PARO’s Guide To Optimal Academic Days

Introduction

Academic Days make a unique contribution to residency training through opportunities for dedicated teaching time and different approaches compared to teaching in a clinical setting. PARO is committed to helping programs, residents, and clinical teachers optimize dedicated academic time, and has developed a vision of success that makes up the ideal academic day: 

  1. Academic Days are well-executed to promote engagement and celebrate learning    
  2. Academic Days reinforce clinical learning
  3. Academic Days provide opportunities to add to and expand on clinical learning 
  4. Academic Days model the ideal learning environment

What’s In This Guide

PARO has designed this guide to help Chief Residents, Program Directors, Program Coordinators, and others plan and deliver excellent Academic Days. We’ve collected numerous tips, ideas, and suggestions for how to optimize academic time from residents across the province, who were eager to share what their programs did really well when it came to teaching. All the ideas included in this guide represent the best of the best – all of the most effective, creative, and useful ideas and practices that are currently being used by programs in Ontario to deliver excellent academic days. We encourage you to draw inspiration from these examples in order to customize an approach for your own program. 

We have best practices and ideas for all of the following: 

Why We Created This Guide

PARO champions the issues that create conditions for residents to be their best and ensure optimal patient care. We advocate for optimal training where residents feel confident to succeed and competent to achieve excellence in patient care. 

Academic Days make a unique contribution to residency training through opportunities for dedicated teaching time and different approaches compared to teaching in a clinical setting. Residents from across specialties and training programs value Academic Days and the contribution they make to residency education.  Over the years, residents have identified that there is a great deal of variation in how this time is structured and how teaching is delivered. In order to support programs looking to optimize their Academic Days, we asked our members to share what they love about their Academic Days, and the approaches that help them learn best. Based on the feedback from hundreds of residents from across the province, PARO has articulated a vision of success for Academic Days and curated a selection of best practices for programs to consider.

Vision 1: Academic Days are well-executed to promote engagement and celebrate learning    

Residents value well-planned and delivered academic time. Instructors and speakers may need support and guidance from the Program in order to ensure they are able to deliver effective and engaging sessions. Chief residents and others involved in the planning and delivery also may benefit from guidance to deliver optimal academic days. Variety and novelty – in the form of new speakers, exciting new topics and ideas, or new formats – will help engage learners. Uninterrupted time that is protected from clinical duties and scheduled well in advance will help ensure residents can attend. Finally, finding ways to make the learning process fun will help keep residents focused and motivated. 

PARO’s Top Tips For Planning and Executing Optimal Academic Days

Engage your Learners

  • Make learning fun – games like jeopardy or trivia, or quiz platforms like Kahoot can break up long didactic sessions and offer residents a low-stakes way to consolidate learning and test their own understanding. 
  • Even when presenting a highly theoretical subject or using a didactic teaching style, try to find opportunities to make sessions hands-on and interactive. Having ongoing Q&As (if your session is virtual, Zoom’s Poll feature can be useful), providing lots of opportunities for residents to ask questions, and finding a way to apply the concept all make the session more engaging for listeners. Ensuring a strong discussion at the end can help to solidify learning. 
  • Encourage open discussion throughout the session by asking open-ended questions. Make sure you’ve allotted enough time in the session to allow for a full, in-depth discussion. 
  •  Consider the flipped classroom method – this approach involves learners completing readings or prep work at home and then engaging in problem-based learning or discussion during academic time. This allows for academic time to be focused on more in-depth concepts or discussion. Given the additional work of preparing for these sessions, they may not be appropriate to every academic day, but can be a valuable tool as part of a varied teaching approach.  

Deliver Effective Teaching Sessions

  • Use a variety of teaching techniques to keep sessions engaging. 
  • Utilize case consultancy rounds (a junior resident brings interesting cases for a senior resident; the senior resident demonstrates an approach, and a staff supervises and adds learning points).
  • Embrace SIM sessions or rounds 
    • One of the biggest benefits of SIM is how interactive it is. This can be boosted by having residents who aren’t running the SIM provide feedback to those who are involved in SIM. 
    • The more realistic the cases are, the better – this is a great way for residents to refine their skills. 
    • For disciplines that increasingly provide care virtually, SIM can be used to provide observed feedback in a virtual setting. 
  • Problem-based learning in small groups provides an opportunity for residents to apply their learning. Staff can create a case, and residents can work together to discuss, identify questions and core issues. This is a highly engaging approach to case-based learning that allows residents to self-identify their learning gaps and collaborate with their peers. 
  • Some programs have found success with a model that sets a question at the beginning of the week; provides opportunities for small group learning around the topic with staff during the week; and ending the week with an exam-style answer, followed by an active discussion. 
  • Having residents teach each other can be effective if implemented well. Consider pairing junior and senior residents together to discuss a case. This can allow seniors the opportunity to apply their knowledge to teaching and providing feedback, and juniors an opportunity to learn core topics from their peers. 
  • Residents value the opportunity to teach others, and to learn from faculty and outside experts. Ideally, there will be opportunities for both resident and faculty-led teaching throughout the year. Consider getting feedback from residents on what subjects they think would be beneficial to learn about from faculty vs residents to ensure there is a good balance being struck.  
  • To support residents in leading excellent teaching sessions, programs can: 
    • Pair residents with a faculty mentor who can help prepare cases and lectures. 
    • Provide opportunities for residents to get feedback on their presentations, both before and after they deliver their session. 
    • Provide residents with protected time to prepare for teaching. 
    • Provide key resources to pull cases and answers from. 
    • Provide slides from previous years as a starting point. 

Find Opportunities to Celebrate Learning 

  • Cultivating a safe space for learning and participation is key. Make sure that residents understand that mistakes are a normal part of learning, and not something to fear. As a facilitator, consider how you respond to correct and incorrect answers from residents. Participation is an important part of learning, and if residents are limited by a fear of failure, they will not get as much out of a teaching session as they could otherwise. 
    • Be sure to recognize answers that demonstrate a resident was paying attention and actively trying to make connections, even if they got an answer wrong. 
    • If a resident gets an answer wrong, use that as an opportunity to foster discussion – if they misunderstood a concept, there may be others who have that same misunderstanding. This is a good opportunity to clarify core points. 
  • Consider the personalities of the group you’re working with in your approach to questions. Introverts may need some time to reflect on questions and may not perform well when put on the spot. Extroverts may need a minute to think out loud before they can arrive at an answer. As a facilitator, do your best to cultivate an approach to learning that allows your group to perform at their best. This will ensure you’re able to engage your group, and that they are focused on learning.  
  • Do your best to keep the environment low stakes. Academic time is ultimately about learning, not about performing or assessment. Make it clear that there are no consequences to making mistakes or asking clarifying questions. If you’re using OSCE or exam-style questions, quizzes, or calling on residents randomly, explicitly remind the group that the purpose is learning and practice, not performance. 
  • Offering pre or post reading and resources is generally appreciated by residents. However, try to keep expectations for pre-reading and prep reasonable from week to week. Residents have minimal control over their own schedules, and those who are balancing family or personal responsibilities on top of their training may struggle to incorporate significant academic work on a regular basis. Instead, consider making suggested reading lists by topic available to residents so that they can make use of them when their schedule allows. Ideally, prep work would be voluntary, and any mandatory pre-reading kept minimal. 
  • In general, a moderate approach to engaging residents, particularly early in training, is encouraged. Rather than calling out residents individually, consider using tools like quiz platforms like Kahoot or Zoom polls  to engage residents in asking questions. Rather than starting with an open discussion, break residents into pairs or small groups to discuss an answer and then share their conclusions with the group. These approaches have the added benefit of providing everyone in the group with the opportunity to work through an answer, not just the individual being questioned. 

Planning, Structuring, and Scheduing Your Academic Sessions to Maximize Attendance

  • Advance notice is crucial for ensuring residents can attend easily. We recommend sharing the dates of all days at the beginning of the year with residents, as well as off-service rotations. Ideally, academics would be scheduled consistently – at the same time, on the same day of the week. 
  • If half days are challenging to facilitate, consider dedicating full days to teaching, even if they’re less frequent. It can be easier to facilitate resident attendance for full days, as they don’t need to worry about transitioning to/from clinical work. Longer days also offer more opportunity to combine didactic sessions with hands-on teaching. 
  • Alternatively, consider smaller, more frequent sessions. Some programs report success with doing 1 or 2 mini sessions per day, usually right at the beginning of the day. These shorter sessions mean knowledge is easily digestible, and resident energy stays high. 
  • Scheduling breaks is crucial for maintaining energy levels and focus. Structure the day so that there are opportunities for participants to stretch their legs and take a break. Consider trying to limit each topic to 45 minutes or less, with a short break in between topics or sessions. 
  • Residents benefit from their academic days most when they are well-rested and can participate without interruptions. Protecting residents from call the night before as well as during the session is the best way to ensure residents can attend, and benefit from learning. We recommend that Programs proactively communicate this requirement to off-service rotations on their residents’ behalf. 
  •  If residents need to leave clinical duties to attend, ensure there is time allotted for residents to wrap up admin responsibilities, complete handover, and grab lunch. 
  • The Program can support residents by proactively communicating with preceptors about the importance and value of attendance at academic days, and ensure they are aware of the schedule for each block. 
  • For residents covering a pager during their academic time, consider identifying an attending staff who can temporarily cover the pager. If there are no clinical staff who can manage the pager, there may be an appropriate administrative staff who can monitor the pager and then provide residents with a list of pages received and a callback number. 
  • Residents are often managing busy schedules, so being provided with timely reminders is always appreciated – whether that’s an email at the beginning of the week, or a reminder page (to both residents and staff) 15 minutes in advance. 
  • If a session starts early, or goes over lunch, consider offering a meal, snacks, or coffee (or, if sessions are virtual, a small per diem for food). Having food available saves time for residents, especially if they’re running between a busy clinic and teaching, and ensure they’re not distracted by hunger during the session. It also is a great way for the program to signal the value of these days to their residents. 
  • If your program has multiple sites, consider offering parking vouchers to residents who are based outside the site where the academic session will be held. Parking costs can add up quickly, and this is an easy way for programs to remove a small source of stress from residents and facilitate attendance. 
  • Consider structuring teaching throughout the year around major themes or topics. Having a series of sessions that are linked by key concepts or skillsets helps participants to identify causal links, build on their knowledge, and consolidate learning. 
  • If your program relies heavily on Chief or Senior Residents to plan or deliver academic days, there are some key supports programs can provide in order to ensure they are able to put together excellent sessions for their co-residents: 
    • Programs can introduce Chiefs to speakers, offer ideas for topics or guest lecturers, and share best practices from previous years. 
    • Programs can ensure protected time for planning is provided. 
    • Support from Program Coordinators can be particularly valuable because of their expertise in administration. Helping residents organize logistics, schedule speakers and sessions, identify locations and/or technology needs, facilitate IT support, and disseminate materials are all crucial areas where the Coordinator can offer support that allows the Chief to focus on the medical content. 

Vision 2: Academic Days reinforce clinical learning 

Residents benefit from a broad range of clinical exposures during training to support the goal of becoming functional practitioners within their specialty. Programs can best meet resident needs by developing a curriculum that reinforces the learning that takes place in a clinical setting and focuses on the core areas and competencies of their specialty. 

Residents look forward to dedicated time for discussion of complex topics, reflection on challenging scenarios, and expansion on interesting ideas that are not always possible in a busy clinical environment. In an ideal scenario, expert teachers can be given the time to distil complex cases in a nuanced and detailed way that might not be realistic in a clinical setting. 

PARO’s Top Tips For Reinforcing Clinical Learning

  • Residents appreciate a hands-on opportunity to practice skills and receive feedback in a low-stakes environment. Hands on practice allows residents to ask questions as they go, and errors can be used to stimulate discussion. 
    • Residents identified the frequent use of SIM as one of the best ways to reinforce learning and practice skills from across the CanMEDS spectrum. A range of SIM techniques from procedural simulations, to role playing, and more, can be effectively leveraged for practicing clinical skills, improving communication with patients, practicing providing virtual care, and more. 
  • Reinforcement of topics and concepts is key! One of the benefits of academic days is the opportunity to consolidate knowledge. Focusing on clinically relevant topics, scenarios residents have seen in clinic, or cases that apply the same theory in a variety of ways help residents solidify a deep understanding of a topic.
  • Opportunities to combine clinical and academic learning are highly valued by residents. Incorporating live patient viewing rounds is one way to take advantage of this, as is case review on topics residents may have recently encountered in clinic. 
  • Case-based learning is a highly effective and engaging teaching method for reinforcing a specialty’s core concepts, as they reflect the real-life clinical experience residents have and offer a participative way to build on their existing knowledge. Some topics may be approached entirely through cases; for others, discussing a case after a lecture allows residents to practice applying the theory. 

Vision 3: Academic Days provide opportunities to add to and expand on clinical learning 

Academic Days are an opportunity for exposure to learning that would not naturally arise in a clinical setting and cannot be easily replicated through self-study. Training programs are uniquely able to provide residents with opportunities to learn from experts in niche areas of their specialty, and to facilitate teaching from experts in other specialties/disciplines. 

Programs can leverage Academic Days to support residents in building skills in non-Medical Expert CanMEDs roles. These can be challenging to learn and teach in a clinical environment, and not all residents will have the same opportunities to build their skills day to day. Residents have identified that they benefit from a more structured approach to these non-Medical Expert roles, and from learning from experts in those fields.   

While exposure to subject matter experts is a huge source of value to residents, there are also opportunities to network, work collaboratively, and connect with other residents both within and outside their specialty provided by Academic Days. By providing these opportunities for peer-to-peer engagement in a learning environment, programs can encourage residents to learn collaboratively and work together more effectively in a clinical setting. 

Finally, learning how to study effectively is a crucial skill for physicians at all career stages. By teaching effective and relevant study skills, residents can be better prepared to succeed in exam environments. As they transition to practice and throughout their career as a physician, there will be a continued need to maintain, expand, and deepen their skills and knowledge. 

PARO’s Top Tips For Adding To Clinical Learning 

  • Dedicated academic time offers opportunities for comprehensive didactic teaching to fill in the gaps from clinical learning. Didactic teaching with opportunities for discussion can be a useful way to delve more deeply into the theory behind cases seen in clinic. 
  • While residents value the opportunity to hear from experts and specialists outside their fields, these talks are most useful when they have been adapted to the learning needs of the program and related back to the learning objectives of the residents. Programs can help by ensuring speakers from other disciplines are provided with the learning goals and objectives of the residents, and understand what their residents need to know about their area of expertise in order to be effective clinically. 
  • While specialized topics or research within a specialty can be interesting, residents place the greatest value on teaching that is relevant to what residents see in clinic or need to understand for exams. Programs can support resident learning by connecting these niche topics to their learning objectives. Programs can support presenters and teachers by providing the group’s learning objectives to the speaker and ensuring they have tailored their content to the level of training of the resident group. 
  • One valuable way that academic days can offer value to residents is by providing a succinct overview of the latest research in the discipline, tailored to their level of training. To maximize the benefit of these sessions, Programs are encouraged to ensure that the implication of the research on clinical work is discussed in full. 
  • Consider saving time after formal teaching to provide an opportunity for self-study . This allows residents to delve deeper into the topics covered, or to focus on areas where they need additional study. This also helps residents build consistent study habits, which will support them throughout their professional career. 
  • Having residents present cases in the style of oral exams can be a useful approach as it helps residents get used to the format they will need to use during their exams. Keep these sessions low-stakes, as the exam format can be anxiety inducing for some residents. 
  • Self-reflection is an important element of professional growth and development. Consider whether any protected time can be provided for completing self-reflections, self-evaluations, or patient encounter reflections. 
  • Ask lecturers and teachers to identify suggested resources for further reading, and/or provide take-home summaries of key points or algorithm approaches.
  • Small programs can help foster a fun and supportive learning environment by having collaborative academic days with other programs in their specialty at other schools – provincially or even nationally. These days offer opportunities for residents to be exposed to experts from other centers, network with other residents, and allows programs to pool resources.  

Vision 4: Academic Days model the ideal learning environment 

An ideal Academic Day will foster an environment in which all individuals learn effectively. Residents appreciate the structure provided when programs identify achievable learning objectives for teaching sessions that can be customized to their needs as required. 

The contributions made by skilled and enthusiastic instructors should not be overlooked.  Instructors who are demonstrably engaged in their topic and able to communicate in a way that addresses a variety of learning styles can consistently deliver teaching sessions that allow residents to learn effectively. There are often different levels of experience and comprehension in an audience, and an instructor’s ability to adjust their delivery to meet those needs has a significant impact on the effectiveness of a teaching session. Effective teaching is a skill that can be honed; programs that offer training, professional development, and ongoing support to their teaching staff can directly impact the quality of teaching sessions and residency education. 

Residents celebrate programs who conscientiously structure teaching in a way that considers a variety of accessibility needs.  For example, simple practices such as recording sessions can provide enormous assistance for residents. 

Finally, we encourage programs to seek ongoing feedback on teaching sessions and academic programming to identify strengths and areas for improvement. 

PARO’s Top Tips for Fostering An Ideal Learning Environment

Teaching For Different Learning Styles, Levels, and Needs

  • Variety is key! The best way to engage different learning styles is to provide a range of teaching modalities (workshops, structured lectures, case-based teaching, hands-on teaching, etc. – you’ll find a longer list on page X), topics, formats, and presenters. There is no one-size-fits-all approach, so utilizing a range of tools, based on the needs of the topic being covered, is the most effective strategy. 
    • Consider ways to combine methods and styles that maximize effectiveness. For example, some residents prefer to listen to a didactic lecture, take notes, and review in their own time. Others prefer a case-based or problem-based approach with lots of opportunities to engage or take a hands-on approach. By having a short didactic lecture, followed by a case-based discussion where the theory is applied, the preferences of both groups of residents can be met. 
    •  Consider what the benefits might be to a particular approach and try to replicate them with other strategies. For example, some residents prefer a virtual session where they can sit comfortably at home and limit distractions. Others value a highly interactive session and find it harder to engage virtually. Consider how you can utilize tools to maximize engagement during virtual sessions (see our list on page X), or how you can minimize distractions or provide opportunities for quiet reflection when in person. 
    • Some tools and techniques will be better suited to the needs of your program than others. Don’t hesitate to ask residents for feedback on the approach they find to be most useful. 
    • If your program has identified an approach or format that works best for your context, consider creating a handout, template, or outline that can be provided to guest speakers or faculty in order to help them structure their presentation. 
  • Ensure attention is paid to the level(s) of training in the group. PGY1s will benefit most from having academics that address common clinical scenarios they might encounter. More theoretical concepts will be of most benefit to those senior in their training, who can put complex or theoretical concepts into context based on their experience. 
    • Consider dividing up teaching sessions into smaller groups based on level (early junior, mid-junior, and senior lectures)
    • For some programs, having a two-year rotating curriculum will allow residents to get the same learning as a junior and a senior. This reinforces key concepts and allows the seniors to dive deeper into the topic. 
  • Questions are a tool for reflecting on and deepening learning. As such, they are most effective as a teaching tool when residents can answer them by reflecting on their personal experience When asking residents questions, try to tailor them to levels of training – what scenarios might that resident have seen in clinic? What procedures are they familiar with? A challenging question that a resident can answer by reflecting on their experiences and learning is a useful way to engage learners; a question that is challenging because it requires a higher level of training than the resident has is likely to make learners feel put on the spot. 
  • Good slides make a difference. 65% of the population are visual learners, so using tables, flowcharts, photos, videos, and diagrams can be extremely beneficial to your audience. 
    • Consider where multimedia teaching can be incorporated (angiograms, hemodynamic tracings, etc.) to enhance learning. 
    • Where text is included on a slide, try to keep it to just the key takeaways – this helps your audience focus on the speaker, rather than be distracted by cluttered visuals. 
  • Where possible, coach your speakers to avoid reading off slides verbatim, and instead, use slides for visuals and key clinical pearls. Reading text is less dynamic and engaging for the audience, particularly if your academic sessions are being held virtually. 

Boost Your Accessibility 

  • The simplest way to support accessibility needs is to simply record sessions and make them available to all residents after the fact. Making slides and materials available in advance is also a great way to help residents with accessibility needs. 
  • Consider additional resources for those who are unable to attend a session – in addition to the lectures themselves, are there suggested readings, quizzes, or practice questions residents can access to catch up on their own time? 
  • Take a proactive approach to accessibility. Even if your current cohort of residents does not have any specific accessibility needs, future cohorts may. Doing a review of the tools, techniques, and mediums you currently rely on to identify any potential future challenges may save you time in future. Furthermore, taking a proactive approach to accessibility signals to your residents that you respect, and are responsive to accessibility needs – which may prompt some residents to be more comfortable asking for the support they need to be successful. 
  • Need a place to start?

Seek Feedback Effectively

  • Responsiveness to resident feedback is what allows academic days to achieve excellence.
    •  Ideally, get feedback from current residents about the subjects and areas they’d benefit from learning about at the beginning of the year about in order to structure your sessions for the full year. 
    • Consider getting feedback halfway through the year as well, so that residents can identify any gaps in learning or knowledge they’d like to address, clinical areas they’d like to revisit during academic days, or new topics they’d like to propose. 
    • Seek feedback regularly (even every few months)   from your residents about the range of topics and quality of sessions. Asking detailed questions about the teaching tools or techniques used, the format of sessions, the style of presenters, and the applicability of sessions to exam preparation as well as clinical encounters will give you actionable data you can use to make adjustments in order to optimize teaching in subsequent years. 
  • The most effective way to tailor teaching to individual learning objectives is to proactively get feedback from residents about the areas they feel they would benefit most from dedicated teaching, areas where they feel they’re struggling, or areas of particular interest or focus for them. This helps take the guesswork out for the presenters and ensures residents’ academic time is maximized. 
  • Provide learners with opportunities to engage in self-reflection and develop learning goals for themselves as part of your half-day process. These goals might be used to help design your half days, or may simply be a personal objective for the learner. 

Conclusion

PARO is here to help residents be their best, and we hope this document will support Chief and Senior Residents, Program Directors, Clinical Teachers, and all others involved in planning and delivering academic days in optimizing the educational opportunities available.

This document was created based on the feedback and input of residents (including Chief and Senior Residents) from different programs across the province and we intend for it to evolve to reflect new best practices and experiences over time. We are committed to continuous quality improvement and welcome your feedback at any time. We invite you to share any ideas you may have for additional content, your key lessons learned, and best practices.