Teaching Competencies: Setting Up | In the Moment of Teaching | Giving Feedback | Additional Supports | Improving Future Teaching
Setting Up – Lean
The effective ‘set up’ in teaching is often overlooked. This helps focus learning experiences, so they are most effective and paves the way for productive future feedback conversations.
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#nurture
#develop
Develop your Learning Environment
STRATEGY
What to do?
- Welcome and orient your learner to your workplace, the learning space, or the session/rotation
- Develop respect, equity, diversity, inclusion (EDI) competencies
APPLICATION
What might this look like?
Your learners are familiar with the people, space, schedule, systems
Emails and designated clinic staff or other learners can do parts of this.
Customizable templates for a pre-rotation email to the learner, and an email to staff to introduce a learner can be downloaded from the Resources section below.
Your learners feel belonging and psychological safety when learning with you
Teachers tend to over estimate what they have communicated to their learners, and over assume that their intentions towards learners will be recognized by the learner as supportive or positive. Thus, teachers are wise to explicitly acknowledge their learners as individuals, express their confidence in the learners, remind learners that feedback is being given with their best interests at heart.
E.g., “I am interested to learn that you were a physiotherapist before medical school, that background will be really valuable to you as a physician. I look forward to learning with you during this rotation, and hope I might be able to offer you some feedback and tips to help you on your new path.”
You attend to anything disrespectful, inequitable, or unsupportive to diversity or inclusion
E.g., “You’re describing that the patient made a sexist comment to you. I am very sorry. That is unacceptable behaviour towards you as a member of this healthcare team. I would like to discuss with you how we best address this, as I want a plan that is supportive and comfortable for you. We can organize to have you reassigned to other patients if you wish. I am prepared to address this with the patient. Do you have hopes and thoughts at this point?”
EDI review needed
REFLECTION
What would your learners say?
Are learners focusing too much on performing for you relative to learning from you? Are all learners feeling welcome and if experiencing mistreatment getting your support?
DEEPER DIVE
Underlying theories
Psychological safety: When the learners feel safe to voice ideas and reveal what they do and do not know without fear of negative consequences, learning thrives. This requires the teacher to establish empathetic and respectful relations, and communicate unconditional acceptance of the learner’s worth, as well as engage in open bidirectional feedback conversations about strengths and areas for improvement (Ramani et al., 2023).
Resources
- Email Templates: Welcome/Orientation to Learner, Introducing Learner to Staff
- Module: Inclusivity in the Learning Environment
#establish
Establish an Educational Alliance
STRATEGY
What to do?
- Communicate with learners about the scope and boundaries of your role across teaching relationships and encounters
- Make explicit when you have expectations of learners that go beyond those of the program
- Set the expectation that you will do frequent low stakes observations (assessments), and that as possible you provide learners the chance to demonstrate improvements (deliberate practice)
- Make feedback conversations less threatening by discussing a plan in advance (when, where, how, etc)
APPLICATION
What might this look like?
You and your learners are clear on your role(s) and boundaries
The curriculum establishes some assumptions teachers and learners will have of each other. Individuals may add to and refine these with time. Teachers should be aware whether they are working as knowledge conveyer, preceptor, coach, mentor, advisor, sponsor, evaluator, advocate, etc..
Your learners are aware of unique expectations you might have of them up front
E.g., “In this office, we have a particular chart note format that you’ll need to follow.”
E.g., “I know a lot of students ask preceptors for reference letters, just so you know up front, I only provide a reference to students who have written a case report during the rotation”.
Your learners quickly recognize that they should seek your observation and feedback
Learners tend to be open to showing vulnerabilities when the teacher demonstrates a growth mindset. Trust in this is built through setting up and following through with opportunities for the learner to demonstrate the ability to learn after failure.
Learners are not “caught off guard” when you initiate feedback, nor unsure when to open conversations
E.g., “I tend to provide little suggestions along the way, including in front of patients, and then more formally at mid and end of rotation”.
E.g., “Please catch me for feedback discussions with your WBA form in hand at least once a day. Whenever there is a pause in clinic flow, that is so long as there is no patient waiting, you are welcome to ask me”.
REFLECTION
What would your learners say?
Are learners feeling neglected or that you’re not providing enough active learning opportunities? Are learners feeling negative or resistant to your feedback? Do learners interpret your assessments as learning opportunities?
DEEPER DIVE
Underlying theories
Educational Alliance: There is evidence that just as a patient’s healing is compromised when they do not sense a positive relationship with their psychiatrist, a student’s learning is compromised by deficiencies in the teacher-learner relationship (Telio et al., 2015).
Development along multiple layers of competence: Distinguishing the layers of medical competence into ‘what everyone should have’, what those in particular contexts need, and personal competencies (ten Cate et al., 2023; Ramani et al., 2023) may support empathy of teachers and learners in aligning their relationships and foci in feedback conversations.
#establish
#emerge
Emerge a Shared Learning Agenda
STRATEGY
What to do?
- Review objectives with the learner
- Support the learner’s intrinsic motivation for the session/ rotation
- Set yourself up to personalize discretionary parts of the rotation
APPLICATION
What might this look like?
You take your learner’s educational history at the start of the rotation
A learner’s educational history includes an overview of previous rotations and relevant work experiences, their career goals, and any objectives the learner might have beyond those of the program. This should also be done in a way that supports the learner in communicating if there is a need for educational accommodations.
The teacher and learner are focusing on the same objectives
If not yet familiar with the curricular objectives, teachers can ask students to provide a summary. Helping a learner understand the relevance of content fosters their motivation to invest in deeper learning.
You work with learners to define their Zone of Proximal Development at the start of the session/rotation
The educational history and discussion of objectives serves as a foundation upon which to start to define the learner’s zone of proximal development; that space between which the learner can act independently and with the support of the teacher. The goal is to focus workplace learning in that zone.
REFLECTION
What would your learner say?
Are all learners intrinsically motivated during your rotation/session? Is the balance between support and challenge optimized for each learner?
DEEPER DIVE
Underlying theories
Motivational theory: When learners are intrinsically motivated (v.s. motivated by extrinsic factors such as grades or money) their learning is deeper and more lasting. Teachers can support learners to develop intrinsic motivation by helping them understand the relevance of the competencies to the learner’s goals, and when there is discretion during a rotation, develop learning activities most relevant to the learner (Jarvis Salinger, 2012; Armstrong, 2013).
Zone of proximal development: This is the space between which the learner can act independently and with the support of the teacher. With the teacher’s ‘scaffolding’, the learner can efficiently ride steep learning curves. A teacher finds the learner’s zone by listening to and observing the learner (Vygotsky 1978; Ramani et al., 2023). More on this below.
The Daloz model (1986) purports that respective levels of challenge and support determine whether the leaner will grow, regress, have status, vs. validation.
Figure: Support vs challenge: Balancing support and challenge is essential for professional development and growth of mentees (Daloz, 1986; Chen TCP talk).
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