New Beginnings: Building a Foundation between Educators and Learners By Carmen J. Martinez, MD, MSMEd, FACEP, FAAEM
Summer for those in medical education is filled with big endings and new beginnings. At the end of June, we said goodbye to our graduates, and on July 1, we welcomed new learners and new educators. It is an excellent time for everyone involved to examine how we teach and give feedback, and look for ways to improve our skills as we strive to be outstanding medical educators. Before we begin our journey this academic year, let’s look at how we frame our teaching to be as successful as possible. First, we must create a safe and supportive learning environment, and next, we should orient our learners and ourselves. Setting the stage for a safe and supportive learning environment is vital at the beginning of a learning period, and cultivating it is essential to promote critical thinking in the clinical setting. Jaffe and colleagues conducted a multi-institutional qualitative study that examined faculty’s perspectives of teaching critical thinking. The article discusses five main themes related to establishing a safe environment: building trust, respect, empathy, laying ground rules, and a “safe to be wrong” clinical setting. One faculty member describes that a crucial first step was laying the “groundwork (and) setting the atmosphere” so “people feel relaxed and safe.” Table 1 discusses the common themes needed to create a safe and supportive learning environment and some examples on how to build on these themes.1 As we begin to cultivate a positive and engaging learning environment, as educators, we should also focus on the 40
By Caroline M. Molins, MD, MSMEd, FACEP, FAAEM
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Table 1: Common themes needed to create a safe and supportive learning environment. Theme
Description
Examples
Building Trust
Show the learner that feedback is intended to be supportive and constructive, not shaming or belittling.
“Dr. Lee, I saw that you were having some difficulty with this procedure. I did, as well. So let’s go over the procedure and see how I can help you succeed on the first attempt next time.”
Respect
Modeling respect of all roles (nursing, tech, medical students, residents, subspecialists).
After a pediatric resuscitation, the attending has a debriefing session with those involved (nursing, techs, residents and medical students) to discuss successful moments and how to improve for the next time.
Empathy
Empathy in relationships (teacher-learner/ learner-learner).
“You bring up a great question, and I am not sure of the answer. Let’s look it up together.”
Ground Rules
Discussing expectations, curriculum, establishing roles in the clinical environment.
“Hi, I’m Dr. Smith and I will be your attending for the rest of your shift. I do not think we have worked together before. However, I usually give feedback at the end of our time together. Is that ok with you?”
Safe to be Wrong
Clarify the importance of learning and critical thinking process rather than on “right answer.”
“Dr. Gonzalez, this is a very challenging case. Can you tell me why you think this patient should get TPA for these symptoms?”
teaching and learning that will occur. In 2000, Heidenreich and colleagues described eleven key methods to lead educators to efficient and effective EMpulse Summer 2021
teaching. The first one is the role of orientation in setting the stage for the learners. The description and use of orientation can be ambiguous.
