Professor of Medicine, Duke University School of Medicine
One way to help your student strengthen their fund of knowledge would be for you to encourage them to do some self-directed reading about the patients they see with you. Linking that information to the clinical interaction enhances their learning, which is why some of our very best teachers confer with their learners at the end 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 ask a student to read about the common physical findings which could be due to lobar pneumonia, or perhaps they could read about the best combination of medications to treat community-acquired pneumonia. To solidify things further, a teacher might even ask the student to later teach-back some of what they have learned in order to reinforce important key concepts.
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 the student an email or text and direct them to the result. For instance, if someone has 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 upon 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 as it relates to the assessment of a new clinical problem.
Assigning homework to a learner reinforces the importance of independent reading and learning. Over the years, there has been an ongoing shift from teacher-centered learning 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 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,” Third Edition, published by Elsevier in 2021. And in the meantime, keep thinking about ways to extend your teaching to enhance the experience for our many amazing students who come work with us each day.