Teaching in the Operating Room Deirdre Bonnycastle Pasqua Hospital March 25 th , 2009

Objectives Upon completing this session, the participant will be able to: Identify the steps in the BID method, a student-centred approach Plan a teaching session using the BID method.

Upon completing this session, the

participant will be able to:

Identify the steps in the BID method, a student-centred approach

Plan a teaching session using the BID method.

Excerpted from The Briefing, Intraoperative Teaching, Debriefing Model for Teaching in the Operating Room Nicole K Roberts, PhD, Reed GWilliams, PhD, Michael J Kim, MD, Gary L Dunnington, MD, FACS Journal of the American College of Surgeons

The Briefing, Intraoperative Teaching,

Debriefing Model for Teaching in the

Operating Room

Nicole K Roberts, PhD, Reed GWilliams, PhD,

Michael J Kim, MD, Gary L Dunnington, MD,

FACS Journal of the American College of

Surgeons

Theoretical Underpinning Like Patient-centered medicine, Student-centered learning focuses not on what the physician wants to teach,

Like Patient-centered medicine,

Student-centered learning focuses

not on what the physician wants to

teach,

Theoretical Underpinning Like Patient-centered medicine, Student-centered learning focuses not on what the physician wants to teach, but on what the student/resident needs to learn.

Like Patient-centered medicine,

Student-centered learning focuses

not on what the physician wants to

teach,

but on what the student/resident

needs to learn.

BID Method B riefing I ntraoperative D ebriefing Picture Life Magazine

B riefing

I ntraoperative

D ebriefing

Educational Principle A survey of 181 doctors, published in the open access journal BMC Medical Education, has shown that from ten of the procedures medics are officially required to be competent at, most are only confident of their ability to perform five. Graeme Baldwin

A survey of 181 doctors, published in the open

access journal BMC Medical Education, has

shown that from ten of the procedures medics

are officially required to be competent at, most

are only confident of their ability to perform

five.

Graeme Baldwin

Preparation Who is your student? Objectives for that level Previous rotations Personal skills

Who is your student?

Objectives for that level

Previous rotations

Personal skills

Unconsciously Incompetent Theoretical Underpinning Consciously Incompetent Observation

Unconsciously

Incompetent

Theoretical Underpinning Consciously Incompetent Consciously Competent Teaching

Theoretical Underpinning Unconsciously Competent Consciously Competent Practice

Unconsciously Incompetent Theoretical Underpinning Unconsciously Competent New Challenges

Unconsciously

Incompetent

Preparation What resources are available? Personal Colleagues Team Simulators

What resources are available?

Personal

Colleagues

Team

Simulators

Simulation Technology Among the key determinants of learning a spinal anaesthetic technique are the acquisition of knowledge and recognition of certain characteristic "sensations" as the procedure is performed. http://www.idc.ul.ie/dbmt/technology.html

Among the key determinants of learning a

spinal anaesthetic technique are the

acquisition of knowledge and recognition of

certain characteristic "sensations" as the

procedure is performed.

http://www.idc.ul.ie/dbmt/technology.html

Briefing 1 Skill/Procedure Observe Practice 1-2 CanMeds Roles Observe Practiced Mutually select what the student will learn today .

1 Skill/Procedure

Observe

Practice

1-2 CanMeds Roles

Observe

Practiced

Scrub Sink Briefing Rehearsal Great patient safety technique What are the 5 steps of…?

Rehearsal

Great patient safety technique

What are the 5 steps of…?

Intraoperative Coach and guide the learner through the operation Discussion focused on mutually shared learning goals Intentionally Role Model

Coach and guide the learner through the operation

Discussion focused on mutually shared learning goals

Intentionally Role Model

Intraoperative Verbalize your actions and try not to throw around the instruments – surgery resident

Verbalize your actions and try not

to throw around the instruments

– surgery resident

Debriefing Ideally during the closing, the preceptor and the learner debrief about the encounter based on the agreed upon objectives. 10 minutes

Ideally during the closing, the

preceptor and the learner debrief

about the encounter based on the

agreed upon objectives.

10 minutes

Debriefing The debriefing consists of four elements: reflection rules reinforcement correction.

The debriefing consists of

four elements:

reflection

rules

reinforcement

correction.

Plan a teaching session using the BID method. Briefing You and the 1 st year resident agree that they are ready to learn to do spinal anaesthetic technique. How do you decide if she is ready to observe or practice?

Briefing

You and the 1 st year resident agree

that they are ready to learn to do

spinal anaesthetic technique.

How do you decide if she is ready to

observe or practice?

What CanMeds role might the student learn during this process? How do you decide if he is ready to observe or practice that role? Does the student need a rehearsal?

What CanMeds role might the student

learn during this process?

How do you decide if he is ready to observe

or practice that role?

Does the student need a rehearsal?

Intraoperative Practice What do you need to Intentionally Role Model? What questions might you ask the student?

What do you need to Intentionally Role Model?

What questions might you ask the student?

Debriefing Practice What questions might you ask to help the student reflect? What key rules might you want to cover? Give an example of specific encouragement? Give an example of specific correction?

What questions might you ask to help the student reflect?

What key rules might you want to cover?

Give an example of specific encouragement?

Give an example of specific correction?

More Information http://medicaleducation.wetpaint.com/page/Teaching+in+the+Operating+Room

http://medicaleducation.wetpaint.com/page/Teaching+in+the+Operating+Room

Thank You