Culture of Teaching

Message from the Garnjobst Chair of Medical Education

"Resident learning and caring for patients are our primary concerns"

John HeffnerThe medical staff and faculty at Providence Portland Medical Center have an extraordinary commitment to teaching and creating what has become a truly remarkable educational environment.  Many of our educators are nationally and internationally recognized experts who have advanced medical knowledge in their fields of expertise and all of our faculty and medical staff share a strong interest in passing that knowledge onto the next generation of physicians.  It is no wonder that our faculty have developed close ties with the Oregon Health & Science Center and carry university academic titles.  Our hospital and ambulatory clinics are state-of-the-art facilities with sophisticated information technology and patient care resources envied by many university healthcare systems.  We have effectively launched our transition to an advanced medical home clinic model.

Although we define ourselves as educators and teachers of advanced medical knowledge, we take special pride in our roles as mentors who help shape our residents' life balance, professionalism, and joy in caring for patients.  We value most our success in starting residents on their paths toward highly gratifying professional careers, during which they may remain mindful of life balance. 

We welcome residents into our program who want to make a difference in their communities, practice patient-centered care, and work with dedicated faculty who teach the art of being a physician.  We hope to see you in Portland.

John Heffner, M.D.
William M. Garnjobst Chair, Medical Education

A Culture of Teaching

A devotion to and ability for teaching represents the most important criterion for recruiting new faculty members.  Our faculty take pleasure in one-on-one and small group teaching and always put teaching opportunities ahead of their other academic pursuits.  We also continuously develop new and innovative approaches to medical education, such as eLearning modules that allow residents to learn specialized information or tasks on the intranet.

Other programs include:

  • Integration of evidence-based medicine into everyday teaching and practice
  • Close collaboration between faculty and subspecialty medical staff for inpatient learning
  • Opportunities for interdisciplinary care that allow residents to teach and learn from other healthcare professions
  • An emphasis on systems-based practice with programs to implement best practices through computerized order entry
  • Specialized rotations and learning modules to teach medical skills, such as ECG and chest radiograph interpretation and the performance of procedures
  • Learning a receptiveness to life-long learning, by both giving and receiving effective feedback

We believe in continuous improvement for our program, which means we value resident feedback and identifying opportunities to further advance our teaching effectiveness.  An open environment welcomes direct verbal feedback and provides electronic resources for confidential comments to the program.  Residents share in governance decisions regarding curriculum.

Faculty mentorship and individualized teaching

  • Each resident has a member of the faculty as a mentor who meets regularly with the resident through the year to ensure their personal and professional success and wellbeing.
  • One faculty preceptor is always available for every three residents during continuity clinics
  • Collaborative practices have either a 1:1 or 1:2 faculty-resident ratio
  • Subspecialists work directly with residents on ward teams and in subspecialty rotations, providing highly individualized teaching based on direct observation
  • Residents choose a faculty mentor to help in the development of American College of Physicians presentations and other scholarly projects

Dedicated Teaching Rounds

  • Work rounds, designed to facilitate team clinical decision-making assigned patients, are highly efficient and effective being separate from teaching rounds
  • Teaching rounds occur 4 hours each week being led by one of the teaching faculty
  • Teaching rounds faculty emphasize evidence-based medicine and challenge residents to solve problems and think through clinical challenges.  Decision analysis represents an integral part of our program

Subspecialist Teaching

  • Providence Portland Medical Center does not have internal medicine subspecialty fellowships, so residents work directly with master subspecialty clinicians.  Our resident on inpatient rotations have opportunities for advanced patient care, problem solving, and procedures usually reserved for fellows at university programs.
  • Residents on subspecialty rotations work one-one-one with subspecialty clinicians.  An experienced subspecialist staffs resident consultations providing an effective experience for learning complex physical examination skills, clinical reasoning, and targeted diagnostic and therapeutic approaches.

Inpatient Teaching

  • Work rounds and education rounds are separate. Work rounds are designed to facilitate team clinical decision-making on assigned patients.  Education rounds are focused on broader issues raised by patients under the care of the ward team, with a heavy emphasis on academic literature and principles of evidence-based medicine.
  • Morning report is lively, participatory, academic and stimulating.  It is based around a formal case presentation and a daily, resident-prepared literature review.  All contributions are treated respectfully, and residents find the process educational and enjoyable.
  • On ward rotations, residents have the opportunity to work with both hospitalists and Medical Education attendings on the day-to-day management of hospitalized patients.

Resident as Educator

  • In outpatient didactics, residents and faculty alternate teaching during the small group discussion that precedes seeing patients. Teaching goals and materials for each session are available online
  • Second and third year residents serve as educators in Morning Report which includes a case discussion and the presentation of an evidence-based answer to a specific clinical question.
  • Each senior resident presents a capstone conference to faculty and residents in a Grand Rounds format.
  • During the EBM rotation, residents present a formal analysis to the core EBM faculty.
  • Residents are often key contributors to medical student education on the wards, in the ICU, and during subspecialty electives.

Outpatient Teaching

  • Preceptor involvement in the ambulatory setting is intense.  There is one faculty preceptor per three residents during continuity clinics.
  • Collaborative practices have either a 1:1 or 1:2 faculty-resident ratio
  • In continuity clinics, residents develop their own panel of patients for whom they become the primary care provider
  • Didactic Sessions are emphasized throughout the ambulatory experience.  There is a 30-minute didactic session each day in the outpatient continuity clinic as well as weekly small group sessions on professionalism and behavioral medicine.

Mentorship

  • Each resident is assigned a faculty advisor who assists in resident development and achievement of learning goals
  • Residents choose a faculty mentor to help in the development of ACP presentations and other scholarly projects