Teaching
Educational philosophy
Hepatology is rarely a focus in medical school curricula compared to other organ groups and remains underrepresented in post-graduate training exposure. Compounding this is a national shortage of hepatologists that is projected to worsen. My motivation as an educator is to work at a grassroots level and draw learners toward this field before they settle on a specialty. It is also why I established a four-year medical school track in hepatology and transplantation, giving students longitudinal exposure from their preclinical years onward; the shortage will not be solved at fellowship level alone.
Being an academic physician requires adaptability, medical expertise, and compassion. As a Transplant Hepatologist, I have the privilege of working with medical trainees at every stage of their career, from medical school through to Transplant Hepatology fellowship. I am a firm believer in combining bedside education with hepatology pathophysiology, linking real-life cases to key topics to bridge the gap between theoretical knowledge and clinical practice. My training across Canada, Ireland, and the United States gives me diverse experience to draw from and the ability to connect with students from a wide range of backgrounds.
I have incorporated several educational theories into both my bedside teaching and my lecture development. Given the breadth of learner experience I encounter, Vygotsky’s zone of proximal development is central to adjusting a complex concept, such as cirrhosis or liver transplantation, to a learner’s baseline knowledge (Vygotsky, 1978). Much of what I do at the bedside is described by Bandura’s social cognitive theory, in which the learner, their behavior, and their environment influence one another (Bandura, 1986). For procedural training I integrate modeling and design simulation sessions using Peyton’s Four-Step Approach (Krautter et al., 2011). Finally, Mayer’s Cognitive Theory of Multimedia Learning is now instrumental in my formal teaching practice and lecture development in order to avoid cognitive overload (Mayer & Moreno, 2003).
Learner assessment is where my practice has changed most. I now design formative and summative tools to do different work, a distinction that was not evident to me prior to this program and has directly influenced my assessments, particularly in e-module development. Effective feedback is also a skill I had underestimated. I now structure it deliberately, using the REFLECT rubric for written feedback (Wald et al., 2012) and the PEARLS framework to combine self-assessment, focused facilitation, and directive feedback when debriefing (Eppich & Cheng, 2015).
Every day I use bedside clinical medicine to augment the education of trainees at all levels. What has changed is the scale: I now know how to build a curriculum, design an e-module, and integrate technology into my teaching, which lets me reach learners well beyond the patients present at hand. This program has given me the tools to expand my educator footprint and create a regional and national impact.
References
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10(2), 106–115. https://doi.org/10.1097/SIH.0000000000000072
Krautter, M., Weyrich, P., Schultz, J. H., Buss, S. J., Maatouk, I., Jünger, J., & Nikendei, C. (2011). Effects of Peyton’s four-step approach on objective performance measures in technical skills training: A controlled trial. Teaching and Learning in Medicine, 23(3), 244–250. https://doi.org/10.1080/10401334.2011.586917
Mayer, R. E., & Moreno, R. (2003). Nine ways to reduce cognitive load in multimedia learning. Educational Psychologist, 38(1), 43–52. https://doi.org/10.1207/S15326985EP3801_6
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Harvard University Press.
Wald, H. S., Borkan, J. M., Taylor, J. S., Anthony, D., & Reis, S. P. (2012). Fostering and evaluating reflective capacity in medical education: Developing the REFLECT rubric for assessing reflective writing. Academic Medicine, 87(1), 41–50. https://doi.org/10.1097/ACM.0b013e31823b55fa
Resources for learners
LIMES is a separate site I built for self-directed learning on liver disease and liver transplantation, written for medical students and other trainees.
Open liverlimes.com (opens in a new tab)
Portal Hypertension: A Systemic Disease is an e-learning module I built with two medical students through the UNMC E-Learning Awards, hosted in the university’s E-Gallery.