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Title: CHAMP%20Teaching%20on%20Today


1
CHAMPTeaching on Todays WardsSession 1
Improving the Process
  • Chad Whelan, MD
  • Julie Johnson, PhD
  • Paula Podrazik, MD

2
Todays Agenda
  • 1000 1010 Overview of Teaching on Todays
    Wards, Sessions 1-5 and
  • Introduction to Session 1
  • 1010 1030 Introduction to Mapping the Process
  • 1030 1115 Small Group Exercise
  • 1115 1125 Break
  • 1125 1145 Debriefing from Small Group
    Exercise
  • 1145 1200 Take Home Points and Homework
    Assignment for Session 2

3
Teaching on Todays WardsOverall Objectives
  • Recognize teaching as a process
  • Review affect barriers to teaching
  • Link to Clinical Teaching course
  • Link to ACGME competencies
  • Develop Strategies for
  • Improving teaching on todays wards
  • Teaching ACGME competencies
  • Learn some new tools for applying these
    strategies

4
Clinical Teaching CourseImproving Your Teaching
  • Learning Climate
  • Control of Session
  • Communication of Goals
  • Promoting Understanding and Retention
  • Evaluation
  • Feedback
  • Promoting Self-Directed Learning

5
ACGME CompetenciesWhat are they?
  • Patient Care
  • Medical Knowledge
  • Practice-based Learning Improvement
  • Interpersonal Communication Skills
  • Professionalism
  • Systems-based Practice

6
Teaching on Todays WardsSession Outline
  • Sessions 1-2
  • Review your teaching process successes and
    barriers
  • Recognize how your process influences the
    decisions you make
  • Sessions 3-5
  • Teaching systems-based learning
  • Teaching practice-based learning
  • Teaching lifelong learning

7
Teaching On Todays WardsSession 1 Objectives
  • Learn generalizable process mapping skills
  • Recognize teaching as a process
  • Map your teaching process
  • Link to communication
  • Link to professionalism
  • ID successes and problem areas

8
Teaching on Todays WardsSession 1
  • Intro. teaching process on the wards
  • Overview of the month-long process
  • Setting goals
  • Setting expectations
  • When can teaching occur?
  • Preventing burn-out

9
Teaching on Todays WardsSession 1
  • Overview of the day on the wards
  • Setting goals
  • Setting expectations
  • ID the teachable moment
  • Incorporate the clinical trigger
  • Maintaining Balance!!!?!!!?

10
What is your Primary Goal when on the Wards?
  • Achieving Excellence in Clinical Care and
    Teaching
  • Providing outstanding teaching and clinical care,
    getting your work done, getting residents home,
    and maintaining balance

11
Teaching on Todays WardsSession 1
  • Intro. to mapping the teaching process
  • Demonstration of sample teaching maps
  • Link to teaching professionalism
  • Link to teaching communication
  • Small Group exercise

12
Process Mapping
  • A process map or flowchart is a picture of the
    sequence of steps in a process
  • Useful for
  • Planning a project
  • Describing a process
  • Documenting a standard way for doing a job
  • Building consensus about the process (correct
    misunderstandings about the process)

13
Process Mapping
  • Ovals are beginnings and endings
  • Boxes are steps or activities
  • Diamonds are questions
  • Arrows show sequence and chronology


14
  • The first step is to draw a flow diagram. Then
    everyone understands what his job is. If people
    do not see the process, they cannot improve it.
  • W.E. Deming, 1993

15
Process Mapping
  • Can be high-level to get an overview of the
    process

Bedside teaching?
Go to see patient
Go to next patient
Team meets in work room
Rounds complete
No
Yes
Make teaching point
16
Process Mapping
  • Can also be very detailed and drilled down to
    show the details and roles

Team has test results to review
Team meets in work room
Team leaves work room
Team prioritizes order to see patients
Team Discusses routine patients
17
Process Mapping
  • Detailed process maps are especially helpful to
    standardize and improve processes
  • For use as an improvement tool, it is important
    to map the current process, not the desired
    process

18
Process Mapping
  • The teaching process
  • Sample maps in handout
  • Disclaimer before looking at maps
  • The evidence about how to teach/where to teach is
    mixed
  • There isnt a wrong or right way they are just
    different

19
Process of TeachingPost Call Day Case Study 1
20
Process of TeachingPost Call Day Case Study 2
21
How Are These Processes Similar/Different?
  • What, if anything, surprises you about the maps?
  • What are some similarities between the maps?
  • What are some differences between the maps?
  • Where are links to communication and
    professionalism

22
Small Group ExerciseMapping Your Process
  • The Goals of this exercise are to
  • Learn how to create a process map
  • Recognize teaching as a process
  • Recognize the differences in our teaching
    processes
  • Instructions
  • Form a dyad
  • Interview each other to create the first draft of
    the process map of your post call day

23
Demonstration
  • Mapping Chads process (a hypothetical process
    for example purposes)

24
Small Group ExerciseDebriefing
  • Re-group discussion session
  • What insights do you have about your teaching
    process?
  • Where in your process does teaching occur?
  • Where does teaching not happen because of
    clinical care needs?

25
  • What are some of the barriers to teaching on
    the wards?

26
Some of the barriers we came up with . . .
  • Time constraints
  • Misdiagnosis
  • Maintaining resident interest
  • Power struggles
  • When can I call it a day?
  • ???

27
Take Home Points from Process Mapping
  • Everyone has his/her own style for teaching
  • Being explicit about your process for teaching
    will provide insight into how to improve the
    process / overcome some of the barriers
  • This type of exercise can be applied to any issue
    that you want to understand and improve the
    method can be generalized

28
Homework Assignment
  • Finalize your process map
  • Review your process teaching map
  • ID the successful portions of your map
  • ID the problem areas of your map
  • Link your process to the best places to teach
    communication and professionalism
  • Where does your process serve you well?
  • Where does your process start to interfere with
    the ultimate goal of achieving excellence in
    teaching? How will these teaching activities
    affect providing clinical care?
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