A relatively straightforward way to help your student strengthen his/her fund of knowledge would be for you, the teacher, to encourage them to do some self-directed reading about the patients that they see with you. Linking that information to the clinical interaction enhances their learning. This is why some of our very best clinicians confer with their learners at the end of some of their clinical sessions. At these moments, the teachers will often pick some aspect of a case for the student to read about. It can be overwhelming to instruct someone to “just read about pneumonia”. It’s less daunting to ask the student to explore one aspect of a problem. For instance, a teacher might alternatively ask a student to read about the common physical findings which could be due to lobar pneumonia, or perhaps he/she could read about the best combination of meds to treat community-acquired pneumonia. To solidify things further, a teacher might even ask the student to later teach back some of what he/she learned in order to reinforce important concepts and take home points.
I often try to extend my “classroom time” when I review labs or X-ray results of patients I have seen with a learner during the day. If I see or read about an abnormality, I might send him/her an email or a text and direct them to the result. For instance, if someone has a new anemia, I might ask the learner what they might consider ordering to further evaluate the anemia. This too should lead to some focused reading on patient-centered topics. Additionally, I find this methodology to be part of a relatively easy way to begin to assess a student’s ability to do some critical reasoning when it comes to the assessment of a new clinical problem.
Homework assignments as described represent some clear messaging that independent reading and learning are vitally important. Over the years, there has been an ongoing shift from teacher-centered learning (with a focus upon what the teacher teaches) to student-centered learning. Faculty take on the role of “facilitator” and are no longer expected to be the main source of information. Understanding this role should help you in the clinic so that you won’t feel like you need to give a “chalk talk” to your student, which would be hard to do with our busy schedules. If this topic interests you, I would direct you to a great paperback text entitled Essential Skills for a Medical Teacher, published by Elsevier in 2021 (3rd edition). And in the meantime, keep thinking about ways to extend your teaching to enhance the experience for our many amazing students who come to work with us each day.