July 19, 2021

Incorporating learners into your busy schedule 

Bruce Peyser, MD, FACP
Provider, Duke Primary Care Pickett Road
Professor of Medicine, Duke University School of Medicine
Director of Education and Teaching, Duke Primary and Urgent Care
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Over the past year, I have attended provider meetings at a variety of sites throughout our network. Part of the reason I do this is that I want the chance to meet as many of you—our providers—as possible. I also want to address the concerns and challenges you face while incorporating learners into your already busy schedules. Folks have been accommodating, and I appreciate the allotted time when providers listen to my presentation. At the very least, they get some breakfast or lunch, thanks to supporting from our senior leaders, Liz Long and John Anderson, MD.

In this new role as a traveling minstrel, I have heard some recurring themes and worries. A common refrain is “I’d like to teach, but I am just so busy seeing patients, and I need to get home at the end of the day for my family.” I understand this sentiment. When my children were younger, my most stressful moment of the day was being sure I could leave work at a specific time in order to drive our children to soccer practice in Cary.

There are a large number of tricks and methods and approaches you can use so that working with a learner is not so disruptive to your schedule. Careful planning, good communication, and realistic expectations are all critical to achieving a good experience for all involved. If one is teaching, it’s not expected that that person is going to take time out to give a chalk talk about anemia or the differential of shortness of breath. There are many teaching points that can be made in the room with the patient and family present. The recently perfected note template allows many students to assist with some note writing, which can save time as well. And there are a variety of other ways that teaching can be incorporated efficiently into one’s day. This is the main topic I cover when I meet folks in individual practices. It is very important that we end on time so we can take care of ourselves and our families.

Previously, it was felt that adding a learner might add 15-45 minutes to one’s workload at the end of a half-day session, and, understandably, not many wanted to sign up for such a disruption. Nowadays I think most providers find working with a learner does not add that much extra work at the end of the session, and sometimes the learners actually help make the morning session run more smoothly so that the provider might actually be able to eat some lunch and take a bathroom break before the afternoon session begins!

I have lots of tips to share, and I try to be open and transparent about sharing tricks that have worked much of the time. But I also try to share lessons learned from errors I have made, that hopefully won’t be replicated too often by others.

I do truly enjoy coming out to the practices and if I have not yet visited your site, please consider letting me come for 45 minutes to talk about teaching and education. I promise I won’t run over schedule, and we promise to bring good food as well!

Our goal is to get everyone teaching since we have so many learners who want to work in our practices. For the many of you who already incorporate learners into your day, your efforts are very much appreciated. For those who have not tried teaching, I urge you to consider having a student come work with you. As Coach K says, it could very well be a “game-changer” that might enable you to enjoy even more being a health care provider in our amazing health system.