About Tuesday School
The traditional residency program noon conference is no one's idea of a great way to learn. Residents race in late and leave early, preoccupied with their work on the wards while medical subspecialists lecture (however skillfully) on topics that feel disconnected from one day to the next. The learning experience for residents is usually quite passive.
In academic year 2009-2010, we canceled our traditional noon conference program and replaced it with Tuesday School, a dedicated weekly half-day of inpatient curricular programming. Over the years, we have refined the academic offering based on feedback from learners and introduced new features and cross-cutting themes.
Tuesday school has 2 terms:
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Summer Term: Foundational topics in hospital medicine that are geared toward common symptoms (respiratory distress, chest pain, dizziness, etc.) and common diseases (cirrhosis, opioid use disorder, acute renal failure). These are targeted primarily toward new interns' knowledge and skills. Topics are taught on an annual repeat cycle with second and third-year residents serving as co-teachers alongside hospitalist faculty.
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Term II (Blocks C-M, September to June): Subspecialty blocks including psychiatry and geriatric inpatient medicine. There are longitudinal themes on clinical reasoning and radiology throughout the year.
Teaching and education is a priority at CHA
Attendance is required at Tuesday School unless you are on a night rotation, in the ICU, on vacation, or an away elective. Residents on inpatient rotations sign-out their patients and their pagers to the hospitalist service at lunchtime so they can be fully present for the whole afternoon of teaching and learning.
The curriculum is designed using principles of adult learning theory. Whenever possible, teaching is case-based using real CHA patients. Faculty are encouraged to consider the four hours of teaching time as an opportunity to engage residents in active problem-solving exercises, debate, conversation and genuine inquiry. We embrace the challenges and opportunities associated with a one-room schoolhouse, where residents at the PGY1, PGY2, and PGY3 level learn together and teach one another. Supplementary reading for each session is made available, as we know that learning at the residency level is a self-directed process.
The syllabus is integrative. The Accreditation Council for Graduate Medical Education (ACGME) mandates learning across six core competencies. Medical knowledge and patient care are central to the curriculum. We also weave across all three trimesters of learning experiences related to the development of interpersonal skills, communication, professionalism, practice-based learning and improvement, and systems-based practice. In our infectious disease block, we review our hospital's performance data on nosocomial infections. Our geriatric block explores role-play family meetings and end of life care. Often teachers bring in patients to the sessions to demonstrate key physical findings and presentations to gain insight from a homeless patient or experience of care from an elderly hospitalized patient.
Though the curriculum reflects the content of the American Board of Internal Medicine (ABIM) Board Examination, we don't pretend to address every topic in internal medicine. Instead, we hope to address a broad range of important subjects and engage each in some depth. We aim to ensure that through participation in this curriculum residents build their skills as a curious and effective lifelong learner in internal medicine.
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