Not yet a dinosaur: the chalk talk

Flipping the Teachers: Impact of a Standardized Physiology Curriculum on Neonatology Medical Educators

OBJECTIVE

 Academic physicians must teach elements in an Accreditation Council for Graduate Medical Education (ACGME)-mandated curriculum while balancing career development and clinical workload. Exploring educator perceptions on the learning environment and comparing two instructional methods (traditional didactics [TD] vs. flipped classroom [FC]) in one pediatric subspecialty may elucidate current challenges, barriers, and strategies to optimize learning and educator satisfaction.

STUDY DESIGN

 A randomized trial comparing effectiveness and learner preference for FC versus TD physiology teaching was conducted in ACGME-accredited neonatal-perinatal medicine (NPM) fellowship programs in 2018 to 2019. Educator preferences were elicited through online surveys pre- and postintervention. Free-text comments were provided for questions exploring strengths, challenges, and opportunities in fellowship education. Statistical analysis included comparisons of demographics and pre-post-intervention educator responses between groups. Thematic analysis of text responses was conducted to identify common subthemes.

RESULTS

 From 61 participating programs, 114 FC educators and 130 TD educators completed surveys. At baseline, all educators experienced professional satisfaction from teaching fellows, but noted challenges with time available to create and/or deliver educational content, limited content expertise amongst faculty, colleagues' limited enthusiasm toward educating fellows, and lack of perceived value of education by institutions given limited protected time or credit toward promotion. Postintervention, educators in both groups noted a preference to teach physiology using FC due to interactivity, learner enthusiasm, and learner-centeredness. FC educators had a 17% increase in preference to teach using FC (p = 0.001). Challenges with FC included ensuring adequate trainee preparation, protecting educational time, and providing educators with opportunities to develop facilitation skills.

CONCLUSION

 Overall, NPM educators in a trial evaluating a standardized, peer-reviewed curriculum report professional satisfaction from teaching, but described logistical challenges with developing/delivering content. Educators preferred instruction using FC, but identified challenges with learner preparedness and ensuring adequate educator time and skill. Future efforts should be dedicated to addressing these barriers.

KEY POINTS

· Many challenges exist for educators teaching neonatal-perinatal medicine fellows, including time, support, and recognition.. · Many educators preferred using flipped classroom methodology with a standardized curriculum due to interactivity and learner-centeredness.. · Benefits of a standardized, peer-reviewed curriculum include reduced preparation time, adaptability of content, and learning environment enhancement..

Chalk Talks for the Clinical Setting: Evaluation of a Medical Education Workshop for Fellows

Introduction

Chalk talks are effective teaching tools in the clinical setting. However, data on optimal strategies for teaching medical educators how to develop and deliver them are limited. We designed and implemented two 50-minute workshops to help subspecialty fellows across GME create and deliver a chalk talk.

Methods

The first workshop comprised a demonstration of an effective chalk talk and a discussion of best practices for creating chalk talks; the second was a practice session where fellows presented their chalk talks and received feedback from faculty and peers. We evaluated pre- and postworkshop confidence in the ability to create and deliver a chalk talk and develop learning objectives. Secondary outcomes were faculty and peer evaluations of the chalk talks.

Results

Eighteen of 33 participants (54% response rate) completed both pre- and postsession surveys. Fellows reported improved confidence in their ability to create a chalk talk (22% vs. 83%, p < .001), deliver a chalk talk (17% vs. 83%, p < .001), and develop well-written learning objectives (11% vs. 83%, p < .001). After the workshop, participants were more likely to correctly identify a chalk talk that made use of an advanced organizer (67% vs. 89%, p < .05). Thirty-eight faculty and peers completed feedback evaluations of participants' chalk talks; most rated fellows' chalk talks highly in domains of content, delivery, design, learning objectives, and engagement.

Discussion

The incorporation of these workshop within a course on medical education can effectively develop clinical teaching skills among subspecialty fellows in GME.

A Primer for Developing Chalk Talks

Chalk talks are a ubiquitous teaching strategy in both pulmonary, critical care, and sleep medicine and medicine in general; yet, trainees and early career faculty are rarely taught how to design, prepare, and present a chalk talk. Skills necessary to deliver a chalk talk are transferable to other settings, such as the bedside, wards during rounds, and virtual classrooms. As a teaching strategy, the chalk talk can involve learners at multiple levels, foster practical knowledge, stimulate self-assessment, encourage the generation of broad differential diagnoses, and promote an interactive learning environment. Suited for both formal and informal learning, the chalk talk can be prepared well in advance or, after some practice, can be presented "on the fly." Furthermore, often on the wards or in the intensive care unit, team members are asked to "teach the rest of the team" at some point during rounds. There is little guidance in medical education for students and trainees to prepare for how to do this, and the chalk talk can serve as an excellent format and teaching strategy to "teach the team" when tasked to do so. To highlight our perspectives on best practices in using the chalk talk format effectively, we first briefly review the literature surrounding this very common yet understudied teaching strategy. We then provide a primer on how to design, develop, and deliver a chalk talk as a resource for how we teach residents, fellows, and early career attendings to deliver their own chalk talks.

Evaluating Live Virtual Chalk Talks as a Teaching Tool for Medical Students on a Dermatology Clerkship

The COVID-19 pandemic has highlighted a continued need for innovative virtual teaching methods. Chalk talks, or brief illustrated interactive talks, are easily made virtual with an online whiteboard. We evaluated the efficacy of a live virtual chalk talk curriculum for medical students on their dermatology clerkship. A curriculum of one to three 1-h chalk talks was designed on the following topics: papulosquamous diseases, erythroderma, and immunobullous diseases. Talks were delivered monthly via Zoom to dermatology clerkship students. Pre- and post-talk surveys were administered to assess knowledge, confidence, and satisfaction. Compared with pre-talk, students (n = 18) achieved a greater percentage of possible points on knowledge assessment questions after the talks (41.0 ± 27.7% versus 90.4 ± 18.4%, p < 0.001). As assessed on a Likert scale (1 = not at all confident, 5 = extremely confident), students became more confident in differentiating conditions within each disease group and working up the conditions (2.02 ± 0.53 versus 3.53 ± 0.55, p < 0.001, and 2.09 ± 0.44 versus 3.76 ± 0.89, p < 0.001, respectively). Qualitative responses showed that students appreciated the student-teacher interactions. In conclusion, we found that live chalk talks are an effective and engaging way to teach dermatology to medical students in the virtual setting.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01781-4.

TEAMwork! An Innovative Hospital Medicine Teaching Program to Enhance Learners' Educational Experience

PROBLEM

Workplace-based learning and assessment are dependent on frequent observations, feedback, teaching, and evaluations. Yet high physician workload and multiple learners limit these efforts. A local needs assessment demonstrated insufficient direct observations, small-group teaching, and high-quality evaluations for learners. In response, the authors developed and implemented Teaching Excellence Among Medical providers (TEAM), a teaching program to enhance the educational experience of learners in pediatric hospital medicine (PHM).

APPROACH

The TEAM program, grounded in a self-regulated learning framework, launched in 2019. The University of Colorado Department of Pediatrics provided salary support. TEAM hospitalists completed professional development for teaching and feedback skills. During their TEAM shifts, they observed, provided feedback, completed evaluations, and led teaching sessions for learners on PHM rotations. The program's impact was evaluated by using an electronic work tracking form and surveying learners, attending hospitalists, and TEAM hospitalists, leading to iterative program improvements.

OUTCOMES

Over an 18-month period, TEAM hospitalists completed 1,573 direct observations, 265 teaching sessions attended by 1,921 learners, and more than 497 learner evaluations. Survey results showed that 95% of learners indicated TEAM was "very effective" or "somewhat effective" in helping achieve individualized learning goals, and a similar percentage "strongly agreed" or "agreed" that TEAM hospitalists were effective educators. Eighty-four percent of attending hospitalist survey respondents reported TEAM contributed "very much" or "somewhat" to learner education. Attending hospitalists particularly appreciated TEAM's ability to focus on learners identified as struggling, while TEAM hospitalists rated observation of rounds and small-group teaching sessions as the most valuable TEAM activities.

NEXT STEPS

The TEAM program employed concepts of self-regulated learning to enhance education in PHM through direct observation, feedback, written evaluations, and teaching efforts. This program can mitigate many challenges facing attending physicians and can serve as a model for other institutions. Next steps include evaluation of higher-level learning outcomes.