287 - Employing Reflective Writing to Gain Insights from a Resident Teaching Elective Curriculum

Poster Number: 287
Publication Number: 287.421

Grace S. Chandler, University of Colorado School of Medicine, denver, CO, United States; Grace Huh, University of Colorado School of Medicine, Denver, CO, United States; Savannah Brackman, Children's Hospital Colorado, Denver, CO, United States; Jamie Archambault, University of Colorado School of Medicine, Denver, CO, United States; Kimberly O'Hara, University of Colorado School of Medicine/Children’s Hospital Colorado, Denver, CO, United States

Background: The ACGME requires programs to promote lifelong learning in residents by developing their practice as “scholarly teachers.” However, patient care and scheduling demands often limit time dedicated to honing teaching skills. Prior research has shown reflection can foster self-regulated learning, leading to enhanced knowledge and competence. We created the Teaching Elective At Children’s Hospital (“TEACH”) to allow protected time for pediatric residents to improve their educator skills through deliberate practice and subsequent reflection.

Objective: To describe residents’ perceptions of their practice as teachers after TEACH and to evaluate this dedicated teaching elective through the use of narratives

Design/Methods: TEACH, a 2- to 4-week curriculum, was developed using Kern’s Six-Step Approach and implemented in Fall 2018. Residents (PGY 2-4) completed the following educational strategies: readings and videos about clinical teaching; direct observation and feedback to learners in the inpatient setting; small group teaching. They were instructed to write about their experiences at the end of the elective, reflecting on their time as educators and the effectiveness of the curriculum. The focus of this abstract is on these resident narratives. Using basic interpretative qualitative methodology, four reviewers coded all written reflections individually, as pairs, and then as a group, iteratively until consensus of themes was obtained.

Results: Thirty-two pediatric residents completed the elective and written reflection. Qualitative analysis revealed the following themes: 1) Self-perceived improvement in teaching skills, including increased intentionality and providing more specific and actionable feedback; 2) Benefits of deliberate practice, such as enhanced confidence with teaching and feedback during difficult situations like struggling learners; 3) Utilization of effective teaching tools (e.g. visual aids); 4) Greater appreciation for learner-centered teaching and longitudinal observation of learners; 5) Affirmation of a career interest in medical education. Regarding TEACH, residents commented on: 1) The value of dedicated time to hone skills; 2) Possibility of “feedback fatigue” (Table 1).Conclusion(s): Reflective writing offered valuable insight into self-reported change in behaviors and attitudes related to many tenets of high-quality teaching and feedback following completion of this elective. Narrative medicine may be helpful in evaluating learning outcomes of similar curricula. Next steps include observing residents before and after TEACH to confirm increased competence and behavior change.
Table 1Themes obtained from qualitative analysis of TEACH resident narratives and illustrative quotes regarding resident experiences as educators and the elective’s curricular design