Level A
- Identifies the learner’s goals
- Describes the institutional goals for the learning experience
- Communicates clear expectations to learner as educational experience begins
Level B
- Collaborates with learner to prioritize goals
- Assists learner to align institutional goals with learner goals
- Clarifies roles and responsibilities with learners and clinical team
Level C
- Integrates learner’s goals into teaching activities
- Facilitates opportunities for learner to meet goals
- Collaborates with learner and clinical team to adjust expectations based on learning context
Level D
- Coaches and monitors learner’s progress toward goals
- Fosters accountability of learner and clinical team to collaboratively meet responsibilities
Author: Priyanka Tulshian, MD, MPH
Resources
Reed, S., Lockspeiser, T. M., Burke, A., Gifford, K. A., Hanson, J. L., Mahan, J. D., McKenna, M., Rosenberg, A., & Li, S.-T. T. (2016). Practical suggestions for the creation and use of meaningful learning goals in graduate medical education. Academic Pediatrics, 16(1), 20–24.
https://doi.org/10.1016/j.acap.2015.10.005.
STFM Teaching Resources CBME Toolkit (links to Individualized learning plans and webinar series)
https://www.stfm.org/teachingresources/resources/cbme-toolkit/cbme-toolkit/
https://www.stfm.org/teachingresources/resources/cbme-toolkit/cbme-individualized-learning-plans/
https://www.stfm.org/teachingresources/resources/cbme-toolkit/cbme-faculty-development-webinars
George, P., Reis, S., Dobson, M., & Nothnagle, M. (2013). Using a learning coach to develop family medicine residents’ goal-setting and reflection skills. Journal of Graduate Medical Education, 5(2), 289–293. https://doi.org/10.4300/jgme-d-12-00276.1.
Level A
- Identifies the importance of self-reflection skills for learner
Level B
- Creates opportunities for learner to actively engage in self-reflection
Level C
- Discusses barriers and solutions discovered through self-reflection
Level D
- Review self-reflection with learner to ascertain learner’s progress
Author: Priyanka Tulshian, MD, MPH
Resources
Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Med Teach. 2009;31(8):685-695. doi:10.1080/01421590903050374.
Brockbank, A., & McGill, I. (2007). Facilitating reflective learning in higher education. McGraw-Hill Education (UK).
Ní Mhurchú, M., & Cantillon, P. (2023). Reflective practice in medicine: The hidden curriculum challenge. The Clinical Teacher, 21(2). https://doi.org/10.1111/tct.13682.
https://asmepublications.onlinelibrary.wiley.com/doi/full/10.1111/tct.13682.
Gathu, C. (2022). Facilitators and barriers of reflective learning in Postgraduate Medical Education: A narrative review. Journal of Medical Education and Curricular Development, 9, 238212052210961. https://doi.org/10.1177/23821205221096106.
Level A
- Recognizes the bidirectional nature of feedback
- Identifies feedback as important for learner progression
Level B
- Helps the learner develop skill in giving feedback
- Engages learner in setting expectations and provides learner with timely and actionable feedback
Level C
- Requests and listens to learner feedback and is able to reflect on potential changes
- Helps learner initiate an actionable learning plan based upon feedback
Level D
- Consistently seeks feedback and adjusts teaching behavior to be learner-centered
- Helps the learner make meaning of feedback and select strategies for a development plan
Author: Brian Johnson, MD
Resources
Aagaard E, Czernik Z, Rossi C, Guiton G. Giving Effective Feedback: A Faculty Development Online Module and Workshop. MedEdPORTAL. 2010;6:8119. https://doi.org/10.15766/mep_2374-8265.8119.
Weallans J, Roberts C, Hamilton S, Parker S. Guidance for providing effective feedback in clinical supervision in postgraduate medical education: a systematic review. Postgrad Med J. 2022 Feb;98(1156):138-149. doi: 10.1136/postgradmedj-2020-139566. Epub. 2021 Feb 9. PMID: 33563716.
Ramani S, Könings KD, Ginsburg S, van der Vleuten CP. Feedback Redefined: Principles and Practice. J Gen Intern Med. 2019 May;34(5):744-749. doi: 10.1007/s11606-019-04874-2. PMID: 30783881; PMCID: PMC6502935.
Book from communications literature on different types of feedback including best practices for recipients: Stone, D., & Heen, S. (2015). Thanks for the feedback. Portfolio Penguin.
Level A
- Recognizes that a learner can have contextual and multifactorial difficulties
- Recognizes when a learner is not meeting expectations
- Describes approach to the learner in difficulty
Level B
- Seeks to understand contextual factors that may be influencing learner’s behavior
- Discusses observed behaviors with learners in difficulty and seeks institutional support if needed
- Engages in developing learning plans for learners in difficulty
Level C
- Collaborates with learner and institution to address and overcome contextual barriers
- Coordinates learning plans for learners in difficulty
Level D
- Works with institutions to remove contextual barriers and improve practices for assisting learners in difficulty
- Builds systems for supporting and assisting learners in difficulty
Author: Brian Johnson, MD
Resources
Overview of remediation of medical learners: Hauer KE, Ciccone A, Henzel TR, Katsufrakis P, Miller SH, Norcross WA, Papadakis MA, Irby DM. Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature. Acad Med. 2009 Dec;84(12):1822-32. doi: 10.1097/ACM.0b013e3181bf3170. PMID: 19940595.
A faculty development workshop that includes a simple model for approaching struggling learners: Stafford M, Johnson B, Hessler D. A Systematic Approach to Working With Medical Learners in Difficulty: A Faculty Development Workshop. MedEdPORTAL. 2020;16:10872. https://doi.org/10.15766/mep_2374-8265.10872.
Faculty development with a focus on clinical reasoning. Weinstein A, Gupta S, Pinto-Powell R, Jackson J, Appel J, Roussel D, Daniel M. Diagnosing and Remediating Clinical Reasoning Difficulties: A Faculty Development Workshop. MedEdPORTAL. 2017;13:10650. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10650.
Level A
- Acknowledges when beliefs, attitudes, language, and behaviors are influencing the learning environment
- Promotes physical, emotional, and social safety in learning environments
Level B
- Engages learner and colleagues in identifying barriers to a safe learning environment
- Identifies and disrupts the imposition of increased labor and cognitive and emotional load on minoritized colleagues and learners
Level C
- Identifies areas for change in own institution to help promote safety in the learning environment
- Addresses barriers and aids in creating learning environments that promote safety
- Demonstrates the internalization of inclusive and antiracist beliefs, attitudes, language, and behaviors
Level D
- Leads others in addressing the promotion of safety in the learning environment
- Leads others in promoting inclusive and antiracist beliefs, attitudes, language and attitudes
- Demonstrates improvement in learning environments that promote safety through interventions
Authors: Tanya White-Davis, PsyD, and Ellen Tattelman, MD
Resources
Black, indigenous, and trainees of color stress and resilience: The role of training and education in decolonizing psychology. Pinedo AC, Caso TJ, Rivera RM, Carballea D, Louis EF. Psychol Trauma. 2022 Apr;14(S1):S140-S147.
Addressing disparities in academic medicine: what of the minority tax? José E Rodríguez, Kendall M Campbell, and Linda H Pololi. BMC Medical Education (2015) 15:6.
Level A
- Identifies the impact of bias on health care and health outcomes
- Recognizes that language and content in one’s own teaching has the potential to include bias and oppression
Level B
- Reviews language and content in one’s own teaching to remove areas that promote bias and oppression
- Intentionally incorporates principles of diversity, equity, inclusion, and antiracism into all of one’s teaching (precepting, didactics, rounds, assessment and evaluation, etc.)
Level C
- Demonstrates improvement in language and content of teaching
- Teach others to recognize biased language and content
- Works collaboratively to promote diversity, equity, inclusion, and antiracism into all the teaching in own’s department
Level D
- Leads collaborative efforts to promote diversity, equity, inclusion, and antiracism into all the teaching at one’s own institution
- Disseminates teaching strategies that promote diversity, equity, inclusion, and antiracism outside one’s own institution
Authors: Ellen Tattelman, MD, and Tanya White-Davis, PsyD
Resources
How Medical Educators Can Foster Equity and Inclusion in Their Teaching: A Faculty Development Workshop Series. Katherine L Lupton, Patricia S O'Sullivan. Acad Med. 2020 Dec;95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments):S71-S76.
The weight of our words. Anekwe CV. J Hosp Med. 2022 May;17(5):410-411.
Do words matter? Stigmatizing language and the transmission of bias in the medical record. P Goddu A, O’Conor KJ, Lanzkron S, et al. J Gen Intern Med. 2018; 33(5):685–691.
Level A
- Recognizes the importance of sociocultural and sociopolitical values and differences
- Identifies the impact of sociocultural biases* (including teacher bias) and stereotyping on learners
Level B
- Teaches and communicates effectively with learners who are socioculturally and sociopolitically different from self
Level C
- Addresses conflicts caused by differences in sociocultural and sociopolitical values and beliefs
Level D
- Teaches and role models how to consider personal, sociocultural and sociopolitical contexts when working with learners, even in complex and/or stressful situations
*Sociocultural biases include class, gender identity and expression, sexual orientation, race, ethnicity, ability (mental or physical), education, age, language, finances, religion, body habitus, etc.
Authors: Tina Kenyon, ACSW
Resources
Definition and reflection on socio-cultural awareness.
https://idealsintopractice.site.wesleyan.edu/competencies/socio-cultural-awareness/.
Importance of Diversity and Multicultural Awareness in Education – strategies.
https://drexel.edu/soe/resources/student-teaching/advice/importance-of-cultural-diversity-in-classroom/.
Integrating Cultural Anthropoloy into Faculty Development for Medical Educators. Oikawa, S., Iida, J., Ito, Y. et al. Cultivating cultural awareness among medical educators by integrating cultural anthropology in faculty development: an action research study. BMC Med Educ 22, 196 (2022). https://doi.org/10.1186/s12909-022-03260-7.
Level A
- Acknowledges that different teaching strategies are beneficial
Level B
- Actively invites learners’ perspectives, knowledge, and insights to co-create strategies to enhance learning
- Demonstrates different learner-centered teaching modalities
Level C
- Reflects on appropriate teaching strategy for specific learner and context
- Uses growth mindset(1) to align and adjust teaching strategies to meet learners
Level D
- Coaches others in how to adjust teaching strategies to meet learners’ needs
(1)Dweck, C., 2016. Mindset: The New Psychology of Success. 2nd ed. New York: Random House.
Authors: Brian Johnson, MD
Resources
Harden RM, Sowden S, Dunn WR. Educational strategies in curriculum development: the SPICES model. Med Educ. 1984 Jul;18(4):284-97. doi: 10.1111/j.1365-2923.1984.tb01024.x. PMID: 6738402.
Ramani, S., & Leinster, S. (2008). AMEE Guide no. 34: Teaching in the clinical environment. Medical Teacher, 30(4), 347-364.
Thomas, P. A., Kern, D. E., Hughes, M. T., & Chen, B. Y. (2015). Curriculum development for medical education: A six-step approach. Johns Hopkins University Press.
Level A
- Recognizes that learners have their own diverse backgrounds and experiences
Level B
- Explores learners’ background, knowledge, and experience
Level C
- Actively incorporates learners’ unique background, knowledge, and experience in learning plans
Level D
- Co-creates systems with learners to support a diversity of learner styles
Authors: Brian Johnson, MD
Resources
Ramani, S., & Leinster, S. (2008). AMEE Guide no. 34: teaching in the clinical environment. Medical Teacher, 30(4), 347–364. https://doi.org/10.1080/01421590802061613.
Hammick, M., Olckers, L., & Campion-Smith, C. (2009). Learning in interprofessional teams: AMEE Guide no 38. Medical Teacher, 31(1), 1–12. https://doi.org/10.1080/01421590802585561.
Medina, J. (2009). Brain Rules. Pear Press. brainrules.net/brain-rules/
