Diabetes Education Classes Reflections (August 2020- November 2020)

• First Take at DM Class #1 (Taught Half of it, preceptor taught half)

o Today I had my first go at teaching half of diabetes class after watching the classes one
time through. I was surprised on how calm I felt beforehand. I had an incredibly busy
diabetes clinic this morning, and just about everything that could go wrong did go
wrong. I could not wait for today to be over, until I got my chance trying to teach. My
entire day, mood, attitude, everything got better when I was teaching. I was having a
blast. My patients were engaged, it seemed like they were actually paying attention to
me. The students were also engaged. I certainly forgot several things I was planning on
saying when I was on the spot, but teaching was the highlight of today hands down. I
cannot wait to do it again.
• First Take at DM Class #2 (Taught Half of it, preceptor taught half)
o During DM class today, I was very uncomfortable with the material. Before I even
walked into the room I recall saying “This is not going to go well, the “meals” class is my
very least favorite one. I was so uncomfortable with this material that I told myself I
would just memorize it and see how I did. When it got time for class, I could not
remember the script I had tried to memorize. I felt like I was just saying whatever came
to my mind, and I was incredibly out of order. I have no doubt I was difficult to follow.
When I realized I was not doing well, I started calling for active participation. I asked the
students and patients lots of questions, luckily the students jumped in and answered my
questions. Asking questions and encouraging participation was the only thing that saved
this class from entirely going downhill.
• First take at DM Class #3 (Taught Half of it, preceptor taught half)
o This half of class went better than class #2. I felt more comfortable presenting, but I still
was trying to recite a script I had memorized. My preceptor was kind and told me I was
a natural presenter, but I sometimes share information all over the place. I was just
relived it went better than class #2, and I was motivated to get better.
• First take at DM Class #4 (Taught Half of it, preceptor taught half)
o I would not say I was particularly excited about the material I was covering today
because I did not feel very confident. My section was to talk all about eye complications
and teeth complications for diabetes. I spent hours researching the anatomy of the eye,
and what different eye conditions were. I felt like I was studying for an exam. I then
tried to type out exactly what I would say. I did not practice, but I studied for hours and
knew what I wanted to say. When it came to show time, I presented all of the
information I wanted to, but not in the logical order I had intended to. It was like I could
not remember what to say when, so I would just say it when I remembered it. I
recognize I still don’t quite have it yet, but I want to get better. I am intimidated thinking
how am I possibly going to teach the entire set of classes by myself starting next week?
How am I going to talk for 2 hours and be good at it? I was nervous.
• First take at the whole DM Class #1- Independent
o A whole 2 hours of material. This was my show now, and I was nervous. I practiced the
class 3 times, which means I literally spent 6 hours saying it out loud, and probably 2
hours of typing out what I wanted to say first. I without a doubt had this memorized. I
thought this would be the ticket. I recited every word perfectly, and I got some
 participation, but something did not feel quite right. I did not have a ton of fun, I was
not shining after class, and I felt a little confused on what I was doing wrong. My
preceptor had a long list of things that I could do better, and a short list of things I did
well. He brought to my attention that I had everything memorized perfectly, I had
everything in place, but by memorizing my lines, I had taken away the human part. He
said nothing sounded natural, and everything sounded very rehearsed. Those comments
hurt me. I had been told my whole career that I could talk, that presenting was one of
my stronger suits and I did not want to believe him.
• First take at whole DM Class #2- Independent
o All of the constructive criticism I received from class number one, stayed with me for
several days. Although I was a little upset, I knew I could do better. I was recommended
to make my class more conversational- and less presentational. Today I was delighted
with a patient (an older gentlemen) that made that incredibly easy. He kept the
conversation going and answered all of my questions I asked- rhetorically and not. I felt
entirely comfortable, and I had a blast. I had a new preceptor watch me this time, and
he was very excited for me. I was unsure if this was due to him being an easier
evaluator, or if I really did have a killer class. Regardless I could not stop smiling after
today’s class.
• First take at whole DM Class #3- Independent
o I was a little nervous for class today, as I knew my tough evaluator would be watching
again. I was hopeful the patient I connected with last week would be present today. I
did not feel quite as strong as I did after the second class, but my evaluator was
gleaming for me after I finished. He told I was not just presenting anymore, he told me I
was teaching. I was relieved, because I did not think it went as well as the second class.
However this class was a little more serious in nature as opposed to the previous one.
• First Take at Class #4- Independent
o I was stressed today. I had a lot on my plate, and I knew after class I had to jump right
on another call, I still had four patient notes to finish, I still had 2 anticoagulation
patients to call, and I still had to finish my 2 hour medical didactic lecture for tomorrow
morning. I noticed the energy I brought into the class, is how I started off the class. I was
stressed and nervous before class, which made me a little less comfortable opening up
and welcoming everyone. As I made the class more conversational and remembered
what my preceptor previously told me- don’t forget to smile- I loosened up as did the
entire class. This taught me to be intentional in how I open up a class or lecture, as the
energy I brought with me, set the tone for the whole class. I also had a patient challenge
me today. Part of the class was about vaccinations in diabetes, and one of my patients
got so upset he turned his camera off and started challenging everything I was saying. It
turns out he was anti-vaccine, and I had to figure out a way to keep the class composed
and professional so we could move forward. This proved to be challenging, however I
think we reached a common ground and I was able to wrap up his responses both
respectfully, but also not allowing him to influence the rest of the audience. This was my
first patient to challenge me during a class, and I think I handled it well.
• Second take at DM Class #1- Independent
 o Technology issues. An older gentlemen could not figure out how to get his zoom to
work, and he was very grumpy and interrupting the entire start of the class. I tried to
help him, but as I noticed the class was growing impatient I decided I needed to move
on and I told him a student would call him to help him get hooked up. I was unsure how
to appropriately balance helping this patient get connected, but also being respectful of
the rest of my patient’s time. Luckily most of the other patients were relatively amused
and not frustrated or inpatient. I encouraged everyone to share their cameras so we
could make this class as interactive as possible. After the initial bloopers, things got
better. By the end of the class however I found myself struggling to
• Second Take at DM Class #2- Independent
o I am getting really comfortable with these classes. I am not really preparing much for
them, and I really enjoy them a lot.
• Second Take at DM Class #3- Independent
o I am perhaps getting a little too comfortable with these classes, as I was noted to
overshare a little too much. In attempt to relate to the audience I acknowledge my
downfalls in trying to exercise too- and how I struggle and tend to choose the elevator
vs the stairs everyday, how I eat too much Nutella, etc. I was told by a preceptor to be
cautious, as this might take away from some of my credibility. I certainly know where he
is coming from, but I find it difficult not to be honest with my patients, I find it
frustrating to pretend I am doing everything correctly (when I know I am not). I have
found I admire leaders far more that will admit their faults and what they struggle with.
However, I have also found to lose respect for some leaders that have the mentality “do
as I say, not as I do”. I am really glad this was brought to my attention, because I need to
find a way to balance both perspectives and be a positive and empowering example for
my patients, while still sharing my humility.
• Third Take at DM Class #3 Independent
o Audience participation was like pulling teeth. No one was responding to me, and this
was frustrating. This lasted I would say the first half hour of class. I eventually got the
group to warm up and be more interactive/ responsive to my questions.
• Second Take at DM Class #4 Independent
o Family Emergency
o A family emergency turned my whole world upside down a few days prior to this class. I
recall just trying to keep myself together/ present enough at work to get by the week or
so following the emergency. This was probably my worst class yet. This material
generally takes me 2 hours (easily) to get through, and I got through it in one hour and
fifteen minutes. I was only hitting certain points and I was just trying to get through the
material. I felt triggered by the material as it was diabetic complications – my heart was
not in the right place to educate patients on the complications of diabetes. My
preceptor told me he could tell I was trying to be there, but he could tell my mind was
somewhere else. I felt incredibly guilty, guilty enough to bring me to tears after this
class for not providing a valuable/ educational session for my patients. At the same
time, my patients were still very thankful to me after class and stuck around to ask
questions/ chat which gives me some relief.
• Third Take at DM Class #1 Independent
 o Redemption
o I had my head in the game today, and I would say it was my best first class yet for DM
Class. I set the tone for the class this time, by having everyone share their videos and set
a precedent from the beginning that we would make this very interactive/ tailored to
their interests. The class responded terrifically to this. All of my patients were sharing
their videos and telling me their stories. They answered my questions, they were
engaged, and they asked me good questions. Today, class was a blast and I had a great
group of people. I was intentional to include each and every patient in the discussion,
and I think it paid off/ helped me build a rapport.
• Third take at DM Class #2 Independent
o Quarantine 
o I was exposed to covid and undergoing testing (twice) with a fever, cough, sore throat,
and zero appetite. ☺ As this is normally the food class, my preceptor told me he would
take the class over the night before. The day of, I felt incredibly guilty not atleast
teaching the non-food/ prop parts. So last minute I told my preceptor I could manage all
of the non prop parts from my home, he would just need to do the food demonstration.
I started off the class being entirely honest with my patients that I was in quarantine and
apologized in advance for coughing (which I did indeed cough), but I think this made it
more human. This certainly was not a class I felt like a rockstar in- I looked how I felt
(terrible) and I even had a heart monitor on ☺. I would say giving the circumstances I
still provided a valuable education service to my patients. Even when I was not feeling
well during the classes I remember focusing on previous feedback to keep me going –
remember to smile- engage audience by saying their names- tell stories. Not my best
session, but I made it work and am thankful for the help of my preceptor for the food
prop part.
• Third take at DM Class #3 Independent
o Retaining my class!!
o I have noticed a trend- patients tend to drop off after the first or second class.
Sometimes they tell me why or they have to work, sometimes I take it personally. I have
managed to retain my patients for DM class through the third class, and that feels like
an accomplishment! I would say today was my best Class #3 by far. I felt so comfortable,
and the conversation/ teaching came naturally. My class was engaged the entire time. I
took a risk this time, at my preceptors request from the previous DM Class #3. There is a
small component talking about the emotional/ mental side of diabetes. I tend to shy
away from this and only say surface things on this topic as it makes me nervous. Today,
remembering my previous feedback I dove right in. To my amazement my patients were
soon all talking and openly sharing their emotional frustrations/ anxiety/ depression/
concerns about their diabetes. I think it was incredibly beneficial for them to see that
they are not alone. I will never shy away from this topic again from a fear of being
awkward, because the pay-off was worth it for my patients. I felt incredibly fulfilled after
today’s class and my patients seemed genuinely thankful.
• Third take at DM Class #4 Independent
o Amb Care goes inpatient
o With a hospital full of morbidity and mortality- the ambulatory care pharmacists have
been pulled to help treat covid patients inpatient. The air is very heavy, everyone is
tense. I comment this, because my diabetes class today was like a vacation. I had a blast.
I was happy and having fun for two hours. I did not feel nervous AT ALL today, not for
one minute, not for one second before it. It is not that I got very nervous before, I would
say I really don’t suffer from that too bad at all. It is very minor when it is present (as
opposed to when I take an exam). However, today I had zero nerves. There was nothing
there. I logged in and immediately was on the ball. This is exciting for me. It is also
saddening that it was my last diabetes class for now. I kind of expected to feel really
accomplished, as I passed my half of the year with DM classes, and conquered them- it
is like a milestone in the residency. Today after my class all I really felt was sad. This has
probably been my favorite part of the residency so far, and I have grown here in more
ways than I can count. A few key take aways I have from DM classes.
▪ Presenting and teaching are very different.
▪ Your group/ class can make the world of a difference and you must interact with
each group differently.
▪ Building a rapport is huge, incorporate yourself into your teaching somehow so
they can get to know you
▪ Your words can be very powerful- good or badI
▪ A lot of people really want to learn- a lot of people can’t pay attention for very
long so try to keep them involved
▪ Not every class will be your best, but the off ones can get much better. An off
class is also not the end of the world.
▪ Roll with bloopers/ mistakes (they can be funny or they might even go
unnoticed)
▪ I am starting to gain confidence (I think that means my residency is working) –
and that makes things a lot easier and honestly a lot more fun. I hope I can
continue this momentum in my different avenues of teaching. – We will see on
Wednesday when I give a one hour lecture on organ transplants.