# "In the OR I tried to let the senior nurse anesthetists do most of the procedural teaching. They were competent with IVs, intubations and spinals and generally did a good job of demonstrating their skills to the students. Again, it was early in the year, so few of the students had much procedural experience. I used my time in the OR to highlight physiology and pharmacology and relate it to the previous dayís lecture. In the one-on-one setting of the OR, the students were less reluctant to ask questions so I tried to give as much individual teaching as possible. I intentionally did not do any of the cases."
"Each afternoon I would give a 2-hour lecture following the syllabus. However, on a couple of occasions I felt the need to stray from the curriculum. For example, we were reviewing the pre-operative physical exam and I discovered that none of the students had ever heard a cardiac murmur or knew what might cause a murmur. Few of the students could actually name the valves in the heart. Needless to say, there was no point in discussing murmurs if they didnít first know that valves existed. I struggled with feeling that I had to teach them all of anatomy, physiology and pharmacology during my month."
"The other difficulty with the lecture format was that the students had a very wide disparity of knowledge. Some students had no previous knowledge about the nervous system while another student asked very detailed questions about acetylcholine receptors. I tried to lecture to the middle third and catch up with the others after class to either get them caught up or challenge them to stay ahead."
"I had originally planned on giving my lectures in PowerPoint but discovered it didnít allow enough spontaneity. Instead, I prepared handouts that emphasized the key points of each day and provided pictures or diagrams I couldnít reproduce on the chalkboard."
"The last half hour of each lecture was for the students to give their own presentations. I assigned each of them a drug used in the OR and asked them to present mechanisms of action, indications, side effects, etc. It helped them to practice giving talks to their peers and it helped me gauge their understanding of the topic. It also helped me to see how they thought a lecture should be given. I suspected that the Socratic style I was subconsciously using wasnít what they were accustomed to. I tried to change my style throughout the month to reflect what I learned from them."