Understanding didactic and clinical education

Residency Program Insider, December 17, 2020

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Editor’s Note: The following is an excerpt from The Residency Program Director's Handbook, Third Edition. For more information about this book, click here.

Regularly scheduled didactic sessions are required for every residency program. A didactic session may take many forms, such as formal lectures, journal clubs, case discussions, workshops, simulation training about patient care and procedures, and computer-based learning modules. Residents and faculty should be active participants in these sessions, and the six ACGME competencies must be incorporated throughout them. The program director must monitor the quantity and quality of educational sessions at all clinical sites.

The more traditional schedule of didactic sessions includes a daily morning report and noon conference as well as weekly grand rounds. A more recent approach to didactic scheduling is forgoing daily sessions and replacing them with a half-day of protected didactic time. This approach requires that resident involvement in clinical duties be interrupted, with attending and midlevel providers assuming the residents’ clinical duties until didactic time is completed.

Regarding clinical teaching for residents, the responsibility falls upon board-certified attending physicians to supervise, mentor, and ideally find teachable moments in all clinical encounters. More senior trainees and nurse practitioners participate in the training of junior trainees and medical students. The program director can also refer to available resources to help residents in their own roles as teachers. The expectation is that all clinical shifts, including those at night, will include quality teaching at all levels and have the relevant resources available.

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