Like a new parent whose behaviors are shaped by how he or she was parented (1), a new teacher establishing his or her role may draw from memories of being taught. In discussing the need to improve our training of residents to be teachers (2, 3), we may be overlooking—and underutilizing—a qualification for the teaching role that all residents have: their experiences as medical students, including hundreds of hours of teaching by medical educators of every description. By considering this, we might reframe an aspect of the discussion as follows: how can we help our residents organize and apply their experiences as medical learners to their new role as medical teachers? A solution that I have used with second postgraduate year (PGY-2) psychiatric residents for more than 12 years is to provide a forum for the residents to process their peak experiences as medical learners and organize these into practical principles of good teaching. The premises of the intervention are that residents already have internalized models of how to teach that were formed by the experiences of being taught, and that remembering, sharing, and analyzing these experiences with their peers and a faculty facilitator can access, clarify, and activate these internalized models for immediate use. This article describes this teaching method and provides examples of the residents’ experiences and the teaching principles they derived from them, the results of a survey questionnaire of its effect, and comments on aspects of the group process that may account for that effect.

My department allots 2 hours in the PGY-2 curriculum for teaching to teach. In the first hour, I conventionally presented the psychiatric clerkship structure and content, its goals and objectives, and the residents’ specific roles and responsibilities to the medical students as their teachers. The second hour—which I call “experiential anamnesis and group consensus,” in which the residents share their experiences (“experiential anamnesis”) and articulate from these experiences general principles of medical teaching (“group consensus”)—is the innovative method that is the focus of this report.

After I briefly described the purpose and format of the hour and assured the residents that sharing their experiences was voluntary, I gave them a minute or two of silence to reflect on their medical education and to choose an experience as a learner that stood out as a high point or that was educationally ineffective or counterproductive. A note taker jotted a summary of each experience on a dry erase board. The great majority of experiences recounted by the residents occurred during their clerkships. Other residents commented on the experience and proposed educational principles that it illustrated, which were also jotted on the board. After all shared their experiences, the teaching principles generated were reviewed and discussed as a whole.

I wrapped up the session by telling the residents that teaching clerkship students marks their first opportunity to acquire some of the core skills they have identified. I emphasized that learning to teach is a career-long process, which, as the department’s director of medical student education, I am available to facilitate throughout their residency. Immediately after class, I sent a memo to the PGY-2 residents summarizing the discussion and restating the principles of teaching that they derived from their experiences.

The academic year 2009–2010 PGY-2 class evaluated the session by filling out a four-item voluntary and anonymous questionnaire, with each item scored on a four-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). This educational research project was determined to meet exemption requirements by the institutional review board.

Examples of Recollected Experiences and Teaching Principles Derived From Them

In the 2009–2010 academic year, 11 of the 12 PGY-2 residents attended this session. They shared a total of 18 experiences—nine as peak positive experiences and nine as particularly ineffective teaching. From these experiences, the residents derived a set of clinical teaching principles which fell into five main areas: giving students defined roles on clinical teams, using interesting and challenging teaching formats and exercises, tailoring teaching to the students’ level, role modeling, and giving direct, specific feedback. Table 1 shows representative examples of the 18 experiences, each illustrating a major teaching principle.

Survey Results

All 11 residents filled out the evaluation questionnaire. Table 2 displays the means and standard deviations of the responses.

Group Process

In this and all past groups of residents, I have observed that in recounting their vignettes, many residents re-experienced some of the emotions that accompanied the original event, evoking empathic responses in the group. This was an unanticipated aspect of the method, but it appeared powerful and may account for a large part of the session’s effect. When residents shared vignettes that illustrated a high point of their medical learning, as in the first, second, fourth, and fifth examples in Table 1, their pleasure at the recollection was usually apparent on their faces and in their voices, and the nods and knowing smiles of the other residents made clear that they shared their colleague’s appreciation of the experience. When a resident shared an experience of poor teaching, as in the third example in Table 1, he or she often visibly reflected the disappointment of that event, and likewise, the group’s empathy was observable. The subsequent cognitive processing that identified a principle of medical teaching for each experience was usually quick and transparent.

The survey results (Table 2) suggest that the residents viewed this seminar as useful preparation for their roles as teachers, despite its brevity. On the basis of my observations of the group process during my use of this method for more than 12 years, I hypothesize that the session owes a large measure of its success to enabling residents to access, socially validate, and cognitively process memories that are highly affectively charged.

I first conceptualized this method as a cognitive exercise that would use the residents’ memories of being taught as raw material from which they would derive basic concepts of medical teaching for their use. I was unprepared for the degree to which this exercise has repeatedly shown itself to be an intensely affective and social experience. Specifically, the residents’ memories of being well or poorly taught are generally highly affectively charged, these emotions are on the surface and readily re-experienced in the retelling, and the residency peer group has responded first and foremost with a spontaneous display of empathy toward the speaker. I now view these emotional and social aspects of the exercise as the psychological “fuel” and “glue” that make the cognitive task of identifying and agreeing on teaching principles vivid, compelling, and ultimately useful to the residents.

This study’s limitations are the lack of independent indicators that the residents are better prepared to teach students as a result of the intervention and the small sample size of the survey data (i.e., one academic year in one institution). However, the informal data are larger: In more than 12 years of using this method, I have the impression that the residents appreciate the exercise from year to year. After I presented it as a workshop at a national meeting of the Association of Directors of Medical Student Education in Psychiatry in 1998, other program directors adopted it and continue to use it. Personal communications from some of them indicate that it has succeeded at their programs. I hope that this report will encourage wider use of the experiential anamnesis and group consensus method of teaching residents to teach, result in additional testing of its effect at other departments of psychiatry, and lead to its use in other specialties.

At the time of submission, Dr. Polan reported no competing interests.