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05.20 - Dr. Bakshi

Course video 80 of 100

The objectives for this module are that after you actively engage in the activities, you will be able to: 1. Describe the basic theoretical underpinnings of the BID model. 2. Develop a briefing focused on a learning objective 3. Perform intra-encounter teaching focused on the learning objective 4. Perform a short debriefing focused on the learning objective Note: while this model was developed for the operating room, you will find that it applies to any clinical setting. In each encounter think about first working with learner to set her objectives, then teaching during the clinical encounter and finally providing feedback or debriefing.

The purpose of this course is to improve feedback, clinical teaching, and assessment of clinical skills.

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Ministrado por

Sally Santen, M.D., Ph.D.
Associate Professor - Emergency Medicine

Transcrição

Today we're talking with Doctor Rishi Bakshi from the University of Michigan.

Dr. Bakshi tell us a little bit about your practice?

>> Sure Cheryl.

I'm a PONR trained and I perform interventional spine procedures,

along with clinic and rehab of the spine and the muscular skeletal system.

>> Well we've been learning about the BID model and

we know it can be successful in a number of context.

But I'm curious as to how you might use it in your practice.

In part because your patients are awake.

Do you think this would be difficult to use, this model?

>> I don't think so.

I think the model of the interopt component of it,

the middle, the eye, will be helpful in terms of

teaching explaining during the procedure, while the patient's awake, like you say.

I think if I treat everybody in the world as though they're a trainee and explain

everything to the patient as I would the trainee, they're going to benefit from it.

I'm allowed to then do the interop training that I'd like to do,

and I think everybody's going to feel comfortable

that they know what's going on during the procedure.

>> I also have a question about the B part of the model, the briefing.

In surgery we're fortunate enough to have some scrub time

where we spend some time alone with anyone we choose, but in particular the learner.

In a procedural unit, do you have that time?

And how do you think you could create that time, if not?

>> So we don't.

We don't have a formal scrub and in fact,

I don't think we have two sinks that are next to each other.

But I do think that that's extremely valuable.

And I'm trying to find a way in my mind to incorporate the briefing part

into our procedures.

And I think what I can do is find a way to have a situation arise

where the trainee and I are both going to be next to each other physically and

involved in some pre-planning portion of the procedure.

Whether it's even just bringing the charts together or maybe even

discussing consents, or even getting materials, just getting the trays out,

where we're forced to be together, we can do that briefing part.

>> Lastly, I'm thinking about a fast paced unit like you have, and

you're doing multiple procedures in a day

Is it feasible to debrief at the end of each procedure, or

would you do it at the end of the day, or how would you approach that?

>> Sure, we do one procedure every 30 minutes, and

in that 30 minutes, we get a consent, we set up the tray,

we talk to the patients, we prep, clean, and then we do the procedures.

So in between procedures,

I don't think there would be time to do a fulldeep-brief.

However, at the end of the day, considering that the procedure are all of

a similar nature, they might be in different locations of the spine, or

the neck, or the low back, joint injection versus epidural.

The themes can be either written down during the day,

or I can just create a log, and then we can discuss things at the end of the day.

I can ask the resident or trainee what they thought went well for them.

I can give my own opinion of what I think went well and

they can tell me where I could use some work too.

>> Fantastic.

Thank you so much for those great insights Doctor Bakshi.

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