Peer Observation to Enhance Teaching
September 25, 2023
Speakers
- Shari Whicker, EdD, MEd, Assistant Dean, Faculty Development, VTCSOM; Senior Director, Office of Continuing Professional Development, Carilion Clinic; Director, Teaching Excellence Academy for Collaborative Healthcare (TEACH); Associate Professor, Department of Pediatrics, VTCSOM
- Jennifer Cleveland, PharmD, BCPS, MBA, Assistant Professor, Department of Basic Science Education, VTCSOM
Objectives
Upon completion of this activity, participants will be able to:
- Articulate the benefits of teaching observation
- Describe what teaching observation is and is not
- Participate in the teaching observation process
*The Medical Society of Virginia is a member of the Southern States CME Collaborative, an ACCME Recognized Accreditor.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Southern States CME Collaborative (SSCC) through the joint providership of Carilion Clinic's CME Program and Carilion Clinic Office of Continuing Professional Development. Carilion Clinic's CME Program is accredited by the SSCC to provide continuing medical education for physicians. Carilion Clinic's CME Program designates this enduring material activity for a maximum of 1 AMA PRA Category 1 CreditTM.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Welcome to our session today um talking about peer observation I think I know all of you Mo I know almost all of you um my name is Sher wicker I am a senior director for professional development at the hospital and assistant Dean for faculty development over at the medical school um I'll let Jen uh Dr Cleveland introduce herself in just a minute but I just wanted to say pure observation it's one of my favorite things um that we offer it's just so customized uh faculty development to to what you're doing to each individual um and while we'll we're going to focus most of our discussion on um um on the the service that teach offers our teaching Academy um however this all of this content exists and is relevant for across the board if you have a peer somebody else that you respect as a as a teacher as an educator who you would like to have observe you um all of the same Concepts uh translate for that as well so anyway uh Dr Cleveland if you'd like to introduce yourself sure I'm D Cleveland I'm assistant professor in basic science uh and my primary role is pharmacology um I trained as a pharmacist and then came into education roughly 12 years ago started with Pas and and now full-time with the med school students um and as my role within teach I'm also the sub subcommittee chair for our teaching consultation and observation subcommittee so um that's how we're intertwined between the two different schools so it's exciting to be here and thanks for the opportunity absolutely all right so our learning objectiv today is that we really want to go through and share some of the benefits of the teaching observations and what everyone could potentially get out of them um we want to talk about what the observation process is and what it is not um and we also want to go through and uh talk about the process how you can go through and actually participate in a teaching observation process so what is a teaching observation and who is it for okay so teaching observations sorry that something else flashed up on the back screen it got logged out on the back one sorry it's um so teaching observations are for educators like ourselves who are looking for ways to improve our instruction skills uh for those who are curious about new approaches and uh instruction methods and for those who are interested in finding new ways to conve knowledge and information to our Learners our teach program has structured an opportunity that's available to all okay so available all throughout our system so Ru uh vtcm Cillian Clinic all of our uh Educators and we paare them with experienced Educators who are looking for ways to improve their teaching skills um these observations are going to provide objective and also confidential feedback it's going to be to our participants and can also go through and provide some resources and and ways that we can go through and improve our skills so let's dig into why an OB observation may be helpful so these are some of the ones that we came up with it's a way to have some honest unbiased feedback on one's teaching uh it's a way that you can look at what's there and you can either scale it up uh and get some perspectives on what you're already doing and how you can emphas and make that better uh you can balance some new skills with what you're already doing and it doesn't take much like you said having like a little bit of a gap and then finding out what it is and tweaking it just to make it a little bit better and more engaging for your learners uh new pedagog pedagogical approaches uh so at the med school we've been really uh pushing and moving to having a complete Active Learning environment and so our second year we don't have any dactic lecture it's all active learning and application of knowledge and I guess one of the most important ones is is at the end it's a safe environment uh that we can go through and we can talk so that we can maximize our teaching potentials another reason is for those that are on the tenure to title track this is a requirement um it is one of those where it is required to have two teaching observations uh and there needs to be a gap within six months so you can have an initial one and then a followup at at the earliest six months it could be anytime after that or longer but at least six months in between to to gauge any type of progress and implementations of new strategies so while this is a current requirement for tenure and tenure to title track promotion word on the street is that eventually AKA July 1st of next year possibly it's going to be required for everybody going through the promotion process and why we thought it was so timely to have this um session now is because as Jen mentioned you can have as much time in between two observations as possible but you need to have at least six months so imagine if you will pulling together everything for your promotion packet doing all the things that you all do in your busy daily lives and also trying to balance having at least 6 months between two observations in a year's time that you're trying to prepare for promotion right which is why we really encourage folks to try to get um have your first observation done before you even enter the promotion process right because then what they really want to do they just want to see that you've grown from your first observation so if you have one now and you're not even in the promotion process yet maybe two years from now you start promotion process then you can have your second one to show some growth all right so let's talk about what observation is and is not so what it is is an opportunity to have a confidential process um where you can go through and you can get feedback and improve your teaching and you get that individual development that you're needing it's an opportunity as we just discussed for promotion portfolio and we have a great group of experienced Educators who genuinely care about teaching and your teaching success and so it's a way to get to be a part and uh have a relationship and even Mentor uh with that person uh what it's not uh it is definitely not critical in nature okay it's not punitive it's not evaluative this is truly just formative it's just to get feedback on what opportunities are there and really uh what you are already doing exceptionally well and then how you can tweak it just to make it a little bit better and it is not focused on content so it doesn't have to uh for me to go and evaluate it doesn't have to be pharmacology content it's truly the process and your teaching so with that I'm going to turn it over and talk about how to get started yes so lots of great things about a concept of observation right so how easy easy is it to get started it's just so easy so right here we have a link and you will have access to this presentation but also at the end of our presentation there's a QR code if you want to just take a little picture you can uh do that and that will bring you right to the same link on the teach website or you can just go to the teach website poke around and you'll find it under educator resources okay so but really if you want to start the process just in your mind think about all the teaching that you do and what which teach teaching officer opportunity might be the best to have have an observation on so is it something that you've been doing for a while and you feel pretty confident in it but you're like I might want to spice it up a little bit might want to change it up I might want my learners to be more engaged so we saw this dramatic increase when we started uh or when we um around March April May June of 2020 if you could all think of you know what was happening then so everybody was going online all of the sudden right and um really without much practice ever doing so so a lot of folks said hey I I I really need to learn by how to engage my Learners from a virtual environment so we either did a consultation which is also an option which is this minus the observation you know just talking it through um we did a lot of online observations um and you'll see all the different opportunities that are appropriate for an observation um so you go right to this link choose your Observer I think we have about 10 or 11 observers as a part of our group now you'll see who they are we usually strongly encourage um choosing somebody either um just really outside of your own discipline so that you're not concerned these are all skilled observers they recognize the importance of not being focused on um the content but just so you're comfortable that they're not focusing on the content and so you're not distracted by that um I I learn every time I'm non-clinical so I learn something clinical every single time I go to observe um and but I'm not focused on the content I think it's interesting but I'm not going to be the one if if I'm the one correcting you on something clinical um you might want to double check the facts there because it's not for me to coret um so we also strongly encourage providing as much advanced notice as possible right we know y'all are busy we know sometimes this isn't the um the Forefront of your mind um and that maybe you have something coming up next week and you're like oh shoot I'd really like that observe submit it we'll do it we'll figure out who can do it we'll work with you right but just remember that this whole observation group they are folks that um most of them are just as busy as y'all and this is something that they work into their schedules on the side so in order to be able to have them most opportunity to get the Observer of your choosing just provide as much advanced notice as possible and then uh once you fill out this form online super quick super brief um usually it's Deb who will respond to you and she'll say it may take a few days but she'll respond to you and say hey uh I am putting you in contact with your um potential Observer and making sure what she's doing in the background the reason why it might be a few days is it goes to Dr Cleveland as well it goes to Deb they're trying to figure out can this person that was chosen um do do they have the time to do it at the chosen time um or do we have to find somebody else and sometimes that person is busy at that specific time and so we'll say okay Dr damat is busy would um would Dr Cleveland suffice in this um situation okay so once you sub that once that contacts you once you're um connected with your Observer it's a three-part process so what your Observer should do is schedule a time to meet with you briefly it can be on P in person or virtual whatever you want um I usually I prefer to meet in person for these um for these pre meetings mainly if I don't know the person I'm going to observe very well because I want to build that con connection and help them feel comfortable that I'm there purely for their benefit purely not to criticize at all not to find pick apart what they're doing wrong but just build that relationship to say I here for your benefit I care about your improvement um so that's the pre-observation meeting you're going to talk about the venue you're going to talk about certain things like uh because remember it's so broad there's so much you can observe right during an observation session so much involved in teaching but if you will help them to pinpoint what you're looking for assistance on it really makes it a lot easier for them to focus okay then the step two is the actual observation you set a time um to do the actual observation and then you come and do it and and it's um during that first session you'll talk about okay do you want to introduce me um sometimes people say okay this is Dr wicker she's here to help me to learn how to better teach you um and improve your learning environment okay sometimes I'm just flying the wall nobody really notices or maybe they do notice and they're just like who is that woman and it doesn't matter I'm just back there and I'm taking my little notes so sometimes it makes it a little bit easier depending on the venue right I've observed in all different situ a sometimes if there's a patient involved they don't really care because there's this big group of people going from room to room anyway um and if they're introducing people they just think I'm another one of the clinicians um but sometimes if I'm sitting in a a small group setting with um in the back of the room and people are like who is that person um they'll introduce me just so it's not uncomfortable and people aren't wondering uh and sometimes the faculty members like for their Learners to know that they're taking this step to improve their teachings to benefit them ultimately and then after the observation usually um give your Observer time to um Cate their notes and then you will uh get a post like a debrief session you'll set a debrief session up and then that the time at which you get your feedback and I don't know how everybody does it because we don't have any set way to do this but we we do have um uh an observation rubric and sure I go through and I check the boxes how I think folks have done however that's not nearly as meaningful as the qualitative feedback at the end like I will give lots of notes and I will say here are the things that I think you did really well here's something that you might want to try differently if you're trying to engage your learners more or if you're trying to connect with them more um so and then during the debreath that's the time that we discuss that whole situation and sometimes what I do we generally um when I'm giving feedback to somebody I asked them how did you think that went how did you think you did did you notice anything different and then sometimes the faculty member will fill in the blanks in ways that I didn't even consider um they'll bring out things that they were concerned about or oh I noticed that I kept doing this or whatever and then it's an added opportunity for consultation right and then I'll just go through each of my points and then it's it's a really great discussion and that's really where folks have found the benefit is in that customized approach this isn't just okay we're going to a session with 25 people in the session and we're all going to take a little bit of something from it right this is purely directed towards the individual okay so this is just I I've got three slides showing all of our um observation committee our consultation and observation committee right you too could have your lovely picture up here with a little bio I just wanted to provide an example this is all on our website and you'll see a bio for each of us right so we've got clinicians non-clinicians basic scientists we've got folks who are so Dr Fortuna generally is he likes to focus on simulation only um that's kind of how we Wrangle them in to do it um we've got somebody who's retired we got somebody right in the audience um we've got several somebody's right in the audience um um and Missy also she is usually does simulation observation only okay so we asked our observers okay so what is some advice that you could give so two two folks responded with um some points so the first one um is be specific about what you're looking for I already alluded to this a little bit right when you're in an observation situation especially so sometimes I'll go to um an operating room for example there's a lot going on there I am intrigued by everything in there and there specifically to focus on the teaching but there's so much going on right so if you are specific about what you really um would like observed that makes the most difference so somebody I observed recently in the operating room said you know I've got this diverse group of Learners so I've got an MP I've got a nursing Stu MP student a nursing student I've got a resident student um how can I make sure that I'm giving adequate attention to each of them and they walk away feeling as if they've learned something and I walk away feeling as if I've taught something and the patient is safe and all better by the end right so that's a big tip another one um this is just their comment and why they think obser observation is important it's in key to improving so they suggest even before you do this or whenever um videotape yourself teaching this is It's really Illuminating right if you I I I can't I back in when we had answer machines I couldn't even listen to my own voice on the answer machine I can't even listen to myself videotaped I I I don't like doing it at all but this Observer did um suggest videotaping yourself and that's you that's its own sort of peer observation but then you can note the things identify the things that you would like to work on so if you use a lot of filler words or you're not engaging with your learners or um whatever there there are so many things that you can identify yourself that will help you to narrow down what you would like to to focus on okay so who I say who can participate in the observation process but it's really whoever right anybody can anybody who's a part of the the medical school the hospital um and red for anybody who's engaged in teaching right this is what it's all about so if you have trainees and uh so we know that trainees are a big part of the teaching process for um students for junior residents fellows of of residents um they're a huge part of that experience yet sometimes they get left off so if you want to encourage if you see on your ACG surveys perhaps um or you see on the Block surveys um things about the residents not being adequately prepared to teach in one way or another not always so eloquently stated but um that maybe encourage those trainees to take part in a an observation process now of course this is intimidating for faculty members even the most experienced faculty members so you don't always expect that they're going to take you off on that offer um but we observe a lot of trainees and they always at least say that they benefit from it um faculty faculty at any point on the Continuum um so uh the vast majority of at least maybe not including the um the coid observations but the vast majority of our observations I think have been done um for those folks who are already really confident in their teaching they just want to get better they want to improve often times um somebody will have an observation and then once you get one observation you're like okay well I'm going to work on that and then six months down the road they're asking you to come back and do another observation and it may be in a totally different setting or it may be in the same setting to just see if they've Incorporated the feedback anyone who teaches and anyone who seeks Improvement in that teaching we're here for for everybody so teaching is obviously multifaceted uh through Virginia T Coran School of Medicine we can consider all of these rules to be teaching rules and why we why we think through this is because of um The Faculty bylaws and our our mission is focused on teaching for faculty right but we want to make sure that um nobody feels excluded in that so if you're doing teaching you need to have a faculty appointment and if you have a faculty appointment you need to be doing some sort of teaching so if somebody says well I don't give any lectures doesn't matter do you Mentor somebody are you coaching um peers or other Learners do you develop curricula um do you do education research Are you a role model do you assess are you a researcher are you mentoring folks through the research process all of those are included in teaching so anything really associated with that we can help you with so here's some feedback from faculty who have been observed already um so I utilize teach the teach observation program to help make small adjustments in my day to improve my teaching style while also running a busy office I really love this this observation remember um the in office observation provided me with effective feedback to streamline my teaching while still providing high quality care to my patients I highly recommend this program for as practical and effective Approach at improving teaching in medical practice so this one was um somewhat recently done and I loved it because the environment was different than I was used to it was an office where um this faculty member was going from room to room he was in clinic and so he had two Learners with him we would go from room to room we would start in a room he would teach he would take care of the patient and I would notice something we would go back to his office which was right next to his patient rooms which was really cool um and and and then the Learners would you know follow up with the rest of the patient visit we would go back I would give them some feedback and and then he would go back and apply that feedback right in with the next patient it was so cool and so he was growing right within that half day that I spent with him spent a full half day in his office and he grew the entire time and now since then he's done another one um so that was really cool and one of his Learners at the end of this session said hey I'm really interested in teaching can you help give me some feedback on uh ways that I can get more involved so that was really cool and I happened to see her um at our education grant nouns when she came so she uh she really was interested okay next one many clinicians have no formal training and education traditionally our only feedback comes from the Learners themselves while this feedback has been been helpful it's limited by the ability of the Learners to identify and articulate opportunities for improvement very true sometimes Learners will just know that something's off or they don't feel hurt or they don't feel it but they don't really know what to do about it right the observation process uh provides an outside view of One's Own teaching from individuals with expertise having this perspective is invaluable and becoming a more effective teacher great that's what we' like to see so where can we do these observations really anywhere um so lecture we do tradition lecture uh larger small group and a lab facilitating pbl the operating room one to one i' I've sat in several times on um just somebody giving feedback in a onetoone session I mean that that takes um it it it's a different level of vulnerability I think for both the teacher and the learner but they were both totally in on it and um and they appreciated it the Learners were great with it um bedside rounds so remember the our observation process is for whomever whenever we almost took out the whenever I had a whole slide on whenever but then we do have a lot of Surgeons okay and a lot of Surgeons would have us and I'm not just picking on surgeons the way I like to that but they're like can you do these sessions can you come and give us the same session at five I'm like sure we do we do 5 PM that's not what that that's not the five they were referring to so not always uh we're not always going to be super uh available to do middle of the night observations or something like that we will we will stretch and bend as much as we can and we may have some super early morning people that are okay with that um but generally whenever and wherever we're good with that so here's the little QR code if you want to take a little picture of that and that will lead you right to the observation form if you want to complete that um one of the things that I think you can do to prepare for the observation is just one recognize what you want to be observed on right another thing would be potentially um having sort of an informal observation recording yourself or having a colleague or whomever uh observe you and just get some of the little nitty-gritties out of the way um and then just be as specific as possible in what you would like for us to look at or just say you know what I'm totally brand new just tabul Rossa let me know um what would work thank you so much for coming if you all I know a lot of you are uh wonderful Educators already if you would like to um be a part of the observation team you're more than welcome to contact us and find out how to do so or um we look forward to seeing you next time you'd like to be uh observed at any point on the experience Continuum enjoy the rest of your day.