How to Be a Teaching Star

By Teresa Carr
An innovative educational training program is improving the quality of instruction for Einstein students

The teenager had a deep gash in his forehead, and James Yuan, M.D., was a medical student on rotation in the emergency room at Children’s Hospital at Montefiore (CHAM). A resident, William Sokoloff, M.D., pulled in Dr. Yuan to help treat the young man, and the experience is something Dr. Yuan says he’ll never forget. “Will walked me through the process of suturing, explaining what he was doing and why. All the while, he was still reassuring the patient,” says Dr. Yuan, now a pediatric resident at CHAM. “I felt involved even though I was mostly watching. It was really cool.”

Dr. Sokoloff, now a pediatric chief resident in hospital medicine at CHAM, says that the feedback he has received from people like Dr. Yuan through Einstein’s Teaching Star Program has been invaluable in helping him become a better instructor. One of the main things he has discovered, he says, is that “the lessons that stick with students, those that they learn the most from, are interactive and are with or about a patient.”

Now that Dr. Yuan is responsible for teaching medical students himself, he tries to emulate Dr. Sokoloff’s approach. “While on the wards, medical students struggle with whether they are just going to be a fly on the wall or more actively involved with the patients,” he says. “I try to put myself back in their shoes and keep them engaged and interested.”

Dr. Sokoloff adds: “Part of what you are supposed to learn through your medical training is how to teach medicine to other people. Teaching is an art and science unto itself, but most doctors don’t receive much guidance—much less formal training—on the topic.”

Young man uses stethoscope to listen to heart of a child in hospital bed as young woman sits next to child and leans in. Dr. William Sokoloff tends to a young patient at Children’s Hospital at Montefiore as third-year medical student April Dobkin looks on.

A National Model

Einstein’s Teaching Star program was originally developed five years ago to provide nonfaculty instructors with clear learning objectives for the courses and clerkships in which they taught, says Joshua Nosanchuk, M.D., senior associate dean for medical education at Einstein.

Under the leadership of Pablo Joo, M.D., associate dean for medical education and curricular affairs, it has become a national model, earning commendations from the Middle States Commission on Higher Education and from the Liaison Committee on Medical Education, the body that accredits medical schools.

This year, about 2,000 people received training through Teaching Star. “It has been a massive endeavor,” Dr. Joo says. “But it’s the right thing to do—for everyone involved.”

Teaching Guidance

Teaching Star also provides resources to help people become more effective teachers. For example, it’s a teacher’s job to point out students’ mistakes, but sharp criticism can cause students to pull back from learning situations. The training covers practical tips for giving constructive feedback and setting up a positive learning environment—reinforcing what students do right, correcting mistakes without being judgmental, and helping students plan the next steps.

“I wish something like this had been around when I was going through my medical education,” says Amanda Raff, M.D., associate chair of medicine for undergraduate medical education at Einstein and Montefiore. “I would have enjoyed more explicit guidance and direction on ways you can teach.”

In medicine, Dr. Raff notes, “there’s a long history of  ‘see one, do one, teach one,’ with the expectation that we all know how to teach. But most of us can get better with some education about teaching skills. We can give these young teachers some tools so that they can do their best.”

Under Dr. Pablo Joo, it has become a national model. This year, about 2,000 people received Teaching Star training. “It has been a massive endeavor. But it’s the right thing to do.”

In addition to faculty and residents, many other professionals, including graduate students, postdoctoral researchers, clinical fellows, nurses, and social workers, teach students. That diversity of skills and experience creates a rich learning environment, Dr. Joo says. But it can be a challenge to bring everyone up to speed.

“Medicine is a dynamic field,” says Ruth Howe, an M.D./Ph.D. student who teaches histology to first-year medical students. She has been known to belt out “Bone! What Is It Good For?” to the tune of Edwin Starr’s “War” during class while dancing the electric slide, and her engaging style earned her a Teaching Star commendation last year. “You have to be aware of learning styles and figure out how to modify your teaching accordingly,” she says. “Teaching Star helped me become more conscious of that.”

Continuous Improvement

Teachers also need feedback to get better at their jobs, so the Teaching Star program uses surveys that students submit anonymously to evaluate teachers’ effectiveness. The office of medical education reviews each individual comment in order to identify issues that may otherwise get lost in the aggregated information.

All instructors receive teaching evaluation reports based on those surveys and can see how their performance stacks up against benchmarks for teaching behaviors, from subpar to excellent. Those with low scores are flagged for teaching improvement.

“We approach each situation from the position that we all want to provide the best possible educational experience for our students—and that this is an opportunity for growth for instructors,” Dr. Joo says. “Those who need some additional guidance or support meet with their course or clerkship director, and the two of them determine the best way to enhance their performance.”

Those with high marks from their students receive commendations as “Teaching Stars.” According to Dr. Joo, the recognition for teaching excellence has motivated residents to take that aspect of their job seriously and strive for the honor. It is also a nice award to include on their resumes.

Woman holds model of spine as female and male student look on. Ruth Howe, an M.D./Ph.D. student, uses a model of the spinal column to instruct first-year medical students Janet Conde, center, and Obioesio Bassey.

The evaluation reports are “a fantastic part of the program,” says Catherine C. Skae, M.D., associate dean for graduate medical education at Einstein. “Otherwise I would have no idea who the good teachers are and who puts extra effort into teaching,” she adds.

Dr. Skae says she particularly enjoys the opportunity to praise people who are doing a great job. “When residents and fellows, who are extremely busy all the time, are taking the time to devote themselves to medical student teaching, it’s wonderful to salute that,” she says.

Dr. Sokoloff, a Teaching Star award recipient, says he relies on the feedback from evaluations to “learn how to reach people in different ways.” He has discovered, for example, that a short lecture during rounds might help some students, while others need to read more about the subject or see a diagram.

“You are required to teach someone concepts and skills in the moment, often with patients right in front of you,” he says. “If you’re going to get better at it, you need someone to tell you if you are doing it wrong or right.” He adds, “I didn’t realize what went into teaching until it became so much of my job.”

Dr. Sokoloff’s experience is not unique. Data collected from student surveys suggest that the Teaching Star program has helped improve the overall quality of teaching at Einstein and its affiliates. “Over the years, we’ve seen the number of commendations increase, while flags have decreased,” Dr. Joo says. Few people get flagged more than once, which indicates that the personalized guidance on teaching skills is successful.

Lifelong Skills

The next step for Teaching Star, Dr. Joo says, is to expand the program to encompass and train medical students as peer educators. That’s in line with the program’s larger mission, which, he says, is to “help people think about their roles in medical education.” In today’s interactive environment, students learn from their peers as well as from their instructors. And as they progress through their medical training, they will take on increasing responsibility for instructing students in classes that follow theirs.

Expanding the program is a great idea, Ms. Howe says. Teaching skills have been “a bit of a neglected part of clinical training,” she says. “Nothing makes you learn the material as well as teaching it does. I see it as a career skill, something that I’ll use for the rest of my life.”

Dr. Sokoloff says that the time he invests in teaching is helping make him a better physician. “If you are not able to do a good job teaching concepts to your peers,” he says, “then you are definitely not going to be able to talk to your patients and their families in a way that they can understand.”

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