Yesterday was my last ward consultant rounds for October with the PGH endocrine fellows. By asking them to present their patients in the SBAR (Situation, Background, Assessment, Recommendation) format, we went through many “teachable moments” together. A teachable moment is an opportunity where a teacher can offer insight to students. I remembered my own teachable moments with Dr. Lina Lantion-Ang and Dr. Mary Anne Lim-Abrahan and shared them with the fellows. I realized how those “lamunin ng lupa” moments were defining moments in my fellowship training.
I found that our fellows had no difficulty with B (background) but S (situation) can sometimes give them pause. Why are you presenting this patient? Do you have a dilemma in the management? Sometimes I identified their S for them… Ah, you need hand holding 
!
A (Assessment) and R (Recommendation) were opportunities to ask the difficult Why questions. Why this course of action and not the other? Why did you order this? Why is your patient not improving?
I also did RADISH inpatient progress notes and OPD notes rounds. From Dr. Lim-Abrahan, I learned how writing progress notes should showcase your thoughts and communicate your plans with co-managing services. I tried to teach the fellows this as well. I felt the generational gap wading through so many abbreviations in the fellows’ notes. Do you know what UREB means? Upward rolling of eyeballs! What?!!
A fellow thanked me personally for high-yield learning inputs. We had the most teachable moments 
. I told her, Thanks for the opportunity! Why? Because teachable moments may happen by design or by accident, but first the student must have the willingness to learn.