Use specific language: Utilizing a common language between yourself and the trainee is very important. Phrases such as “Go right” or “Put your snare at the bottom” may not be specific enough for your learner. More exact language, such as “Little knob upward” or “Move your working channel to the 6 o’clock position,” will help the trainee comprehend your instruction and hopefully achieve the endoscopic objective at hand.3
Create an effective learning environment: Removing distractions from the endoscopy suite such as “multiple separate conversations” or “loud music” may be beneficial for trainees by minimizing extraneous load. Active engagement by the attending during a procedure has also been shown to be helpful in creating an effective learning environment.4 Examples of this include giving positive motivation or clear advice at a difficult junction of the case or just being engaged and watching the entire case rather than answering emails.
For all locations
Give feedback: Feedback should be given to the trainees on a regular basis in a comfortable, private setting away from the distractions of clinical responsibility. Feedback sandwiches – in which constructive comments are put between positive feedback – are no longer advised because trainees have been shown to not retain the topics they need to improve on but retain only the positive feedback from the end. Instead, utilize a format of soliciting self-reflection from the trainee, providing direct feedback on strengths and targets for improvement, and then concluding with an action plan for improvement.5
Get feedback: Do not be afraid of asking your trainees what you can do better. Don’t wait for the formal evaluations to be reviewed with your chairperson. Ask your trainees what you are doing well and what you can improve on. This feedback is a wealth of knowledge just waiting to be tapped.
Use your resources: There are many local, regional, and national resources available to educators. Senior faculty and fellowship directors at your institution can likely assist you. The office of graduate medical education in your institution likely has educational resources that are available for all faculty. Many institutions have some form of an institute for medical education that offers mentorship, online resources, and medical education journal clubs. The journal Gastroenterology includes a “Mentoring, Education, and Training” section in each issue that has many tips for educators. Lastly, there are national resources such as the AGA Academy of Educators that offer plenary sessions on medical education at Digestive Disease Week® and a collaborative network of faculty interested in medical education within gastroenterology.
References
1. Pascoe J et al. J Hosp Med. 2015 Feb;10(2):125-30.
2. Sewell JL et al. Acad Med. 2017 Nov;92(11):1622-31.
3. Dilly CK, Sewell JL. Gastroenterology 2017 Sept;153(3):632-6.
4. Pourmand K et al. J Surg Edu. 2018;75(5):1195-9.
5. Ramani S, Krackov SK. Med Teach. 2012;34(10):787-91.
Dr. Whitson is associate fellowship director, gastroenterology, assistant professor of medicine, The Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, New York. Twitter: @MJWhitsonMD
