Kimberly A. Gifford, MD, Leslie H. Fall, MD, Dartmouth Medical School, Lebanon, NH
Background: While medical educators recognize the necessity of ensuring that learners develop lifelong learning skills across all levels of training, effective methods to teach these skills are not well defined. Doctor Coach is an innovative resident-as-teacher curriculum for resident teaching of clinical skills with a focus on lifelong learning principals for both the resident teacher and their learner. Goals: To improve resident use of effective clinical teaching techniques and to improve student perceptions of learning, with a focus on teaching and learning physical exam (PE) skills. Methods and Evaluation: A three year longitudinal resident-as-teacher curriculum was implemented at the Children’s Hospital at Dartmouth Residency program. The curriculum consisted of five 45 minute workshops per year focused on tools for residents to use when teaching students. PL2 and 3 residents (N=14) self-evaluated their use of teaching strategies at the end of years 2 and 3. Medical students, who were blinded to the resident intervention, evaluated each resident with whom they worked at the end of their rotation. Responses were rated on a Likert scale (1=never, 3=sometimes, 5=always) and T-tests were used to compare differences between response means between pre and post intervention. Results: Residents reported more frequently asking students how they planned to practice to achieve their learning goals after the intervention (2.29 vs 3.23, p=0.04). Relative to pre-intervention students, post-intervention students reported receiving significantly more feedback from residents on their PE skills (3.17 vs 4.67, p=0.001), that residents more frequently helped them to perform accurate PEs (3.44 vs 4.17, p=0.02), and that residents more frequently asked them to investigate clinical questions and followed-up on their findings (3.89 vs 4.53, p=0.006). Qualitatively, residents perceived that their own lifelong learning skills improved through participation in the curriculum. Conclusions: Doctor Coach is a resident teaching intervention that increased resident use of effective teaching techniques. Additionally, residents reported improvements in lifelong learning skills. Costs of curricular implementation at another institution would include training of the resident-as-teacher instructor, time in the conference schedule for workshops and buy-in from relevant clerkship and rotation directors to ensure residents have an opportunity to apply these new skills.