Teaching residents to teach will improve medical education

If you’ve ever watched a resident sprint down a hallway with a coffee in one hand and a pager that’s auditioning
for a horror movie in the other, you already know a secret of medical education: residents teach constantly.
They teach on rounds, in hallways, in the ED at 2 a.m., and sometimes (heroically) while the computer is “updating.”
The problem is not that residents don’t teach. The problem is that we often ask them to teach without ever teaching
them how to do it.

“Teaching residents to teach” isn’t about turning everyone into a professor with a laser pointer. It’s about giving
residents a set of practical, repeatable skillsso learning becomes more consistent, feedback becomes more useful,
teams communicate better, and patients benefit from clearer explanations. In other words: it’s one of the highest
return-on-investment upgrades a training program can make.

Why resident teaching is the load-bearing wall of clinical learning

Residents are “near-peer” teachers: close enough to remember what it felt like to be new, but experienced enough to
translate chaos into a plan. Medical students often learn a meaningful portion of their clinical knowledge and
workflow from residentsnot just what to do, but how to think on their feet and how to survive the practical reality
of patient care.

Accreditation expectations align with this reality. In U.S. graduate medical education, residents aren’t simply
allowed to teach; they’re expected to demonstrate competence in educating patients, families, students, other
residents, and health professionals. That’s not a “nice-to-have.” It’s part of what it means to train as a physician
in a functioning learning system.

The hidden cost of “teach by osmosis”

When resident teaching is informal and untrained, the learning environment becomes a lottery. Some students get
structured guidance and coaching. Others get a shrug and “just read about it.” Even well-intentioned residents can
fall into common traps:

• Teaching equals telling: long monologues that don’t check understanding.
• Feedback equals vibes: “You’re doing fine” (translation: no one knows what to improve).
• Efficiency eats education: rounds become a checklist instead of a thinking process.
• Patient explanations become inconsistent: especially during discharge and transitions of care.

The result is predictable: students feel lost, residents feel guilty, and faculty assume “someone else” is teaching
the basics. Meanwhile, the system pays for it through confusion, duplicated work, and missed opportunities to build
clinical reasoning in real time.

What “teaching residents to teach” actually means

A strong residents-as-teachers approach is not a single lecture called “How to Teach Good.” It’s a toolkit plus
practice, built around a few high-yield skills that work in busy clinical settings.

1) Teach fast without teaching sloppy: the One-Minute Preceptor

The One-Minute Preceptor (also called the “microskills” model) is popular for a reason: it fits into real clinical
time. Instead of delivering a mini textbook, the resident leads a short teaching conversation that diagnoses the
learner’s thinking. A classic flow includes getting a commitment (“What do you think is going on?”), probing for
evidence (“What findings led you there?”), teaching a general rule, reinforcing what was done well, and correcting
mistakes with a next step.

This is teaching that respects the clock and the learner. It also helps residents avoid the “I’ll just tell
you the answer” reflex, which feels efficient but often short-circuits clinical reasoning.

2) Make the learner do the heavy lifting: SNAPPS

SNAPPS is a learner-centered method that encourages students to summarize, narrow a differential, analyze options,
probe with questions, plan management, and select learning issues. The magic is that it turns case presentations into
thinking presentations. Instead of “Here are the facts,” the student must show their reasoning and name uncertainty.

For residents, SNAPPS is also a relief: it makes teaching more targeted. You teach what the learner needs, not what
you happen to remember from boards.

3) Give feedback that changes behavior (and doesn’t ruin lunch)

Residents often avoid feedback because they worry it will sound harsh, or they feel unsure about what to say.
Teaching residents a simple feedback structure solves this. The best feedback is:

• Specific: tied to an observable behavior (“Your presentation was organized, but the assessment was unclear”).
• Timely: close to the event, not two weeks later during evaluations.
• Actionable: includes a next step (“Next time, give your top diagnosis first, then why”).
• Two-way: invites the learner’s self-assessment (“What would you do differently?”).

This isn’t about being “nice” or “tough.” It’s about being useful. And when feedback becomes a normal, respectful
routine, the learning climate improves for everyoneespecially the resident, who stops carrying silent frustration.

4) Teach patients better by teaching residents better: the teach-back habit

Residents teach patients every daymedications, warning signs, follow-up plans. Teach-back is a simple, evidence-based
way to confirm understanding: ask the patient to explain the plan in their own words, then clarify and reteach as
needed. Done well, it feels like teamwork, not a quiz.

When residents learn teach-back, they also sharpen their communication with learners. The same principle applies:
don’t assume understandingcheck it kindly and correct it early.

How to build a residents-as-teachers curriculum without adding “one more thing”

The best programs treat teaching skills like procedural skills: learn the steps, watch a demonstration, practice,
get feedback, repeat. You don’t need a semester-long course. Many successful curricula use short, modular designs
often 10–20 minutes of content paired with practice during existing conferences, rounds, or simulation time.

Widely used U.S.-based resources already exist, including structured module sets developed for resident teaching.
Programs can adapt these to specialty workflows rather than reinventing the wheel.

Practical design principles

• Microlearning: small lessons residents can apply on the next shift.
• Deliberate practice: role-play a common moment (case presentation, bedside question, discharge teaching).
• Coaching: brief observation with a checklist, followed by 2 minutes of targeted feedback.
• Real artifacts: use real student presentations, real notes, real patient education moments.
• Equity and inclusion: teach residents how to create psychologically safe learning spaces and avoid humiliation-based “teaching.”

A simple example: a program runs a 6-session series across the year (integrated into noon conference). Each session
teaches one tool (OMP, SNAPPS, feedback, bedside teaching, teaching procedures, teaching with patients). Residents
practice in pairs, then set a one-week goal (“I will ask for a commitment before I teach the differential”).
Faculty follow up with quick observation during rounds.

Measuring impact beyond “everyone liked it”

Education programs fail when they only measure satisfaction. A stronger approach tracks outcomes at multiple levels:

• Skill behavior: Do residents actually use a teaching structure? (observations, checklists, short OSCE-style stations)
• Learner outcomes: Do students report clearer expectations, more useful feedback, better reasoning conversations?
• Team outcomes: Are rounds more organized? Are handoffs clearer because reasoning is spoken out loud?
• Patient communication: Are discharge instructions more consistent? Do patients demonstrate understanding more reliably?

Research and program evaluations repeatedly show that resident-as-teacher interventions can improve residents’ teaching
skills, confidence, and learner evaluationsespecially when the curriculum includes practice and feedback rather than
passive content alone.

The ripple effects: why this improves the whole training ecosystem

Students learn better (and ask better questions)

When residents teach with structure, students become more active participants. They commit to diagnoses, name uncertainty,
and build clinical reasoning faster. The learning environment feels less like “survive the rotation” and more like
“grow every day.”

Residents develop leadership and reduce frustration

Teaching skills are leadership skills. A resident who can coach a student through a presentation can also coach a team
through a complex day. Clear teaching reduces repetitive errors, prevents misunderstandings, and can make supervision
feel less like constant correction and more like development.

Patients benefit from clearer explanations

The teaching moment and the patient-care moment are often the same moment. When residents learn to check understanding
(with patients and learners), preventable confusion drops. The resident’s communication becomes a safety tool, not
just a “soft skill.”

Common barriers (and how smart programs handle them)

“We don’t have time.”

The trick is to teach in the work, not beside the work. Methods like OMP and SNAPPS are designed for clinical flow.
Programs can reinforce them with 2-minute “just-in-time” reminders during rounds or pre-clinic huddles.

“Residents rotate; consistency is hard.”

Modular curricula solve this. Residents can complete short sessions in any order. Chiefs can reinforce one skill per
month (“This month we’re doing commitments and evidencedon’t skip the ‘why’”).

“Faculty aren’t trained to coach resident teaching.”

Faculty development can be light but intentional: provide a one-page observation tool, a shared language (“commitment,
evidence, general rule”), and permission to coach in real time. Coaching resident teaching should feel as normal as
coaching note-writing.

A quick playbook: 10 resident-teacher moves you can use tomorrow

1. Ask for a commitment: “What’s your top diagnosis?”
2. Probe the reasoning: “What findings made you choose that?”
3. Teach one general rule (one pearl, not five).
4. Reinforce one behavior done wellspecifically.
5. Correct one issue with a clear next step.
6. Invite one question: “What part are you least sure about?”
7. Use SNAPPS for one patient per day to build reasoning habits.
8. Set expectations early: “On rounds, give assessment first, then data.”
9. Make feedback routine: 60 seconds after a presentation.
10. Use teach-back with one patient per shift to confirm understanding.

Conclusion: Make teaching a skill, not a mystery

Residents already teach. Formal training doesn’t add a new jobit makes the existing job safer, clearer, and more
humane. When programs teach residents to teach, medical education becomes more consistent, feedback becomes more
actionable, clinical reasoning becomes more visible, and patients get better communication.

The win isn’t only better lectures or nicer evaluations. The win is a learning culture where residents feel equipped
instead of improvisational, students feel guided instead of stranded, and the whole team shares a common language for
learning in the middle of caring for real people.

Experience addendum: what this looks like on real clinical days (about )

In many programs that adopt a residents-as-teachers approach, the first change people notice is not “more teaching,”
but cleaner teaching. One internal medicine team described how rounds felt less like a game show and more like
a conversation once residents began using “commitment and evidence.” Instead of quizzing a student with rapid-fire
questions, the resident would pause after the presentation and ask, “What do you think is going on?” The student
would name a top diagnosis, then explain why. Even when the student was wrong, the resident had something concrete
to work with. Teaching became targeted: one general rule, one corrected misconception, and a clear plan for what to
read that night. Students reported feeling more confident because they could see how their thinking was being shaped,
not just judged.

In the emergency department, residents often say the biggest barrier is the pace. But the ED can be where teaching
skills pay off fastest. A common story goes like this: before training, a resident would take over a case the moment
it got busybecause it felt faster. After learning a short teaching structure, the resident would still move quickly,
but would “teach in the turn.” For example, after a student presented chest pain, the resident might say, “Give me
your top two diagnoses and one must-not-miss.” That single prompt forced prioritization. Then, while walking to the
next patient, the resident offered one general rule about risk stratification and asked the student to choose one
question to clarify. The student stayed engaged, the resident stayed efficient, and the team’s reasoning became more
explicitwhich also helped the nurse understand the plan without needing a second conversation.

Surgical services often describe a different benefit: better teaching reduces friction. When senior residents learn
to set expectations early (“In the OR, tell me anatomy first, then the next step, then your concern”), juniors stop
guessing what “good” looks like. One program described how a chief resident started doing 90-second “pre-brief”
teaching before the first case: one instrument, one anatomical landmark, one safety point. The intern’s performance
improved faster, but the bigger surprise was the tone in the roomless snapping, fewer tense corrections, more shared
purpose. The chief didn’t become less demanding; they became more precise.

And in outpatient clinics, residents often say teach-back changed everything. Before, the resident would explain a
medication change, the patient would nod, and everyone would move on. After practicing teach-back, residents began
asking, “Just so I know I explained it well, how will you take this medicine when you get home?” When the patient’s
explanation didn’t match the plan, the resident adjusted immediately. Students watching these moments learned two
lessons at once: how to communicate clearly and how to verify understanding without embarrassment. Over time, those
clinics reported fewer frantic follow-up calls and more confident patient self-managementsmall wins that add up to a
better care experience.

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