Teaching to Enhance Medical Knowledge and Skills

Learning in medical school is said to be like drinking from a fire hose; you are constantly bombarded with new information and you have to retain as much as you can. And then once you’ve learned so much about the human body you find yourself discussing paradoxical emboli in casual conversation, you embark on the challenge of applying that knowledge you’ve learned in the classroom in the real-life setting of the hospital. You find it’s almost never quite the same as in the books, and are surprised at the amount of re-learning you do. Medical school is inherently difficult, and acquiring this medical knowledge is certainly intimidating.

 

Although it is rigorous, the medical learning isn’t all bad. I remember some standout lectures during the preclinical years including a radiology lecture so entertaining I found myself laughing during the middle and an ophthalmology lecture where the speaker teared up while describing a patient care story. These experiences have stuck with me because they helped me realize how conveying passion for a subject can positively impact the learning experience for trainees. These experiences are also what prompted my interest in medical education, something that I’ve worked to explore through several extracurricular opportunities in the med school.

Credit to Dr. Alex Grieco, this is a small clip of a notes sheet from one of his lectures during my M1 year. The connections he makes with the audience and enthusiasm he conveys for the subject are what I hope to emulate.

The Peer Elective Educational Resource (PEER) group was one such extracurricular. Through PEER I was part of a group of M2s who made review slides and practice tests for M1s prior to the M1 block exams. This was intended to help M1s sort through that firehose of information while preparing them for the clinical vignette question format. I worked to condense topics to 3-4 review slides and wrote associated practice questions to go along. I found this to be an enjoyable exercise that not only benefited the class below me, but allowed me to develop my own medical knowledge for my assigned topics. It was hard to condense and simplify without a solid knowledge base to decide what’s important. Further, it was impossible to write a good clinical vignette question without a thorough understanding of the topic. Writing wrong answers was perhaps the most challenging part, inventing believable responses that are still clearly wrong. I remember getting an email from a student citing a PubMed article, explaining why one of my “wrong” answers should have also been considered correct. While I initially felt annoyed and what felt like an over-zealous correction, after further consideration I realized that this is one of the great things about medical education: even teachers have room to learn, and students are often a means of learning. Involvement in medical education helps keep you up to date on the most current, evidence-based clinical information, which will not only benefit my teaching, but will also the patients I care for.

Tutoring is another way I’ve been able to further develop my medical knowledge while exploring my interest in medical education. I was assigned in the fall to work with an M2 student through the Neuro, GI-renal, and Host Defense blocks. I drew on my own experiences and challenges from these blocks to add perspective to the material to facilitate understanding. Again, tutoring involved a good deal of relearning along with my student; at times we spent whole two-hour sessions grinding through single lectures. One surprising challenge I encountered early on was how our different my learning style was to that of my student. I consider myself very type-A, and always followed very ritualized review habits that I felt too superstitious to break. My student on the other hand was a little more relaxed, identified more as type-B, and seemed more flexible in his review style. One of my initial goals I set for myself as a tutor was to not inflict unnecessary stress upon my student by trying to force them into my study routine. It was uncomfortable at first to break from my familiar routine, and our initial sessions definitely fell more in line with my study patterns. Reflecting on and recognizing this after our first few meetings, I then worked to let my student guide sessions and ask me questions to initiate discussions. This got easier towards the end of neuro where things are somewhat more clinically-focused, and for other topics that I felt admittedly more comfortable with than neuro physiology (again, this reinforced how you need to know information well to teach it!) Beyond the medical knowledge component I often felt my value as a tutor was simply in empathizing with the challenge of medical learning. Similarly, tutoring has held value for me in getting to share in my student’s successes. I have thoroughly enjoyed the relationship of mutual learning that I’ve developed over the semester through peer tutoring and the practice it has provided me with being able to share my medical knowledge with others.

Medical Knowledge and Skills aren’t just learned in medical school then put on the shelf, they need to be constantly honed and practiced; through teaching I can share my knowledge while knowing I still have room to learn, both on a medical skills and interpersonal level. To continue to develop my skills in teaching one major area I’d like to work on is my confidence in the role of teacher. I’ve found that preparation prior to tutoring or teaching experience helps me feel more confident, so going forward selecting topics ahead of time with my tutoring student will allow me to better prepare for confusing or complicated teaching points. Similarly in residency, prior to starting a new service I can prepare short teaching points while doing my own review for the rotation to share with the students and other trainees on that service. Finally, I will seek out role models who are proficient medical educators and pay attention to the techniques that I could apply in my own teaching.