Boots on the Ground, Both Hands on the Keyboard: Harnessing the Power of Resident as Teacher Hybrid Teaching Skills in the Midst of the COVID-19 Pandemic

Abstract

Resident as teacher (RAT) programs have grown nationally with much documented success [1], in large part because of their emphasis on “near-peer” teaching and learning [2]. Residents can relate to fellow residents and medical students, as well as be more attentive to challenges and stresses because of shared experiences and proximity in training [3–5]. Residents enjoy teaching and report greater job satisfaction when given teaching opportunities [6, 7]. Efforts focused on training residents to develop and hone their teaching skills have tremendous potential benefits for learners and teachers, and never has this been more apparent than in the current educational climate. The COVID-19 pandemic has upended graduate medical education (GME). Residents have flexed into different roles to meet institutional demands and traditional modalities for teaching and learning have, in some sense, been abandoned due to social distancing guidelines put in place to limit transmission of disease. The Accreditation Council for Graduate Medical Education has relaxed some requirements, allowing for greater program flexibility, but there is mounting concern that this comes at a cost, threatening the mission of trainee education and ultimately trainee competency [8]. Throughout the pandemic, residents have demonstrated remarkable resilience while providing exceptional patient care. As we move forward into the subsequent pandemic phases, we must prepare for the next challenge of prioritizing and reimagining resident education. We must empower residents to serve as educational leaders in this changed medical landscape by strengthening our RAT programs. These enhanced programs can equip residents with the skills necessary to advance education in this new environment. In-person teaching has been disrupted. Numerous publications have described the transition from in-person didactics to “remote” learning and need for increased reliance on technology and simulation. Our experiences early in this pandemic have taught us that we cannot simply use virtual platforms to deliver previously in-person lectures and learning experiences. Substituting prior in-person didactics often resulted in a lack of participation and decreased interactions through the screen. In recent months, there has been extraordinary innovation as we have thought of new ways to increase remote learner engagement. These efforts have largely been faculty driven. We now need to engage residents who already have their “boots on the ground” and provide them with additional tools and training to be effective in this new environment. We must improve the long-term sustainability of these innovative models by instilling the fundamental principles of interactive and hybrid learning in residents who are now building their teaching portfolios. To this end, we describe specific techniques related to bedside teaching and incorporation of technology to assist residents in this changed educational landscape. We also describe how employing these techniques may ultimately improve resident wellness and contribute to future sustainability of RAT programs.