The Reflective Teaching Log (RTL): Effective Documentation of Participatory Teaching Requirements

We created a reflective teaching log for a student-as-teacher elective to track students’ required participatory teaching and to provide a mechanism for reflective evaluation. This Minute Paper–based log is easy to use and can be adapted to similar programs capturing insights of students’ teaching experiences and supports reflective learning.

The professional development of medical students has expanded to include a role as an educator. As future physicians, they will be expected to teach medical students and residents both during residency training and as faculty physicians in a university hospital setting. Recognizing this, at least 44% of medical schools now offer medicalstudent-as-teacher (MST) programs [1]. These programs traditionally include peer or near-peer teaching as well as didactic sessions on the knowledge and skills that are essential to become effective teachers [2]. However, MST students do not necessarily receive feedback from faculty on their teaching performance [2]. A mechanism should be in place to record teaching experiences and allow for an exchange of reflective feedback with the course director about each teaching encounter.
The practice of reflective writing can promote learning through transformation of experience into abstract conceptualization and insights followed by application [3]. Reflective logs have been used to document student experiences during clinical teaching and learning sessions [4]. Data from these student reflections indicate that medical students develop teaching skills, self-confidence, and a professional identity as a medical educator [4]. However, these findings are limited because it may not be practical to gather lengthy reflections after all pivotal teaching experiences [4]. One solution is to incorporate brief Minute Paper elements within a participatory teaching requirement log [5]. The Minute Paper is an assessment technique that allows learners to briefly reflect on and assess their understanding of the material [5].
We developed a brief Reflective Teaching Log (RTL) as a part of our MST elective course offered in the fourth year at the Zucker School of Medicine at Hofstra/Northwell. The MST course is longitudinal and consists of a combination of didactic lectures, workshops, journal club sessions, and a summative capstone project. In addition, students are required to complete 20 h of self-selected teaching, which is documented in the RTL. The RTL was created in Microsoft Excel and is made available to students electronically and stored in a cloud-based platform (e.g., Google docs). Each student shares a link with the Course Directors. This shared spreadsheet streamlined the communication process between students and faculty by allowing for real-time data sharing on their teaching experiences. Students are required to complete the log for each teaching experience including logistical information, educational setting they taught, pedagogy employed, the number of hours taught, their role, and their faculty supervisor. In addition, the major portion of the RTL is comprised of elements of the Minute Paper, such as Bmost important concept learned,^or Bconcept requiring clarification^(see Fig. 1, simulated Reflective Teaching Log RTL). These columns prompt students to briefly reflect on their experience more broadly, asking them to describe any insights gained, the most important concept they learned, what they needed clarification on, and what specific skill they will take away from the experience. The logs also provided important program related feedback, such as which sessions or pedagogies were most valuable to learners and the diversity of teaching sessions selected.
The RTL is an ideal tool for tracking student teaching and reflective experiences without being overly burdensome for the student or Course Director. It can easily be adapted to different educational settings, and individual variables can be tailored to specific course objectives. We encourage other medical schools to utilize the RTL to track program outcomes quantitatively and qualitatively. The outcomes will ultimately improve curricula focused on training MSTs.
Acknowledgments The authors would like to thank Kevin Brian D. McLeod, AdTalem Global Education, Chicago, for technical assistance editing the teaching log, and Wendy Saori Herman for expert assistance with references. A big thank you to our students who are using the RTL.

Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of interest.
Ethical Approval This study was approved by the institutional review board for human subjects review studies.

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CONCEPT REQUIRING CLARIFICATION WHAT IS APPLICABLE TO YOUR FUTURE ROLE AS A RESIDENT
Cultural Competency: Visual Impaired, Deaf, HOH 2/8/18 2 Facilitator 2 Student observer Discussion with paƟents is an excellent modality to offer different perspecƟves and answer quesƟons.
Using small-group break-out acƟviƟes during large group sessions invigorates a session.
How to deliver faculty development to guest lecturers.
ConducƟng large group sessions in a medical school seƫng. Tailor instrucƟons to individual needs and student levels, and approach students at the right Ɵme for instrucƟon. Not so long ago I was at the same level and feel I can relate to students' needs. I hope that hightens my sensiƟvity towards younger students' learning needs.

INTEGRATIVE ANATOMY
Using a flowchart for developing differenƟal diagnosis.
When to interrupt a student group to support learning, and when to wait to allow students discover the concepts on their own.
Clinical reasoning is a key aspect of medical educaƟon. It will be important for me as a resident for teaching of residents below me as well as medical students rotaƟng through. Step back and allow students to lead a session.
Ensuring students are comfortable with the content and voice quesƟons aloud before the role-play starts.
How to adjust complexity of material to learning needs?
Working on how to explain material in a clear way, or idenƟfying a peer-teacher. Step back from your own plan to allow others to seƩle into a scenario.
Expect surprising reacƟons and be ready to comfort. Give others a space for their own reacƟon.
When to interrup silence to drive a difficult conversaƟon.
Leading discussion groups for giving difficult news for fellow residents, aƩendings and students.