Vol. 3 2022 - WHEA Teaching Newsletter : simplebooklet.com

In This Volume:Editor's Note & Director's ReflectionsAbeer Abouyabis, MDAlhamza Al-Bayati, MDRuba Al-Ramadhani, MDVaidehi Avadhani, MDAndrea Crowell, MDSwapan Dholakia, MDMichael Fiedorek, MDTheresa Goodman, PhDJ. Sonya Haw, MDHeather Hipp, MDCandace Hobson, MDH. Joon Kim, MDDeepika Koganti, MDJimi Malik, MDSarah Markley Webster, MDMeredith Maxwell, MDJames McLeod, DNP, CRNA Julie Mitchell, DOYolaine Nozile, RNJeanne Overby Page 03Page 04Page 06Page 08Page 09Page 10Page 12Page 13Page 14Page 16Page 18Page 19Page 21Page 23Page 24Page 25Page 27Page 29Page 31Page 33Page 35Page 01WHEA Teaching Fellowship Newsletter

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Ulemu Luhanga, MSc, MEd, PhDCo-DirectorWoodruff Health Educators Academy (WHEA)One of the program deliverables for the WHEATeaching Fellowship is a Small Teaching Report.Fellows are asked to pick a topic/concept that wascovered during the program and use theExperiential Learning Cycle to 'test' out a smallbut powerful modification to their teachingdesign or practices. This newsletter represents acompilation of reports from the 2021-22 WHEATeaching Fellows. Taryn Taylor, MD, MEdCo-Director WHEA Teaching FellowshipThe WHEA Teaching Fellowship wasdeveloped to support the professionaldevelopment of individuals who arepassionate about teaching and learning. F E B . 2 0 2 2 | V O L . 3WHEA Teaching Fellowship Newsletter Page 03While we could not have predicted it, remote, hybrid, and HyFlex teaching is here tostay. So why not optimize use of these models to provide learners with multipleforms of content delivery, learning environments, and knowledge assessmentresources? This is exactly what many of our Teaching Fellows have done! Over thecourse of the program, Fellows have shared their experiences and strategies and wehave all learned a great deal from one another. We are excited to showcase thiscohort of emerging education leaders and applaud their accomplishments to date. NOTE: Our fellows use the mnemonic “Hook ‘em, Teach ‘em, Assess ‘em” to chunkand apply Gagne’s Nine Events of Instruction model. This mnemonic was developedby Richard Ramonell, MD during his time as a learner in the EUSOM GME’s MedicalEducation Track.

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Written by Abeer Aboouyabis, MDAssistant ProfessorHematology/Medical OncologyEmory University School of MedicinePage 04WHEA Teaching Fellowship NewsletterCONTEXT:In my didactic sessions about inpatientmanagement of sickle cell pain crisis Itarget all healthcare providers (HCPs)involved in the inpatient clinical careof sickle cell disease (SCD) patients:nurses, advanced practice providers,hospitalists, fellows and residents. Mydidactic sessions aim to provide astandardized approach to inpatientmanagement of sickle cell pain crisiswithin Emory healthcare. I usually givethose sessions in classrooms orvirtually. SELECTED TEACHING & LEARNINGTOPIC:I applied Gagne’s 9 stepwise approach tomy didactic session.Learners focus better when the objectivesare clearly outlined in the beginning Repeating the objectives slide betweensections also helps re-focus learnersattention Engaging learners by asking their inputon how they would approach certainclinical situations/ scenarios is veryeffective in providing them with self-assessment of their baseline knowledgeon the topic as well as deficits whichmotivates them to be more engaged in thethought process that leads eventually tothe learning point. Hook ‘em, Teach ‘em, Assess ‘em:Hook ‘em- I added an ‘Objectives Slide’ in thebeginning of the session. Then I started eachsection of inpatient management of SCD withpertinent myths trying to capture learners’attention to common pitfalls in currentpractices. Teach ‘em- I used PowerPoint, making aneffort to keep slides concise and informative.At the beginning of each section I presenteda case with multiple choice questions (MCQs)related to management options in an attemptto assess learners’ foundational knowledge(from Fink’s Taxonomy). Afterwards, Ipresented evidence-based data to facilitatethe development of critical and practicalthinking skills among learners that wouldguide them to the application of appropriatecare management standards.Assess ‘em- At the end of each section wewent back to the initial case presentation,answered the same MCQs and comparedresponses before and after the ‘Teach’em’part.LESSONS LEARNED:F E B . 2 0 2 2 | V O L . 3

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Page 05WHEA Teaching Fellowship NewsletterI intend to incorporate pollingmore into my teaching sessions.Poll Everywhere is a very usefulmethod: Polling during lectures toassess learners’ baselineknowledge on the spot andengage them in the learningprocess. Polling at the end to getfeedback from learners toimprove my teaching process At the end of each session I intendto add a feedback toolincorporating the 3:2:1 method(name 3 things learned from thissession, 2 things you plan toimplement and one thing youwould like to beincluded/elaborated upon in futuresessions) IMPLICATIONS FOR FUTUREPRACTICE:F E B . 2 0 2 2 | V O L . 3

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Written by Alhamza Al-Bayati, MDAssistant ProfessorDepartment of Internal Medicine & GeriatricsEmory University School of MedicinePage 06WHEA Teaching Fellowship NewsletterCONTEXT:My learners are neurology residentsand medical students rotating on strokewards during their inpatient or electiveneurology rotations. Typically, mostteaching activities throughout inpatientneurology rotation are encounteredduring rounds while going overpatients’ clinical and imaging data aswell as at bedside obtaining furtherhistory and going over pertinentphysical exam findings. Historicallyand nationally, neurologists-in-traininghave not had structured neuro-intervention education during theirmedical school or neurology trainingexposure. The main objective is to shedlight on neuro-interventional aspect of neurology by introducing the learners tothis field early in their neurology trainingand education.SELECTED TEACHING & LEARNINGTOPIC:Using Gagne’s model of Hook ’em, Teach’em and Assess ’em, the primary aim is toaugment learners knowledge ofneurovascular anatomy, physiology, andpathophysiology.In addition, secondary fociincluded the importance of time sensitiveworkflow, multi-and intra-disciplinarycollaboration among teams, emphasizingthe importance of weighing therisks/benefits, and understanding theindications and limitations of neuro-interventional procedures. Subsequently,getting learners to consider thissubspecialty as the learners determine theirown career path.On the granular level during our dailyrounds, all learners were “hooked”by ourin-depth analysis of all cerebrovascularcases, particularly those that warrant somesort of mechanical interventionalevaluation. Learners were taught the basicanatomical application of their patients’presenting symptoms, potential underlyingpathological processes along with theiroptimal evaluation, and finally the currentguidelines on how to tackle them. Afterfinishing bedside rounds, learners spentadditional time in the cath lab going overtheir patients’ angiographic imaging,getting to point out the pertinent findingsthat they learned earlier and gettingintroduced to the technical approach ofhow to acquire these images and applyapplicable treatments. F E B . 2 0 2 2 | V O L . 3

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Page 07WHEA Teaching Fellowship NewsletterLESSONS LEARNED:It’s all about first impression!Spending extra attention to developlearners’ curiosity prior to diving intothe overwhelming details will elevatetheir interest and enhance earlylearning skills given their activeengagement from the get go. IMPLICATIONS FOR FUTUREPRACTICE/TEACHING TIPSContinue to plant the seeds and assessall learner interests then furtherdevelop those with keen passion bydedicating extra time to implementmore focused education. Never stopoptimizing your techniques bycritically investigating the feedbackreceived from your learners or co-educators then swiftly modify yourapproach accordingly. F E B . 2 0 2 2 | V O L . 3

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Written by Ruba Al-Ramadhani, MDAssociate ProfessorDepartment of NeurologyEmory University School of MedicinePage 08WHEA Teaching Fellowship NewsletterCONTEXT:My learners were the pediatricneurology residents to whom I wastasked to build a clinical epilepsyrotation based on their level of training.I implemented 30-minuteselectroencephalogram (EEG) teachingrounds for all trainees on the inpatientneurology consult team (includingpediatric neurology residents, adultneurology resident, pediatric residents,and medical students). Rounds wereheld both virtually and in-person giventhe two different locations covered bythe trainees. Teaching sessions wereinteractive and allowed the learners togive immediate feedback and able toanswer questions.APPLYING TEACHING & LEARNINGTOPIC TO YOUR CONTEXT: Aligning learning needs and outcomes.LESSONS LEARNED:Technology is growing and plays a crucialrole in any curriculum development andimplementation. We faced challenges inchoosing the right medium that canaccommodate sharing EEG as well as theelectronic medical record system during theeducational rounds. Building and developing a curriculum goalsand objectives that can fit learners indifferent stages of their training can bechallenging. I have tried to implement self-identification strategy where each learnerwas expected to bring one interesting/challenging EEG for their level ofeducation to discuss in every teachingrounds. Learners were expected to providefeedback at the end of each teachingsession which allowed modification of theobjective and outcomes based on thelearners needs.IMPLICATIONS FOR FUTURE PRACTICE& TEACHING TIPS:I plan to continue interactiveteaching/learning sessions with my traineesand provide instant feedback to improvetheir learning experiences as well as betterimprove my skills as an educator. F E B . 2 0 2 2 | V O L . 3

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Written by Vaidehi Avadhani, MDAssistant ProfessorDepartment of Pathology & Laboratory MedicineEmory University School of MedicinePage 09WHEA Teaching Fellowship NewsletterCONTEXT:With the onset of COVID-19, ourregular teaching modes of one-on-onesignout and in-person conferences forgraduate trainees had to be drasticallymodified. I started looking for othermethods especially online teachingmethods where it could be bothsynchronous and non-synchronous.The CANVAS format was very suitablefor transitioning from our regularmodes to digital/online mode. I starteddesigning a Cytopathology andGastrointestinal Pathology CANVAScourse for School of Medicine- intendedfor graduate trainees and ancillarystaff involved in our laboratory. Aligning learner needs and outcomes– Application of SMART Goals andBlooms Taxonomy Gagne’s principles of instructiondesign SELECTED TEACHING & LEARNINGTOPIC:LESSONS LEARNED:During my in-person teaching sessions, Irarely used “defined” objectives. Aftergetting accustomed to Bloom’s revisedtaxonomy, I structured my online coursealigning the needs of the learner anddefined the outcomes more specifically.With Gagne’s principles I was able todivide up the content and approach theconstruction of the course in a verymethodical way giving me clarity ofthought and approach. IMPLICATIONS FOR FUTUREPRACTICE / TEACHING TIPS:After experiencing this method ofapplying Bloom’s taxonomy to definelearners’ objectives and outcomes andapplying the Gagne’s nine stepsmethodically to modify my teachingmethod, I feel these concepts have givenme tools to approach teaching in a verymethodical and structured way helping toachieve better outcomes. I plan toconsistently use these methods in all myeducation endeavors. F E B . 2 0 2 2 | V O L . 3

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Written by Andrea Crowell, MDAssistant ProfessorPsychiatry and Behavioral SciencesEmory University School of MedicinePage 10WHEA Teaching Fellowship NewsletterCONTEXT:A didactic lecture given to PGY2 andPGY3 residents in psychiatry who areearly in their psychotherapy training. Ihave given this lecture for a few yearsnow, initially in person, then via Zoom,then in person again. Explicitly, thegoal of this teaching lesson is todemonstrate through modeling andguided discussion how to think aboutpsychotherapy material. When given inperson, this learning exercise had highlearner engagement and was ratedhighly in post-class surveys. Whengiven via Zoom, engagement was lowand was not as well rated by theresidents. SELECTED TEACHING & LEARNINGTOPIC:Gagne’s Principles of Instructional Designwas applied to this lesson in an effort tounderstand how to gain consistent positiveresults and high engagement with thistopic. The “Hook ‘em, Teach ‘em, andAssess ‘em” model had not been applied inthe initial design and earlier deliveries ofthis lecture. When in person, this lesson isdelivered without Powerpoint and isconducted as a semi-structured guidedgroup discussion. Residents are given abrief clinical vignette and then offer theirthoughts, feelings, and questions to thematerial. These reactions build upon eachother as each resident contributes and asthe discussion progresses, the residentsrecognize the emergence of a clinicaltheme, hypotheses about the patient’sunderlying difficulties, and psychotherapytreatment strategies. Given the informaldiscussion-based nature of the usualdelivery of this lesson, learner engagementand performance was not expected to varyas much as it did when we moved to zoom-based didactics. How can this be explained? I suspect that the biggest difference inresponse to this lesson when given inperson vs over zoom lies in Gagne’s “Hook‘em” principles. In person, the lessstructured format is not typical of ourdidactic program and is unexpected by theresidents. The objectives were not stated inspecific and measurable ways and priorknowledge was assumed but not formallyreferenced at the outset of the discussion.Despite the lack of clear and specificobjectives, group discussion when in personwas nevertheless successful in guidinglearners to the intended objectives, likely inpart due to the high engagement of the F E B . 2 0 2 2 | V O L . 3

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Page 11WHEA Teaching Fellowship Newsletterlearners. In retrospect, when alllectures (and even clinical work) aredelivered via Zoom, the less-structured, discussion-based format ofthis lesson is much less attention-grabbing compared to in persondelivery. Without high engagementfrom the beginning, the lack of clearlystated objectives and lack of contextin terms of explicit referencing ofprior knowledge increases the mentalwork of the learner and decreasesparticipation, which impedes theemergence of lesson objectives duringgroup discussion.LESSONS LEARNED:The physical learning environmentaffects the way that learners respondto presented material, even whendelivery of the material is not impededby the environment. Early learnerinterest and engagement from a goodhook may obscure some deficits in thedesign of the lesson. Similarly, moreintentional lesson design can helplearners maintain attention in morechallenging environments. TEACHING TIP:When the environment of a lessonchanges significantly, the lessonshould be redesigned with the newenvironment in mind, as previousstrategies for attaining andmaintaining learner attention may nottransfer effectively to the newlearning environment.F E B . 2 0 2 2 | V O L . 3

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Written by Swapan Dholakia, MDAssistant ProfessorNeurologyEmory University School of MedicinePage 12WHEA Teaching Fellowship NewsletterCONTEXT:I am a lecturer for a didactic course forsleep medicine fellows each year. Mylecture consisted of a power pointpresentation but did not have a formalstructure to it and only presentedinformation on the topic to the sleepfellows. SELECTED TEACHING & LEARNINGTOPIC:Principles of Instructional Design:Gagne’s Nine Events of Instruction. This year, instead of the allocated 1hour to deliver my lecture, I divided thetalk into 2 sessions, 1 hour each. Thefirst session was used to gain the the learners’ attention and informing themof the objectives, as well as presenting thelecture content (hook ‘em and teach ‘em). The second lecture was designed in theform of a series of questions leading tofurther discussion, assessment ofknowledge, providing feedback andenhancing retention (teach ‘em and assess‘em). LESSONS LEARNED:This project taught me the importance offollowing a systematic process whiledesigning my instruction. Gagne’s eventsof instruction provided a solid frameworkupon which I was able to anchor anddevelop my lecture. IMPLICATIONS FOR FUTURE PRACTICE/ TEACHING TIPS:I teach a diverse group of learners in aformal classroom setting as well as bedsideteaching in my clinics. In the future, I planon applying Gagne’s events of instructionin both these settings.F E B . 2 0 2 2 | V O L . 3

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Written by Michael Fiedorek MDAssistant ProfessorEmory University School of MedicineAnesthesiologyPage 13WHEA Teaching Fellowship NewsletterCONTEXT:I am teaching four pediatricanesthesiology fellows point-of-careultrasound (POCUS) as part of theirpediatric anesthesiology trainingexperience. The setting is multifacetedand includes classroom, simulation lab,and clinical learning. SELECTED TEACHING & LEARNINGTOPIC:The assessment of learners’ ability todiagnose rare pathology was the focusof my experiential learning cycle. Irealized that the current practice ofteaching from stock images of rarepathology only allowed for assessment of the learner’s ability to recognize thoseor similar stock images. This practiceseverely limited our ability to assess thelearner’s competence to make clinicallyaccurate point-of-care assessments asstock images are most often pristine,exaggerated examples of more subtlefindings. LESSONS LEARNED:We thus changed our way of teaching rarepathology (by compiling a large data file ofrare pathologic findings that each learnerhad obtained during practice scansessions) and are now better able to assessthe learners’ abilities by using theseimages instead of stock images. IMPLICATIONS FOR FUTUREPRACTICE Our reflection on our assessment methodunexpectedly led to a change in ourteaching approach. I believe that allaspects of teaching are interrelated andgreatly affect components that might notseem connected. Thus, careful reflectionon one area of teaching might lead toimprovements in another. With regard toassessment, the modes of materialpresentation may heavily influence whatcan be fairly expected and thus assessed. F E B . 2 0 2 2 | V O L . 3

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Written byTheresa Goodman PhD, MSN, NP-C Program Director Primary Care NursePractitioner Residency Atlanta VA Health Care SystemPage 14WHEA Teaching Fellowship NewsletterCONTEXT:As Director of the Primary Care NursePractitioner Program, one of my rolesis to facilitate several of the didacticmodules within the program. Theintended learners are newly graduatedNurse Practitioners (NPs) who are inthe NP residency program at AtlantaVA. This group consists of a diversegroup (novice to expert nurses,dissimilar generations, and differentlearning needs) of adult learners. Thesetting was originally planned to be in a face-to-face environment, but due tounforeseen circumstances, it was ahybrid setting (instructor-virtual andresidents-classroom). SELECTED TEACHING & LEARNINGTOPIC:I applied Gagne’s hook’ em, teach’ em,and assess’ em strategies to my didacticmodule on “Sexually TransmittedInfections (STI) in Primary Care”. Thesmall teaching modification incorporatedwas a virtual game to assess for priorknowledge and improve residents’engagement. The use of virtual gameshave been shown to boost engagement,provide immediate feedback, andencourage emotional and socialconnections. HOOK 'EMI modified a game called ‘Jeopardy’ toassess STI background knowledge andengage them.This game consists ofdifferent answers and categoriesregarding STIs in the primary caresetting. The three categories covered were‘also known as’, ‘what is this’, and‘teach/test’. The game had five rows thatranged in points 100 -500. Although thegame was similar to the television game, Icreated a slight change to fostercollaboration and teamwork. Theresident selected the category and pointamount and could answer the questionwithout help to receive all the points. Ifthe resident were unsure, he or she couldask a classmate and that learner couldshare the points. TEACH 'EMI presented a two-hour presentation ondifferent STIs that were common in theprimary care setting. The presentationcovered common STIs, assessmentstrategies, diagnostic tests, treatmentoptions as well as education andplanning. I also presented three case F E B . 2 0 2 2 | V O L . 3

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Page 15WHEA Teaching Fellowship NewsletterMy observational learning showedthat students were engaged,working together to help eachother answer questions. Also, theywere laughing and talking witheach other. The use of the virtual gameenabled students to assess theirknowledge deficit. This helpedthem engage in the presentationand find answers to the questionsthey missed during the game. Adult Learners would love to seemore interactive games in theirlearning environment. studies that were analyzed anddiscussed as a group.ASSESS 'EMThe residents completed two surveys.One survey was specific to theJeopardy game and was completedimmediately after the game ended. Thesurvey results showed the residents’first impressions were fun, exciting,and enjoyable. They were asked to listthings they liked about the use of thisgame. Their answers were teamwork,interactive, collaborative, and non-stressful. They were asked to listthings they disliked. Their answersshowed the game was too short, andone resident stated, “It was not a teamapproach.” Everyone agreed that theywould like to see more interactivegames in their learning.LESSONS LEARNED:1.2.3.IMPLICATIONS FOR FUTUREPRACTICE I recommend the use of interactive gameswith multigenerational adults, to enhancelearning, foster engagement, and buildeffective teams. Although developing thegame may be time consuming andchallenging, the outcome is well worth theeffort. With few or no modifications, thegame can be used with other cohorts. Weowe it to our learners to ensure they arereceiving the best training possible and toreach all level of learners. My teaching tipis, explore beyond your comfort zone. F E B . 2 0 2 2 | V O L . 3

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Written by J. Sonya Haw, MDAssistant Professor of MedicineEmory University School of MedicinePage 16WHEA Teaching Fellowship NewsletterCONTEXT:Learners: Internal Medicine and FamilyMedicine residents (PGY1-3) Setting: In-person classroom lectures SELECTED TEACHING & LEARNINGTOPIC:Universal Design for Learning Gagne’s 9 events for Instruction Medical education on transgender careis scarce at all levels of learning and isonly recently beginning to beincorporated into undergraduatemedical education at. For currentInternal Medicine and Family Medicineresidents, however, the degree ofexposure to transgender patients and care is highly varied, unpredictable, andlargely insufficient. This lack of propereducation and clinical exposure exacerbatesthe problem of access for transgenderpatients seeking basic gender-affirmingcare. In an effort to improve knowledge ingender-affirming care in a systematic way,didactic lectures targeted to residents of alllevels were added in both Internal Medicineand Family Medicine residency programs. While the format of these lectures was atraditional in-person classroom, I was ableto use the strategies of Universal Design forLearning and Gagne’s 9 Events forInstruction (Hook ‘em, Teach ‘em, Assess‘em) to optimize learning during the shorttime I had to teach a very broad topic. HOOK 'EM To gain attention of my learners andincrease in-person engagement at thebeginning of the lecture, I posed aninformal question asking the audienceabout their own prior experiences withtransgender patient care. I allowed learnersto further share their self-reflection ofthese experiences. This in-person pollingand self-reflection also better informed meof the diversity of prior knowledge andexperiences of the learners and allowed meto appropriately adapt my content. Afterproviding learning objectives, I began thelecture with a case scenario with audienceparticipation on how to address a newpatient coming to clinic to start theirmedical transition. These strategies allowedseveral opportunities for the learners toengage and demonstrated the importance ofa learner-centric approach. TEACH 'EMWhile using a traditional PowerPointpresentation, I was still able to leverage F E B . 2 0 2 2 | V O L . 3

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Page 17WHEA Teaching Fellowship Newsletterseveral multimedia outlets. Given theimportance of representation oftransgender individuals’ livedexperiences for this type of lecture, Iused quotes from social media platforms(i.e., Instagram) and direct quotes fromfocus group data. I also incorporatedcurrent examples of transgenderindividuals in popular culture as visualcues throughout the lecture. To improve cultural competency inproviding gender-affirming ways tospeak with transgender patients, I gaveexamples of appropriate andinappropriate questions to asktransgender patients. And to allowlearners to practice these skills, I askedthem to demonstrate how they wouldaddress a transgender patient, practicingthe actual language they would use. To enhance comprehension andretention, I used several summary slidesthroughout the presentation, breaking upthe lecture to core topical areas I wantedto ensure the learners were exposed tocultural competency of transgender care,basics of hormonal therapy, and currentresearch on hormone therapy andcardiovascular and metabolic outcomes.These summary slides gave learnersrepetition of the big picture ‘take home’points from each of these topical areasand enabled them to start the initialscaffold for their own knowledge ontransgender care. ASSESS 'EMTo create an efficient form ofassessment and feedback during thislecture, I created a survey at the end of the lecture using a QR code to becompleted immediately after the lectureand during the Q&A session. I attempted tomake this as short and easy as possible tomaximize response rates and used aversion of the “3-2-1” strategy, askinglearners to list 3 things they learned, 2things they found interesting or plan toincorporate into practice, and 1 questionthey had. I also assessed their degree ofcomfort taking care of transgenderpatients after this didactic lesson with asimple Likert-style question. The responserates were still poor- with less than 25% ofthe audience completing these surveys.However, the surveys that were completedwere very rich in data. I was able tomodify and improve the lecture based onthese responses, using more strategies foraudience engagement and providing moreconcrete examples (e.g., ways to usegender-neutral pronouns). LESSONS LEARNED:I learned that there are many creativeways to engage the audience andstrategically teach for improvedcomprehension and retention through atraditional didactic lecture format. Anddoing so was easy and more enjoyable forboth me and the learners. I will need tocontinue to work on improving evaluationand feedback rates.IMPLICATIONS FOR FUTUREPRACTICEI have continued to use the UniversalDesign for Learning and take intoconsideration several of Gagne’s 9 Eventsfor Instruction for other traditional lecturepresentations on different topics. While ittakes a bit more preparation time toincorporate these strategies, I think theend-product is more meaningful andfulfilling for both the teacher and learner. F E B . 2 0 2 2 | V O L . 3

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Written by Heather Hipp, MDAssistant ProfessorGynecology / ObstetricsEmory University School of MedicinePage 18WHEA Teaching Fellowship NewsletterCONTEXT:My learners are a mix of Gynecologyand Obstetrics residents and fellows inthe Reproductive Endocrinology andInfertility (REI) division. The typicallearning setting is outpatient clinic,which tends to be relatively busy withscheduled patients, making it helpful topurposefully “carve” out time to teach. SELECTED TEACHING & LEARNINGTOPIC:For the residents, their rotation on REIis usually only one block during theirfour years of residency. My goal was todo a better job of assessment of initiallearning needs of these reproductive endocrine topics and outcomes. I hadpreviously tried to assess this indirectly butdecided to approach it more purposefully byasking the residents what they wanted toleave their rotation with, in terms of aknowledge base, especially in regard totheir future career path. I then formulatedtheir teaching didactics during their sixweeks to better target gaps in knowledge. LESSONS LEARNED:My notions about what residents may wantto get out of their rotation wasn’t exactlyaligned with their thoughts. It’s importantto stay flexible with each trainee, especiallysince there are so many potential futurecareer tracks and interests. IMPLICATIONS FOR FUTURE PRACTICE:I plan to continue this moving forward forthe residents on their rotation, but alsoapply it more broadly for other mentees. Itis sometimes difficult to think about a 6-month or 12-month learning plan whenthere is a firehose of other information andtasks, but I think it can help keep learnersmotivated in thinking about ultimate goalsof their training to purposefully delineateknowledge gaps and learning goalsF E B . 2 0 2 2 | V O L . 3

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Written by Candace Hobson, MDAssistant ProfessorOtolaryngologyEmory University School of MedicinePage 19WHEA Teaching Fellowship NewsletterCONTEXT:My learners are PGY1-5 otolaryngologyresidents. I interact with and teachresidents in an outpatientotolaryngology clinic, the operatingroom and in a classroom setting. SELECTED TEACHING & LEARNINGTOPIC:I performed a needs assessment andapplied the Hook ‘Em, Teach ‘Em,Assess ‘Em model. I first assessed theneeds of my learners (residents) basedon observations of their knowledgewhile working with them in a clinicalsetting. Based on this, I designed alecture using the hook ‘em, teach ‘em,assess ‘em approach. In order to hookthe residents in my lecture, I utilized PollEverywhere to generate interest anddiscussion about the topic at hand. By usingPoll Everywhere, I engaged the residentsearly in the lecture, allowing all residentsto participate without singling out aparticular resident or making anyone feeluncomfortable about not knowing ananswer. During the teach ’em portion of thelecture, I presented the topics usingPowerPoint format, keeping the slidesconcise, and continuing to engage theresidents with discussion and a mid-lecturepoll. I’ve previously presented cases ormultiple choice questions at the end of alecture, but have found these to be a bit tooeasy for most of the residents. In theclinical setting, however, residents seem tohave a bit more trouble with this particulartopic. I hope that I’ve presented the topic ina way this year that the residents are ableto apply this classroom knowledge to theclinical setting. LESSONS LEARNED:Integrating technology and polling helps toengage the entire classroom, not just a fewlearners.IMPLICATIONS FOR FUTURE PRACTICE:I will continue to use polling or otherinteractive tools when teaching in aclassroom (or Zoom) setting. I would like tochoose a different way to assess learning –perhaps small group discussions ordebriefing by having the residentssummarize the main points of the lecture. F E B . 2 0 2 2 | V O L . 3

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Written by H. Joon Kim, MDAssociate ProfessorOphthalmologyEmory University School of MedicinePage 21WHEA Teaching Fellowship NewsletterCONTEXT:Learners: PGY2-4 ophthalmologyresidents Setting: In-person injectables training SELECTED TEACHING & LEARNINGTOPIC:Background:During their residency, ophthalmologyresidents are trained to performaesthetic injections of neurotoxin (e.g.Botox) and fillers (e.g. Juvederm,Restylane). In the past, this has beendone annually in a single hands-onskills session for all 18 residents with 3instructors. With each residentinjecting 2-3 patients per session, this Inappropriate teacher-to-student ratio Lack of foundational knowledge goinginto the skills session Inadequate time Inability to individualize teaching todifferent PGY levels Lack of adequate supervision duringthe injection Unable to give constructive feedback Feeling overwhelmed (by theteachers and the learners) Loss of interest in the learner duringdowntime Lack of rapport between the residentsand the patients Fatigue resulted in 3 instructors helping to performinjections on 40-45 patients. Additionally,there was lack of interest from many of theresidents and this skill was not prioritizedin the overall curriculum. Hence, the lackof dedicated time usually led to the skillstraining occurring after-hours, oftenending around 10-11 pm. This scenariopresented obvious barriers to both teachingand learning, including: As a result, I revamped the entire programby incorporating the 7 principles ofteaching and learning.1. Prior knowledge: I first gave theresidents an opportunity to showcase theirexisting knowledge and attitude towardscosmetic procedures by having thempresent a sample case – either a familymember or a celebrity and their treatmentplan. Given that cosmetic procedures cansometimes be trivialized and consideredfrivolous by the residents, it was importantto understand their mindset regarding thistopic to align our goals and agree on thesignificance of this in their training. 2. Concept map: Immediately following thecase presentations, a formal lecture on thefundamental elements of neurotoxins and F E B . 2 0 2 2 | V O L . 3

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Page 22WHEA Teaching Fellowship Newsletterfillers was given. Various injectiontechniques and patterns were alsoillustrated. The residents then observedmy technique in the clinical setting. 3. Motivation: A discussion regardingthe applicability of this topic to everyresident was included into the lecture.Since no one is spared from the processof aging (!), methods of rejuvenationare certainly of interest to most people,at least in theory, if not in practice. 4. Mastery: The hands-on skills sessionwas changed to one-on-one during theirrotation on our service and theresidents chose their patients (often aspouse or friend). Peyton’s 4 steps ofdemonstration, deconstruction,comprehension and execution wereincorporated into each session. 5. Practice: Throughout their month-long rotation, the residents couldschedule these one-on-one skillssessions and received feedbackthroughout. Every resident gainedcomfort and showed improvement intheir skills. 6. Teaching-Learning environment:Changing the format to a one-on-onesession and being able to tailor to theirlevel of training was key in keepingthem engaged and the sessions beingsuccessful. Also, being able to practicemultiple times during the month madethem much more comfortable with theinjections. Lastly, being able to choosetheir patients and having someone theytrusted also created a safe space forthem to practice. 7. Self-directed learning: The residentsare encouraged to continue performingthese injections in the resident-run clinics at Grady and hopefully, willincorporate it into their practice whereapplicable! LESSONS LEARNED:I think this really emphasized what most ofus already know - It’s not just what you’reteaching, but how you teach it is just asimportant! IMPLICATIONS FOR FUTURE PRACTICE:I believe applying these 7 principles ofteaching and learning to any curriculumwill lead to a successful outcome. I thinkmany of us already utilize these principles,but seeing them outlined into actionableitems certainly facilitate their use. TEACHING TIPS:Foremost, I think understanding (andredirecting when necessary) the learner’sframe of mind and viewpoint regardingcertain topics are important in aligninggoals and expectations. It is much easier toteach when the students are motivated tolearn. F E B . 2 0 2 2 | V O L . 3

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Written by Deepika Koganti, MDAssistant Professor og SurgeryEmory University School of MedicinePage 23WHEA Teaching Fellowship NewsletterCONTEXT:My learners are third year medicalstudents who are starting their surgeryrotations. Depending on the time ofyear, the rotation may be their firstexperience in a clinical setting or theirfirst exposure to a surgical field. I givethem a lecture each rotation thatfocuses on certain diagnoses, work-up,and basic management of surgicaltopics. At the end of the rotation, I amalso responsible for giving oral examsto the students as well. Both the lectureand exams are done virtually throughZoom.SELECTED TEACHING & LEARNINGTOPIC:I applied Gagne’s 9 Events to mylecture. For the “Hook ‘em,” I discussedthat this session will focus on diagnoses that they will see throughout theirsurgery rotation, and they need to be able tomanage them no matter what specialty theydecide on. Moreover, this information willalso show up on their exam! For the “Teach‘em,” I used case scenarios to teach them thethought process of working up a patient andhow to come up with differential diagnosesinstead of a lecture format. I did the “Assess‘em” portion briefly during the lecture butalso at the end of the rotation during the oralexams. LESSONS LEARNED:I learned that teaching virtually can be verychallenging. Doing the case-based teachingrequires a significant amount ofparticipation. I found that getting thestudents to answer questions so that I canunderstand their thought process could bedifficult at times and made me want to revertmore to lecture-based teaching than cases.However, I did find that students having theirvideos on made them much more interactive.Also, when one student asked a question,other ones tended to speak up as well. IMPLICATIONS FOR FUTURE PRACTICE:In the past, my sessions had been lectures,and I spoke the entire time. While the case-based session is more challenging, especiallyvirtually, I found that students hadsignificantly more positive feedback and evenreached out to see if they could do more casesessions with me. It was helpful to let thestudents know that the cases I was presentingand questions I was asking them to answerare clinically relevant but also something toknow for their oral exams (which alwaysmotivates students!). Overall, I think both thestudents and myself enjoy the case-basedlearning much more. However, I still need towork on more strategies to get all of thestudents actively involved in the virtualclassroom. F E B . 2 0 2 2 | V O L . 3

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Written by Jimi Malik, MDAssistant ProfessorFamily & Preventive MedicineEmory University School of MedicinePage 24WHEA Teaching Fellowship NewsletterCONTEXT:The target audience for the learningsessions done this year were ICUfellows and residents across variousspecialties (surgery, neuro,anesthesiology, and internal medicine)SELECTED TEACHING & LEARNINGTOPIC:The learning was focused on how tohandle questions or statements thatseem “impossible” or unanswerable.Teaching was based on Gagne’s modelof instructional design (hook ’em, teach’em, assess ’em). First, we would role-play an impossible statement elicitedearlier from the group (hook). Next, we would then dissect the interaction as agroup and discuss strategies to facilitatethese statements (teach). Finally, we wouldrole-play another impossible statementfrom the group, followed by a groupdiscussion of strategies used (assess). LESSONS LEARNED: The most obvious realization was that thehour goes very fast! After discussingfurther with learners and faculty, the ideaof breaking the teaching topic up over 2-3sessions during the year seemed like a niceway to address the issue. Another challengethat has come up is balancing the in-personlearners with virtual learners. Keeping bothsides engaged and part of the conversation,as well as ensuring both sides canparticipate in role-play is key. It certainlyallows me to sharpen my skills on being agood facilitator! IMPLICATIONS FOR FUTURE PRACTICE: By eliciting formal, documented pre andpost feedback from the learners, we canfine-tune the lectures and look for commonthemes that may help drive future learningtopics. If other faculty were teaching thesesessions, the facilitation of the lectureswould need to be simple and minimalistic toallow for a nice balance of autonomy andstandardization. Finally, there is potentialfor implementing this learning experienceto medical students who participate on aone-week rotation in Palliative Care. Thelearning can be delivered not only byfaculty, but by Palliative Care fellows aswell, allowing further learning at all levelsthrough leading the facilitation. F E B . 2 0 2 2 | V O L . 3

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Written by Sarah Markley Webster, MDAssistant ProfessorEmory University School of MedicinePage 25WHEA Teaching Fellowship NewsletterCONTEXT:As part of the Internal Medicinerotation for third year medical students,the medical students and I sit downtwice weekly for “didactics” or teachingsessions on topics they will nototherwise have during their dedicatedformal teaching afternoons at themedical school. These sessions are heldas a small group with Emory 3rd yearmedical students, plus any Morehousemedical students or Emory PA studentswho would also like to join. They takeplace in one of the conference rooms,usually round table style, and are meantto be a low-stress environment, wherestudents can ask questions that theymight not otherwise feel comfortableasking their teams or attendings. At the first session, students are provided a list oftopics that they can rank in order ofpreference (and blank spaces to add topicsif so desired). Historically, we havereviewed these topics using a handout andinteractive discussion involvingformulating a differential diagnosis andappropriate treatment modalities for thesetopics.SELECTED TEACHING & LEARNINGTOPIC:I applied the Strategies for EnhancingTeaching and Learning to change thedidactic from passive learning (ie. talkingAT the students) to active learning(involving the students in the teaching). Iused particularly the “Hook ‘em, Teach ‘em,Assess ‘em” strategy.After students ranked their topics, theywere instructed to bring to the next sessiona patient with the topic we were going todiscuss (in this case, inpatient diabetes).The hope was that using a real patient theywere caring for would serve as the “hook”to get them engaged with this topic. Duringthe session, we then pulled up the patient’schart, while the student gave us a briefoverview of the patient’s past medicalhistory and reason for admission. We thenbroke down the patient’s history withregards to diabetes further, such as “Hesaid he has Type 2 Diabetes, diagnosed atage 25 and he’s a thin guy, what kinds ofthings are you thinking about when youhear this?” Using their specific patientssignificantly increased the engagement ofthe students and promoted asking questionsthat they had been too hesitant to ask theirteams. We then assessed their knowledge byreviewing other cases of patients withdiabetes to see how the students thoughtabout the cases and developed plans.F E B . 2 0 2 2 | V O L . 3

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Page 26WHEA Teaching Fellowship NewsletterLESSONS LEARNED:The biggest thing I learned was thatthis method of teaching takes longerthan the standard one-hour didactic.With the one-hour didactic taught atthe students, the instructor is incontrol of the overall flow and speedof the session. With these interactivesessions, the students, and also thecases they brought, control the pace –easier patients make for a fastersession, but more complex patientscan lead to diving deep into diabetescare and management and ultimatelyresulted in different groups ofstudents getting different knowledgeabout diabetes, but knowledge that wasmore geared towards what theywanted to know AND what theyneeded to know for their patients.However, the students weresignificantly more engaged andsignificantly more enthusiastic aboutthis type of teaching, with many ofthem asking to continue the session atthe next didactic (which hadpreviously never been requested!).IMPLICATIONS FOR FUTUREPRACTICE Having patient cases that review thetopics you want to review could beuseful, but negates the enthusiasmand engagement that the studentshave in bringing their own patients.Perhaps at the beginning of eachsession, polling the learners to see ifthere are particular areas of diabetesthey want to focus on (i.e., diagnosis, management, when to use “SSI” vsscheduled insulin, etc.) could help tailor thediscussion so that it is easier to remainwithin the one hour time allotment. Youcould alternately have the students comeprepared with any questions they haveabout the case already written out so thatyou can focus on ensuring that thosequestions are answered as part of thediscussion.F E B . 2 0 2 2 | V O L . 3

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Written by Meredith Maxwell, MDAssistant ProfessorFamily & Preventive MedicineEmory University School of MedicinePage 27WHEA Teaching Fellowship NewsletterCONTEXT:My intended learners will be EmoryPalliative Care and Hospice fellows.For this project, I anticipate thelearning setting will be largely virtualand asynchronous.SELECTED TEACHING & LEARNINGTOPIC:I am applying the theory of backwardsdesign in creating an outpatientpalliative care curriculum.Fellowship programs like ours followguidance from the ACGME in terms ofthe knowledge and skills fellows shouldmaster by the end of their training.Learning outcomes specific to the practice of outpatient palliative care havenot yet been defined. I used backwardsdesign in my project by first focusing onwhat these learning outcomes should be. Ireflected on my own experience as anattending fresh out of fellowship and thoseof faculty in a similar position. From thesereflections, I generated a list of learningoutcomes using Bloom’s taxonomy. Tovalidate these outcomes, I will be sendingthese learning objectives for review in theform of a survey. The survey will be sent tofaculty in our Palliative Care Center inaddition to those at other teachinginstitutions. My plan is to prioritize thelearning outcomes according to thefeedback collected from my survey.LESSONS LEARNED:One of my personal objectives in creatingthis curriculum is to ensure it is high yield.Though I knew it was important, beforethis process I was not sure how I would getthere. I have found that the theory ofbackwards design has helped me thinkthrough this problem as early on in theprocess as possible and thus focus my timeand energy on outcomes that matter most.Time for both faculty and learners isprecious, and I am grateful to have aprocess that maximizes efficiency for allinvolved parties. One example of this was ahelpful suggestion from a teaching mentorof mine after sharing my list of objectives.She recommended organizing learningoutcomes into logical categories, which Iexpect will result in a more organized anduser-friendly final product.I was surprised to find that this model alsohelps in obtaining feedback and buy-infrom my peers early on in my project.Especially in a field whose boundaries andgoals are very much still in flux, it’s F E B . 2 0 2 2 | V O L . 3

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Page 28WHEA Teaching Fellowship Newsletterimportant to me that the projectreflects the experiences and wisdom ofmultiple faculty members. Though Ican’t guarantee it, I am hopeful alsothat obtaining buy-in early on mayalso encourage faculty to engage inboth creation and use of the endproduct. IMPLICATIONS FOR FUTUREPRACTICE / TEACHING TIPS:This model has shown me a new wayof looking at creation of learningmaterials. Previously, I had jumpedinto collecting and presentinginformation basedmore on the information I happen tocome across than what was mostimportant to know. I am now morethoughtful about my goals forteaching before I begin, which I thinkwill ensure my teaching will behigher-yield. I expect to carry thisprocess into essentially all theteaching I do for the foreseeablefuture. I would strongly encouragesomeone considering applying thismodel to do so without hesitation.F E B . 2 0 2 2 | V O L . 3

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Written by James McLeod, DNP, CRNA InstructorNell Hodgson Woodruff School of NursingEmory UniversityPage 29WHEA Teaching Fellowship NewsletterConstructive AlignmentBackward DesignBloom’s TaxonomyCONTEXT:As a senior clinical instructor in theEmory University Nell HodgsonWoodruff School of Nursing, I teachcourses that include advancedphysiology and anesthesiapharmacology. The learners are studentregistered nurse anesthetists that attendclass in person.SELECTED TEACHING & LEARNINGTOPICS:establishing learner objectives based onBloom’s taxonomy as the initial step inplanning lectures,developing lectures and learningactivities based on the objectives,constructing formal assessmentstrategies that aligned with theobjectives and learning activities, andcreating a test bank that matched eachquestion with its content domain,objective, and item analysis.APPLICATION:My overarching goal was to create well-designed lectures that maximize thelearning of complex material whilebalancing cognitive load. Using theprinciple of constructive alignment, Iincorporated the following strategies intomy advanced physiology course: LESSONS LEARNED:The class was more prepared and engagedwhen they had the opportunity to reviewthe objectives and a draft presentation priorto class. The class and I would return to theobjectives at the conclusion of each lectureto clarify any “muddy” points. According tofeedback, the objectives helped the learnersnavigate large amounts of complex materialand provided a guide for exam preparation.As a new educator, I appreciated thesystematic approach by starting with theobjectives and working backwards to alignwith content and assessment. I was able tofocus my preparation by identifyingextraneous information that unnecessarilyadded to the cognitive load of the learners. Ialso found that exam questions performedbetter, and I experienced less “challenges”from the learners.F E B . 2 0 2 2 | V O L . 3

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Written by Julie Mitchell, DOAssistant ProfessorFamily & Preventive Medicine Emory University School of MedicinePage 31WHEA Teaching Fellowship NewsletterCONTEXT:Each fall, I have given a lecture toEmory’s PA and Genetic Counselingstudents together as a large group onvarious topics within the ethics ofpalliative care and the end of life.While last year’s lecture was givenvirtually due to the COVID19 pandemic,this year we were able to return to theclassroom for a typical in personsession.SELECTED TEACHING & LEARNINGTOPIC:I aimed to incorporate Gagne’s NineEvents of Instruction into my lecturethis year.Hook ‘em: To integrate these elements ofinstructional design, I initiated each lecturesub-section topic by asking a generalquestion related to the topic to encourageinteraction and gain attention of thelearners, assess learner’s previousunderstanding or knowledge of the topic,and prepare them for the objectives of theupcoming talk. For example, at thebeginning of the lecture section entitled“Physician Assisted Dying,” I askedparticipants: “Who has thought about theirpotential role in PAD within the healthcarefield?” “Has anyone had experience withPAD?” “Does this topic raise questions,concerns, or feelings for you?”Teach ‘em: I then presented the contentwhile providing learning guidance bydiscussing case studies of PAD in themedia, both past and present. In doing this,my hope was to elicit application ofpresented concepts to real life events thatstudents may recall or resonate with.Assess ‘em: I then assessed performanceand integration of the material by referringagain to the questions I posed at thebeginning of the section as a way toreframe learners’ thinking on the subject:“Have your thoughts about PAD and yourpotential role as a healthcare professionalchanged in any way after hearing thisinformation?” With this technique, I hopedto encourage critical thinking immediatelyfollowing delivery of the new informationas a way to improve retention by applying itto their previous knowledge.LESSONS LEARNED:I found that this approach greatly improvedparticipation during the lecture. It alsohelped me to assess understanding of thematerial in real time as students responded. F E B . 2 0 2 2 | V O L . 3

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Page 32WHEA Teaching Fellowship Newsletterto follow up questions with a newoutlook after learning the newinformationIMPLICATIONS FOR FUTUREPRACTICE / TEACHING TIPS:I do plan to apply this framework toall lectures I give in the future – it isan easy way to ensure content isdelivered effectively. By using asimilar technique for initialengagement (hook ‘em) andassessment (assess ‘em), there wassome bias created, as those whoresponded tended to be the samepeople. If I had used different methodsfor initial engagement andassessment, I may have captured awider audience by engaging differentlearning styles. This is something Iwill keep in mind for future use.While I think many people followthese general principles withoutrealizing it, I strongly feel thatintentional application of Gagne’ssteps helped me to better understandmy own teaching style. I recommendother instructors consider applyingthis framework to their context toimprove their instruction as it didmine.F E B . 2 0 2 2 | V O L . 3

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Written by Yolaine Nozile, RN, MSNClinical InstructorNell Hodgson Woodruff School of Nursing,Emory University and Georgia Baptiste Schoolof Nursing, Mercer UniversityPage 33WHEA Teaching Fellowship NewsletterCONTEXT:I am the clinical instructor at EmoryUniversity Nell Hodgson WoodruffSchool of Nursing and MercerUniversity, Georgia Baptiste School ofNursing. The learners are AcceleratedBachelor Student Nurse (ABSN) in their2nd semester in the nursing programdoing partial virtual clinicals. TheABSN is an accelerated one-yearnursing program for individuals whoalready have a bachelor's degree orhigher in something else. The goal is toassess and arrange high-quality,inventive, and appealing virtualsessions. SELECTED TEACHING & LEARNINGTOPIC:My goal was to apply teaching strategies tomeet the diverse learning needs of students.I incorporated Gagné's nine events ofinstruction in conjunction with Bloom'sRevised Taxonomy to design. In RobertGagné’s concept, my focus was on using“Assess ‘em” and “Teach ‘em” to helpstudents understand various concepts. Iinformed students of the objectives andoutcomes to help them know what they willlearn during the session and to meet theirlearning needs. The style of instruction Idid was virtual teaching; utilizing zoom tocreate small group discussions, videos,concept MAP, and case scenarios to engagethe students. LESSONS LEARNED:I have learned to explore my practices andunderlying benefits for the students, and Ialso learned the diverse ways studentslearn. I have learned nurturing diverselearners is a healthy learning process. Thismethod worked well for the students andthey were all willing to participate and didwell in the sessions. We recorded allsessions for sharing and reflecting.Together, this combination was successfulbecause it fit the students’ learning needs,keeping them engaged at all times. I did notlimit learning to the intended informationbut made informal, unintended learningpossible. Utilizing the teaching tools helpedme establish the correct approach tostudent education, identify the variousstudent populations, and adapt knowledge.. F E B . 2 0 2 2 | V O L . 3

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Written by Jeanne OverbyNurse EducatorAtlanta VA Health Care SystemPage 35WHEA Teaching Fellowship NewsletterCONTEXT:I serve as the Post BaccalaureateRegistered Nurses (PB-RNR) ProgramDirector for the Atlanta VA Health CareSystem. The PB-RNR Program is a 12-month structured federally funded newRN graduate nurse residency program.Nurses who participate in the PB-RNRprogram are in their first role asregistered nurses. In the role ofprogram director over the past fiveyears, I have observed mostly ourMillennial and now the Generation Zstudents become quickly disengagedwhen the PowerPoint and lectureteaching strategy is utilized in the face-to-face classroom setting.SELECTED TEACHING & LEARNINGTOPIC:I will discuss why I chose the “Assess ‘em”concept of Gagne’s 9 Events of Instructionas a teaching strategy to keep this group oflearners actively engaged during a face-to-face didactic session. Gagne’s “Assess’ em”is an excellent method for assessment ofperformance, enhancement of retention,and increased learner engagement. Theconcept of a “simulated escape room” wasintroduced as a method for assessment. Thetopic which I selected to utilize this conceptwas “Recognizing the Changing PatientCondition”. After the PowerPoint andLecture was completed, a patient scenariowas given to the nurse residents prior tothe beginning of the “simulated escaperoom” activity. After the initial patienthistory and background information wasgiven, the “simulated escape room” wasinitiated. The nurses had five stationswhich they had to navigate to ensure propernursing care was administered to preventfurther deterioration of the patient’scondition. These five stations consisted ofpuzzles, games and quizzes which gave thenurse residents clues as to whichsubsequent nursing interventions should betaken to prevent further deterioration. Ifthe nurses did not complete each stationwithin the designated time, their patientwould unfortunately go into cardiac arrestand require advance life saving measures. LESSONS LEARNED:One major lesson learned was theimportance of adequate space to conduct a“simulated escape room”. The use of largersize classroom is better suited for a“simulated escape room”. Unfortunately, Iwas limited in the amount of spaceavailable in the room which I utilized for F E B . 2 0 2 2 | V O L . 3

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Page 36WHEA Teaching Fellowship Newslettermy simulated escape room. As aresult, I had to set up differentstations along a long oval shapedtable. Because of lack of space, someof the suspense which is created fromparticipating in an escape room wasdiminished. Despite the lack of space,I observed my nurse residents werefully engaged as they participated inthis learning activity. Furthermore,based on my post activity surveyresults, three out of the four nurseresidents strongly agreed they weremore confident in their ability torecognize when their patient’scondition is changing afterparticipating in the simulated escaperoom activity. IMPLICATIONS FOR FUTUREPRACTICE:The use of the “simulated escaperoom” proved to be an effective tool toassess performance and to increaselearner engagement. In the future, Iwould highly recommend utilizationof this assessment tool to increaselearner engagement with ourMillennial and Generation Z nurses. Iwould also advocate for a larger spaceor classroom to conduct such anactivity. The use of a larger spacewould ensure our nurses are able tofully immerse themselves in this typeof learning activity. Full immersionwould create a more impactfullearning experience for our nursesand allow for greater comprehension. TEACHING TIPS:According to the most recent literature,benefits of a simulation escape room areincreased confidence in independentthinking and decision-making, higher ratesof retention, increased critical thinking,stronger emotional connection to thecurriculum material, an opportunity forfeedback and return demonstration andreinforcement of learning objectivesI strongly encourage utilization of the“simulated escape room” to assess retentionof concepts and to enhance learnerengagement especially for the youngergenerations such as the Millennials andGeneration Z. This type of interactivelearning activity can be easily modifiedbased on the case scenario.F E B . 2 0 2 2 | V O L . 3

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Written by David Reinhart, DNP, MBA, RNSystem Coordinator for PerioperativeResidency ProgramEmory HealthcarePage 37WHEA Teaching Fellowship NewsletterCONTEXT:The learners are BSN undergraduates atChamberlain College School of Nursing.The setting is a combination ofclassroom instruction, 18 Introductionto Perioperative Nursing modules andshadowing in the perioperative settingto enhance and validate practice. SELECTED TEACHING & LEARNINGTOPIC:When assessing the enormous plan tocollaborate with Chamberlain CollegeSchool of Nursing, Association ofperiOperative Registered Nurses(AORN), and Emory, I used Kern’s sixstep approach of problem identification,needs assessment, goals and objectives, education strategies, implementation andevaluation. I adopted the Gagne’s 9 Eventsas a framework for instruction to “Hook”,“Teach” and “Assess” the learners. To hookthe student’s interest, AORN videos onperioperative nursing were shared with theclass. For example, we showed the studentsthe AORN video, “Behind the mask”. LESSONS LEARNED:The response to these videos were verypromising. Sharing the importantresponsibilities of a professional OR nurseintrigued the students to ask manyquestions. Patient safety and the nursingprocess is shared in these videos validatingthe importance of patient advocacy duringa very stressful time in their lives. BSNundergraduates utilize social media as amainstream of communication. Sharing thevideos of perioperative nursing in practiceand exposing the students to the excitingprocedures nursing assist with every daywas a great hook. Giving the studentsclinical opportunities in the operating roomis also a key to sparking interest. IMPLICATIONS FOR FUTURE PRACTICE:In the near future, creating a video of thestudents during their clinical exposure,types of cases they helped with andinterviews of them sharing their excitementwould be a strong recommendation. F E B . 2 0 2 2 | V O L . 3

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Written by Sara Rizk, MDAssistant Residency Program DirectorGynecology / ObstetricsEmory University School of MedicinePage 38WHEA Teaching Fellowship NewsletterCONTEXT:Goal: To create a concise and effectiveteaching curriculum for faculty. Everyfaculty member is expected to teach,however, there is no formal curriculumto provide faculty with the tools neededto accomplish that goal well. The idea isto create a concise curriculum thatprovides the faculty with tools to helpthem excel in teaching their topics. SELECTED TEACHING & LEARNINGTOPIC:Gagne’s teaching model encompassesthe most complete application toaccomplish this. I would create ateaching module that becomes aconsistent part of onboarding for faculty members. This would likely includea slide deck with embedded videos ofexamples of effective teaching methods. Itwould also include links to resources thatcan help increase engagement duringteaching sessions such as Poll Everywhereand instructions on how to use them forthose who are less familiar with theseoptions. There are also many examples ofgamifying topics that can be found onAPGO; a resource that many may not haveaccess to and can be shared via thismodule.This onboarding module would need toapply to several different faculty and covermultiple topics which makes it somethingthat would require feedback both from thelearner of the module and those they areteaching. Follow up could be done 6 monthsinto starting at Emory; that would be basedon feedback from their learners. Based onthat feedback they would be asked tocomplete a short module based on theaspect of teaching they have foundthemselves to be the least comfortable withor the teaching aspect in which they havereceived critical/negative feedback. Thiswould also be a good time for us to receivefeedback from the faculty in what mayhave been missing from the original modulethat could be improved for the future. LESSONS TO BE LEARNED:There is likely an advantage to doing thisin a class rather than completing it as amodule. This would allow for ideas andexperiences to be shared which would likelymake the short time available for thiscurriculum more impactful. A flippedclassroom, combining the onboardingmodule and in-class time, with more self-directed learning would likely create aneducational strategy that the learners are F E B . 2 0 2 2 | V O L . 3

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Page 39WHEA Teaching Fellowship Newsletterinterested in therefore promotingmore engagement. This would alsoprovide the ability to create smallgroups and provide them withteaching scenarios so they canimplement the newapproaches/resources and have achance to discuss advantages anddisadvantages of these approachesbased on the scenarios they are given.IMPLICATIONS FOR FUTUREPRACTICE:Emphasis on effective teaching couldbe part of the Career ConferencePerformance Review (CCPR).Attending a teaching refresher course(half-day) would also be an availableoption to all faculty withconsideration of required participationevery two years. The onboardingmodule would be updated andrefreshed approximately every twoyears by faculty experts.It is also important to keep in mindthat most people have an idea of howthey feel things should be taughtwhich may hinder their ability tochange their methods. It may beworthwhile to include someinformation about how differentgenerations learn and absorbinformation to capture the attentionof faculty members who feel moreseasoned and set in their ways ofapproaching the learner.Understanding the audience, the needsof different generations and creating apositive environment will likely yield more of an impact. Implementing this is farmore effective in a live classroom settingthan in a module designed of slide decksand embedded videos.F E B . 2 0 2 2 | V O L . 3

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Written by Mildred Sattler, DNPCorporate Director of Nurse Retention andCareer DevelopmentEmory HealthcarePage 40WHEA Teaching Fellowship NewsletterLearners: All clinical nurses andnurse leaders who participate in theclinical lattice program called thePLAN (Professional LatticeAdvancing Nurses) at EmoryHealthcare. Setting: Zoom/Virtual/WebinarsI created PLAN objectives, includingperformance criteria for standardperformance; advancement on the CONTEXT:SELECTED TEACHING & LEARNINGTOPIC:TheUsing Gagne’s Model, I focused ongetting the clinical nurse’s attention onhow much they knew and understoodabout the current PLAN program.clinical lattice program; and establishedinstruction on who, what, where, when,and how to develop nursing professionalgoals professionally.Created a SurveyMonkey survey to seewhat the learners knew and understoodabout the pre-existing PLANPresented new material via PowerPointduring face-to-face and individualmeetings on purpose; the eligibilityrequirements; advancement, evaluation,and maintenance processes; PLANmodel clarification of roles, latticepremiums, checklist and forms,electives, and tool kits; and where toturn in professional portfolios withdates of submission and compensation.Individual meetings with clinical nursesfacilitated nurses to recall professionalprojects and answer questionsI provided feedback to assist clinicalnurses with confirmation, information,and analytical recommendations.To assess performance, a checklist foreach role was created to ensure that theclinical nurse met the criteria for theclinical lattice role.I monitored PLAN advancements andshared with nurse leaders and allclinical nurses to enhance retention. Inaddition, I created tool kits and self-learning instructions for projectplanning, references, and templates.Zoom is very efficient for both time anddidactic training. At the end of theeducational sessions, open question andanswers forums encouraged clinicalnurses to ask questions geared to thePLAN program. As a result, the nurseshad a better understanding of theconcepts.LESSONS LEARNED:F E B . 2 0 2 2 | V O L . 3

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Page 41WHEA Teaching Fellowship NewsletterI underestimated that nurses fullyunderstood an evidence-basedpractice (EBP) project, so I createdan EBP step-by-step guide andtoolkit. Another unexpected lessonis that every learner learns subjectcontent differently and thateducators need to be mindful ofgenerational computer skills.In a post-SurveyMonkey survey, Ilearned that nurses had a betterunderstanding of advancing in thePLAN. In addition, hosting thePLAN webinars and making thenew improvements allowed nursesto thoroughly understand theknowledge, skills, and attitudes forprofessional advancement.In the future, all nurses will learnabout the PLAN program duringtheir orientationMonthly scheduled educationalwebinars (Zoom) are available forall clinical nursesProvide education to PLAN counciland host monthly meetings.Educate all PLAN council membersof all new improvements. IMPLICATIONS FOR FUTUREPRACTICE:F E B . 2 0 2 2 | V O L . 3

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Written by Veketa Smith, MMScAssistant ProfessorFamily & Preventive Medicine Emory University School of MedicinePage 42WHEA Teaching Fellowship NewsletterCONTEXT:The learners were Physician Assistant(PA) students transitioning fromdidactic to clinical curriculum.Throughout the didactic training,pertinent infectious disease content wasintegrated within each fundamentalmodule. As a PA practicing in the fieldof infectious diseases and a newAssistant Professor in the PA Program,I was tasked with creating a focusedand non-graded infectious diseasesreview module. The teaching/learningsetting took place in a hybrid classroomof in-person and live streaming virtuallearners. Because it was a non-gradedmodule, I wanted to create a way tokeep the learners engaged and assessthe effectiveness of the teachingactivities.SELECTED TEACHING & LEARNINGTOPIC:Using Gagne’s model of instructionaldesign, I applied the “Hook ‘em, Teach ‘em,Assess ‘em” strategy.Hook ‘em: I highlighted why and howachieving the learning objectives in thecourse was immediately beneficial to thelearners with examples of relevantapplication. In addition, I interspersedinteresting patient cases from my clinicalexperience throughout the lectures andactivities to keep them engaged.Teach ‘em: The content was delivered vialive lecture with PowerPoint slides incombination with guided case-based groupactivities. Each group was given a differentcase to work through, but all groups were toanswer the same 5 questions that touchedon: differential diagnosis, additionalhistory, pathogens, diagnostic studies, andtreatment plans. Halfway through thecases, new information was presented thatmay alter previous answers.Assess ‘em: Each group presented their caseand answers, which kept the class engaged.Immediate feedback was provided. “Entryand exit tickets” were also incorporatedinto the course that focused on areas ofongoing confusion and objectives achievedduring the activities of the day.LESSONS LEARNED:I learned that it is helpful to know youraudience when planning how to keep themengaged and therefore, there should beroom for personalization of the “hook ‘em”strategy. In addition, I learned the value ofusing multiple strategies to presentinformation and elicit performance whilealso assessing beyond quizzes and exams.While initially planning, I did not expect F E B . 2 0 2 2 | V O L . 3

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Page 43WHEA Teaching Fellowship Newsletterthe amount of logistics required tomake interactive activities feasiblewhen half of the learners wereparticipating remotely. IMPLICATIONS FOR FUTUREPRACTICE:In the future, I will continue toimplement strategies from Gagne’sinstructional design model. I plan tocontinue to utilize interactive contentdelivery in combination with lecturepresentations. I will also continue touse creative formative assessmenttools for this module and align theobjectives with the entry and exitticket activities.When planning interactive activitiesfor a hybrid classroom, don’t forget tofactor in learner locations andtechnology logistics. Be open tolearners using additional technologybeyond Zoom to communicate withtheir groups in the hybrid setting. Ifthe last couple of years has taught usanything, it is that we need to bealways flexible and adaptable.F E B . 2 0 2 2 | V O L . 3

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Written by Marsha Stern, MDAssistant ProfessorPsychiatry & Behavioral SciencesEmory University School of MedicinePage 44WHEA Teaching Fellowship NewsletterCONTEXT:In March 2020, The AccreditationCouncil for Graduate Medical Educationupdated the Psychiatry Milestones forresidents in training. These milestonesprovide a framework for residentmastery of different elements ofphysician competence and Milestones2.0 were implemented earlier this year.One way to evaluate residents onMilestones is through writtenevaluations submitted by faculty uponcompletion of a given rotation. Ourprevious evaluations outlined each ofthe core competencies and asked facultyto assess residents on all milestones.The milestones are arranged into levelsthat track from one to five, with level 1being reflective of a novice and level 5 reflective of mastery or expert within thatdomain. Faculty reported that they found itdifficult to assess residents on everymilestone and similarly had difficultyrating interns at their appropriate level.The resident evaluations were being used toassess milestones; however, they did notalways provide high quality feedback forresidents.SELECTED TEACHING & LEARNINGTOPIC:Using the characteristics of qualityfeedback, we sought to revamp the residentevaluations so that faculty could providemore limited feedback on those milestonesthey feel that they could assess on theirgiven clinical rotation. We polled faculty indifferent patient care settings to gaugewhether they felt comfortable evaluatingeach milestone. Only those competenciesthat more than half of the faculty said theycould evaluate were included in thatrotation’s evaluation. This markedly limitedthe number of milestones that wereincluded in each evaluation. The goal isthat with more streamlined evaluations,faculty will feel more likely to completethese evaluations. The language in theevaluations was also more simplified ascompared to previous evaluations.LESSONS LEARNED:Quantitative evaluations are necessary asthey relate fulfilling requirements forresident advancement and accreditingbodies. Making evaluations applicable todifferent clinical sites or patient caresettings can help to improve the quality andquantity of these evaluations. Quantitativefeedback has limitations, however, as itdoesn’t address specific behaviors orprovide actionable feedback. It is important F E B . 2 0 2 2 | V O L . 3

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Written by Odinae SullivanProgram CoordinatorGraduate Medical EducationEmory University School of MedicinePage 46WHEA Teaching Fellowship NewsletterCONTEXT:As a program coordinator in Emory’sGraduate Medical Education (GME)Office, one of my primaryresponsibilities is managing andteaching the function of theresidency/fellowship database system,called New Innovations. Part of that jobresponsibility is to teach and supportEmory’s Residency/ Fellowship ProgramCoordinators (PC) on how to use NewInnovations (NI) and how to manageprogram prerequisites and requirementsusing New Innovations. I alsoparticipated in GME’s OnboardingTraining for new ProgramCoordinators. Currently, this PCOnboarding training is a 2-hour longsession that covers an array of topics Generate New Innovations Data, Configure Program Set-up, Create Program Evaluations, Run Duty Hour Reports, Aggregate Semi-Annual Review data fortheir Program Directors (PD) andClinical Competency Committee (CCC).And lastly, Utilize NI modules tocomplete ACGME (Accreditation Councilfor Graduate Medical Education)program management requirements.Backwards Design ADDIE ModelUniversal Learning Designincluding ACGME Program requirements,GME and Institutional Core responsibilities,program deadlines, GME Human Resources,and lastly a 30-minute New Innovationsteaching and course training.The learners for this Capstone Project theprogram coordinators of the residency andfellowships programs, and the courseobjective is to engage the learners in beingproficient users of the residency databasesystem (New Innovations). In the newlyrevised NI training sessions, GME programcoordinators will be able to:SELECTED TEACHING & LEARNINGTOPIC:I used the Backwards Design (Wiggin &McTighe) and the ADDIE Model for thisproject. The Backwards Design conceptuallyhelped in creating the mission andobjectives for the revised NI trainingsessions. Structurally, it was important toidentify the desired results of the coursetraining and how best to assess theknowledge base of the coordinators. Nextwas to determine the acceptable evidence(outcome assessment) to measure thetraining. And finally, was planning the F E B . 2 0 2 2 | V O L . 3

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Page 47WHEA Teaching Fellowship Newsletterlearning experience and teachingmaterials specific to the coreresponsibility of program coordinatorsusing New Innovations. Again, to conceptualize the idea ofreviving the NI training sessions, Iincorporate the ADDIE model to helpanalyze, design, develop, implement,and evaluate the current trainingprocesses. Blending the first two stepsof the Backwards Design (Goals &Objective and Outcome Assessment)with the ADDIE model’s first two steps(Analysis and Design) aided in thecomposition of the course materialand the application in the NIprocesses. As part of the analysis andoutcome assessment, the programcoordinators were given a survey tohelp identify insufficient areas oftraining and knowledge base gaps. Thefeedback from the survey highlightedcertain modules and tasks correlatingto the lack of utilization of theresidency/fellowship database system(NI). As part of my strategy to increase theteaching and learning components ofthe NI workshops, I implemented thepilot training course using theUniversal Design for Learning (UDL)model to construct the PowerPointpresentation. The presentationcontained defined objectives,testimonials, personal examples, andcase scenarios. The presentation alsoincluded concepts maps, followed bystep-by-step instructions on set-upand configuration. And the closing portion of the presentation forces ofprocess application and data integrity.Using the 3 principles of the UDL Model(Engagement, Representation, and Action &Expression) I centered the course materialaround the Why, What, and How of thecontent being shared. In the beginningportion of the presentation, I outline thereason as to why it was important tobecome proficient in using NewInnovations. I also highlighted the benefitsof using NI to align with ACGMErequirements. The second portion of thepresentation was set to teach the learnerwhat were the keys modules and frequentlyused features in NI. It was important topresent the areas of NI that programcoordinators required to utilize the most.The end of the training focused on thenumerous ways data can be generated,reviewed, interpreted, and shared in NI.User-guide were all shared with thelearners as well as materials and resourcessupporting the content. Again, ensuringcontinuity of knowledge and application forthe learners.LESSONS LEARNED: There were several areas of growth andopportunity outlined in the design andimplementation of the first installment ofour PC NI workshop series. There weremore program coordinators expressinginterest in the functionality of NewInnovations. The post-training feedbackfrom the coordinators was incrediblypositive. Many said that they found thetraining helpful, informative, and detailed.Several program coordinators also reachedout post workshop to schedule additional NItraining as well as program training fortheir other end-users (program directorsand residents / fellows). F E B . 2 0 2 2 | V O L . 3

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Page 48WHEA Teaching Fellowship NewsletterA major lesson learned is, as aninstructor, do not assume thatlearners will succeed professionallywith only 30- minutes of NewInnovations training. As a futurepractice, it would be useful to scalethe knowledge level of the programcoordinators to better gauge the levelof proficiency of the learners. Thismay be helpful to create a novice andintermediate track for training. Forexample, a new program coordinatorwill have less knowledge of thefundamentals of New Innovationsthan a coordinator who has 2+ yearsof experience. More importantly, another lesson Ihave gathered is that it is crucial tohost training often and intentionally.Moving forward, our department hasimplemented quarterly PC training.This lesson has blossomed into aneminent idea of creating a ProgramCoordinator Professional Development(PCPD) Task Force. The PCPD TaskForce's goal is to develop acomprehensive professionaldevelopment platform that willsupport the needs, responsibilities,and functions of Emory's program &fellowship coordinators. IMPLICATIONS FOR FUTUREPRACTICE: There is the expectation that witheach workshop/ training session therewill be improvements in the designand assessment of the learners. It isimportant to assess and solicitfeedback after each workshop to ensurethat the objectives and goal of the trainingis conveyedTEACHING TIPS:Practice the motto, “Tell me and I forget,teach me and I remember, Involve and Ilearn.” As an instructor, I found it helpfulto put myself in the position of mylearners. I approached the desired outcomeof the training as if you were the learner,asking myself “if I were a programcoordinator, how does this apply to what Iactually do?” Also, involve your learners in the initialphase of your training. The feedback fromsurveying our learners proved to bebeneficial to outlining the content of theirtraining. F E B . 2 0 2 2 | V O L . 3

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Written by Cynthia Thomas, MSN, RN-BCNurse EducatorAtlanta VA Health Care SystemPage 49WHEA Teaching Fellowship NewsletterCONTEXT:I am the Program Director for the RN-Transition to Practice Program, astructured 12-month nurse residencyprogram for new graduate registerednurses. The learners are new RNgraduates who are within the first yearof nursing practice and are employed atthe Atlanta VA Health Care System.The Nursing Education classroom is thesetting for this training.SELECTED TEACHING & LEARNINGTOPIC:To optimize the teaching experience, Iincorporated the “teach’ em” and“assess’ em” aspects of UniversalDesign for Learning and focused on four of Robert Gagne’s Nine Events ofInstruction which are “present the content,”“provide learning guidance,” “elicitperformance (practice),” and “providefeedback.” With varied learning styles andmultigenerational nurse residents, my goalwas to address the learning needs of theauditory, visual, and kinesthetic learners,while implementing teaching strategies thattarget engagement. I provided a one-hourlecture “Adult Immunizations” and includedPowerPoint, group discussion, case studies,Poll Everywhere, and video. My newteaching strategy is Poll Everywhere.Additionally, I reviewed Poll Everywhereinstructional videos and practiced with mycolleagues to ensure a seamless delivery tothe learners. Further, to ascertain a deeperunderstanding of the content, Iincorporated knowledge check points atdifferent intervals in the presentation andutilized Poll Everywhere. I encouragednurse residents to elaborate on the providedresponses in Poll Everywhere, as I providedcorrective feedback. With Poll Everywhere,I believe that the learners were moreinclined to provide more detailed responsesdue to anonymity of their responses andeveryone’s participation. Lastly, casestudies were utilized to assess theirunderstanding of the content. After thepresentation, I disseminated to the nurseresidents a survey which cited whetherobjectives were met, effectiveness ofinstructor’s content delivery, andeffectiveness of teaching strategies. Most ofthe residents strongly agreed and agreedthat the content delivery was effective.LESSONS LEARNED:With Poll Everywhere I incorporated ateaching strategy that increased learnerengagement. The group of learners aremultigenerational, and I received great F E B . 2 0 2 2 | V O L . 3

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Page 50WHEA Teaching Fellowship Newslettersurvey feedback. Several of the nurseresidents stated via survey that PollEverywhere was fun and veryinteractive. One nurse residentcommented, “It made learning aboutimmunizations exciting and alsohelped me recall the information thatwas presented more clearly.” Afterwitnessing the learners’ excitement, Iam excited about learning andincorporating other teachingstrategies that promote groupdiscussions and critical thinking. IMPLICATIONS FOR FUTUREPRACTICE: I will utilize Poll Everywhere andother teaching strategies that willengage multigenerational learners.Also, to cultivate team cohesiveness, Iwill encourage nurse residents toassist their peers in formulatingresponses when their peers aremeeting challenges in providingresponses in class discussions andwith case studies. Utilizing interactiveteaching strategies can enhance theeducational experience; thus,enhanced knowledge and teamworkcan lead to positive patient outcomes.Lastly, with such positivefeedback, I will continue usingGagne’s Nine Events of Instruction forcourse design and student engagement,while facilitating learning.F E B . 2 0 2 2 | V O L . 3

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Written by Rana Vadlamudi, MD Cardiothoracic AnesthesiologistEmory University School of MedicinePage 51WHEA Teaching Fellowship NewsletterCONTEXT:Goal: Establishing a baseline oftransesophageal echocardiography(TEE) knowledge at the start of cardiacanesthesiology fellowship. Setting: aclassroom based didactic curriculum.Trainees come into fellowship withvarying levels of experience andknowledge in TEE; my goal is to createan introductory TEE curriculum so allfellows can begin the year with aminimum standard of knowledge andskill.SELECTED TEACHING & LEARNINGTOPIC:I used Kern’s six step approach toidentify the need for this introductorycurriculum, and on further assessmentand implementation of the one-hour Share a patient case where TEEexpertise helped guide care/managementReview objectives (in this case,comprehensive TEE views)Simple pre-test to assess each learner’slevel of knowledge pre-curriculumClassroom based didactics, TEEsimulator, patient casesGo through a patient case with eachfellow. First, discuss their assessment oftheir performance followed byconstructive evaluation of theirstrengths and weaknessesintroductory lecture, I realized this lecturewas very limited in its scope due tolimitations in time, format, and ability tointeract and assess each fellowindividually. However, I was able tointroduce important topics in TEEeducation: indications, safety, and reviewof comprehensive TEE views. This was inmany ways a pilot session (although thatwas not the original intent) to a larger planI hope to implement in the upcomingacademic year and ultimately, thatcurriculum will be based on Gagne’s 9events (detailed below):.Hook ‘emTeach ‘emAssess ‘em LESSONS LEARNED:I learned that it is beneficial to provide thisintroductory curriculum prior to beginningour intensive educational curriculum.However, more time and utilizing differingeducational methods (didactics, hands-on/simulation based, case based, etc.) vsclassroom based only, will help to create awell-rounded introduction to TEE.F E B . 2 0 2 2 | V O L . 3

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Written by Cherry Wongtrakool, MDAssociate Professor of MedicineEmory University School of MedicinePage 53WHEA Teaching Fellowship NewsletterCONTEXT:The COVID-19 pandemic forced themedical community to adjust caredelivery in a rapid and immediate wayin 2020. Prior to 2020, videotelemedicine visits were used sparselyand with little support or educationaround it. With the pandemic, there wasa rapid burgeoning in videotelemedicine without time to educatetrainees or providers on its benefits anddrawbacks. Pulmonary outpatientmedicine can benefit greatly from videotelemedicine visits, but pulmonaryfellows have not undergone formaltraining in telemedicine. Therefore, thegoal of this project is to design a formalcurriculum around using videotelemedicine in pulmonary medicine.The curriculum will include discussions on what is or is not appropriate fortelemedicine, specific things to rememberwhen conducting telemedicine visits, andspecific things about documentation relatedto telemedicine visits. This curriculum willbe delivered in an in-person classroomenvironment.SELECTED TEACHING & LEARNINGTOPIC:Because the target audience for thecurriculum is pulmonary fellows ofdifferent postgraduate years, there is goingto be varied familiarity with videotelemedicine. I plan to use the universaldesign for learning (UDL) framework tooptimize teaching for all fellows. Althoughthere are three components to UDL(engagement, representation, andaction/expressions), I feel that learnerengagement in the curriculum will be themost challenging because of the variedfamiliarity with telemedicine. There will besome fellows who have done 2 years oftelemedicine visits and fellows who havenot done any telemedicine visits in thelearning group. LESSONS LEARNED:Active engagement seems to work best withthis particular group of learners. Therefore,the tools of polling (in-person or online),discussions, and hands-on tasks are veryappropriate to use to facilitate engagement.I learned how to use Poll Everywhere andhave used it in a separate teachingopportunity with great results.Representation in teaching tools must alsobe varied to keep learners engaged. Case-based discussions are always popular andvideo demonstrations can also be useful inthis curriculum.F E B . 2 0 2 2 | V O L . 3

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Page 54WHEA Teaching Fellowship NewsletterIMPLICATIONS FOR FUTUREPRACTICE / TEACHING TIPS:Every year, there will a differentgroup of learners who undergo thiscurriculum. Understanding thevariation in individual knowledgearound telemedicine can be helpful inrefining the delivery of materialduring the teaching sessions. Acombination of a case-baseddiscussion with polling can be asuccessful approach to engage thelearners and simultaneously obtain apre-learning assessment to align theneeds of the learners with thecurriculum. This should subsequentlylead to the desired outcome of thecurriculum (better patient satisfactionand care with telemedicine visits). Atthe beginning of the curriculum, Iplan to show a video of a telemedicinevisit and poll the audience on positivethings they saw in the video andthings they might have donedifferently if they were the providerin the video. With their responses, Ican identify areas that need more timeand attention in the curriculum, andother areas that only needreinforcement. I can then do a similarcombination of video with polling as apost-learning assessment to see iftheir knowledge improved after thecurriculum. Because the pollingquestions can be changed from year toyear, this approach provides theflexibility to change the learningassessment and align the curriculumto fit the needs of the group that year.F E B . 2 0 2 2 | V O L . 3