Teaching Residents to Teach: A Mini-Fellowship to Improve Teaching Skills and Encourage Careers in Academic Medicine.

Proposal to the Academy of Medical Educators
Maria Wamsley, MD , Katherine Julian, MD,
Margo Vener MD, MPH

Proposal:
We propose to develop and implement a six-month mini-teaching fellowship for selected residents from core clinical departments. Each of the core clinical departments will be asked to identify 1 or 2 residents with a strong interest in teaching for the teaching fellowship program. These residents will be mid-level residents who still have a significant amount of time remaining in their residencies to make contributions to medical student education at UCSF.

The teaching fellowship will be scheduled to begin in July 2003. We anticipate between 15 and 20 resident participants. . The fellowship will require one afternoon and one evening per month. In addition, resident-fellows will be expected to participate in teaching activities and do some out of class on assignments during the six-month period. The fellowship will consist of several components: 1) Didactic lectures about topics related to teaching 2) Small group sessions including role plays of teaching scenarios and reflection on videotaped scenarios 3) Teaching activities 4) Direct observation and feedback on teaching techniques 5) Development of a scholarly project.

Didactic teaching and small group sessions will focus on the following topics:

1) Creating a positive learning climate
2) Finding the teachable moment
3) Bedside teaching
4) Teaching physical examination skills
5) Incorporating evidence-based medicine into teaching
6) Teaching humanism in medicine
7) Effective small group presentations
8) Effective use of power point slides
9) Microskills of teaching
10) Feedback and evaluation
11) Problem learners
12) Effective mentoring skills

Plan for Measurement and Documentation of Project Efficacy and Outcome:
Residents engaged in the teaching fellowship will be expected to achieve competency in the microskills of teaching, feedback and evaluation, mentoring skills, and the evaluation of problem learners. As part of evaluating resident competency in these skills, the following instruments will be used:
· Resident self-assessment about teaching skills/feedback and evaluation skills prior to, and after the teaching fellowship.
· Evaluation of all learners conducted via review of videotaped teaching sessions. The learner and the fellowship directors will review these videotapes.
· Evaluation of all resident-fellows by medical students. Currently, all medical students complete evaluations of clinical rotations through 'e-value' (the electronic evaluation system). Students do evaluate residents on teaching ability. Through e-value, we will compare resident teaching evaluations prior to, and after the teaching fellowship.

Additionally, residents engaged in the teaching fellowship will be expected to disseminate their teaching skills to their resident colleagues within their department as described above. We will survey resident-fellows at the end of the academic year to determine the number of fellowship participants who participated in dissemination of content learned in the fellowship.

Finally, each resident-fellow will be expected to complete a scholarly project with a focus on medical education. A faculty member within his/her department will mentor the resident-fellow. All resident-fellows will then reconvene quarterly after the fellowship to present scholarly works to the group.

Plan for Continuation of Project at the End of the Funding Cycle:
We anticipate that once this elective is developed, it would be offered yearly to interested resident-fellows from each department. Clearly, a large amount of faculty support will be required to develop the program. Once developed, this program will require less faculty support, however faculty time will still be needed for yearly implementation of this program. To sustain this program, continued funding will be sought through grant applications as well as from the department of Graduate Medical Education.

For further information, please contact:
Maria Wamsley, MD: maria.wamsley@ucsf.edu
Katherine Julian, MD: kathy.julian@ucsf.edu
Margo Vener MD, MPH: mvener@fcm.ucsf.edu