication, compassion, and enthusiasm!
Dr. Schwartzstein taught us about critical thinking and clinical reasoning. He emphasized that we must “work the problem.” We learned about recognizing cognitive biases and strategies to combat them and Dr. Schwartzstein expanded on the dual process theory that Dr. Hayes introduced this morning. We also learned the importance of accepting uncertainty. It is our job to help learners THINK! We need to move away from memorization and focus on thinking skills. Dr. Schwartzstein introduced some challenges of AI that we will delve further into tomorrow. One big take home point is to change “differential diagnoses” to “hypotheses” – what do you think? Will you give it a try? We challenge you to try it – in your notes, on your ward team, however you want!!For links to some papers on critical thinking from Dr. Schwartzstein and Dr. Hayes check out - @BIDMC_Education
Dr. Quinn Capers (@DrQuinnCapers4), chair of medicine at Howard University, ended our first day with a powerful talk on Implicit Bias in Medicine and Healthcare. He taught us that we all have implicit biases – it’s how the brain works and these “set the table” for discrimination. Implicit biases CAN BE overridden though. Awareness is the first step! Dr. Capers shared these 4 strategies to reduce/neutralize implicit bias: 1) Common identity formation 2) Perspective taking 3) “Consider the opposite” 4) Counter-stereotypical exemplars. To read more from Dr. Capers check out this from ATS Scholar – a must read for all https://www.atsjournals.org/doi/full/10.34197/ats-scholar.2020-0024PS