As educators, we must remember to go “back to basics,” in times of uncertainty or when we experience new teaching and learning challenges. Adult learners desire to give and receive feedback about their learning experiences. Educators navigating the transition to online teaching and learning can utilize this in their favor. Although varied methods can be utilized, one simple, efficient, translatable, and free way to do so is to implement the “Plus/Delta Debriefing Model” (Plus/Delta) as part of routine educational quality improvement.

Not that long ago, I remember being thrust into the role of a senior resident on wards and being responsible for the educational experience of medical students. I was still trying to figure out how to manage patients - how was I going teach the medical students? How could I be supportive of their learning? It was overwhelming and I remember wishing someone would provide me with additional guidance.

Years later, after finishing a Masters in Medical Education, I gained some tools that allowed me to understand how being a good teacher was an art and a learned skill – not something that comes innately. I wanted to impart some of the skills I had learned to the senior residents in our program so they did not feel as lost as I did all those years ago. Furthermore, residents at our program had expressed a need for guidance in teaching medical students. Thus, I challenged myself to start a curriculum for internal medicine residents focusing on the “One Minute Preceptor” – an educational technique that could be useful for them when teaching on the words.

This past spring, my palliative care colleagues and I sat down in front of Kara Walker’s artwork titled The Jubilant Martyrs of Obsolescence and Ruin at the High Museum of Art in Atlanta, Georgia. For thirty minutes, we slowed down, turned off our cell phones and pagers, and looked slowly and intently at this 58-foot massive cut-paper work. Like the other works of art we studied in the museum, our docent facilitator began the conversation by asking us the following question: What is going on in this artwork?  Some saw a scene of incredible violence. Others saw a satiric commentary on the American Civil War.  One remarked on figures representing different races and identities. Another commented on gender and sexuality portrayed in the work. With each comment, the facilitator asked: What do you see that makes you say that? Our eyes sharpened and our language became more precise with each passing comment.  For example, when a participant was asked to clarify her remark on different eras of American history portrayed in this image, she honed in on the figure in the upper right of the artwork who appears to be wearing a suit. To her, he represented an African American figure from the Civil Rights era more than from the Civil War. The facilitator acknowledged and paraphrased her comment, and then continued: What more can we find?

The medical practice landscape has changed towards a more team-oriented and inter-professional approach. Physicians are expected to function as effective members of multidisciplinary teams, as the patient case mix has increased in complexity, chronicity and age. Developing collaborative skills in medical education is essential as medical students will enter a dynamic world of team-based medical practice. Therefore, teamwork training is a requisite in medical school to nurture appropriate competencies in the physicians of the future. The literature recommends beginning collaborative and teamwork training at the start of medical training, using implicit team learning (e.g. problem based learning and team based learning activities where students work interdependently to achieve learning outcomes while teamwork/collaboration is influenced by the facilitator) for early students and progressing towards more explicit team learning (e.g. clinical simulation activities where students work interdependently and are given explicit instruction and practice in teamwork/collaboration with the goal of improving their performance) as students advance.  

The current coronavirus outbreak is forcing all educators to rapidly adapt to a new method of teaching - online. While many educators may have mastered their teaching domains in the classroom, virtual teaching will certainly challenge their mastery of adapting to this new learning environment. With the help of faculty development colleagues, we can remain nimble during times of rapid transition. How do we as medical educators stay resilient and step courageously into this unfamiliar territory?