LAUSR

During her Internal Medicine sub-internship, Sophia arrives at team rounds, ready to present a new patient admitted with an acute exacerbation of heart failure with reduced ejection fraction (HFrEF). In preparation, she watched a brief online ‘chalk talk’ where the instructor explained the pathophysiology of HFrEF using a digital whiteboard. Additionally, her resident gave her a quick ‘chalk talk’ on a piece of paper to review the medications that reduce mortality in patients with HFrEF. Lastly, she recalls a ‘chalk talk’ that her attending physician delivered on the whiteboard at the beginning of the week, using a diagram to illustrate the differential diagnosis of chest pain. At the patient's bedside, Sophia offers her assessment and plan, incorporating clinical pearls from each of these unique teaching sessions. As the team exits the room, her attending physician states, ‘Sophia, can you prepare a ‘chalk talk’ on HFrEF for our team?’ Sophia agrees, but she wonders what exactly her attending means by the term ‘chalk talk’ and muses that not a single lecturer has used chalk throughout her medical training. ‘You should give a ‘chalk talk’ on ...’ If you are a medical educator, chances are you have either offered this advice to a trainee or received this feedback from a mentor as a strategy to develop one's teaching portfolio. Indeed, medical students and residents evaluate chalk talks as an effective teaching method across studies of highly rated attending physician teaching behaviours. Traditionally, a chalk talk is a small group session led by an instructor who uses a chalkboard or whiteboard as the primary teaching tool. However, in recent publications, the term ‘chalk talk’ has been used to depict myriad teaching modalities, including online digital whiteboard lectures and bedside teaching with a notecard. The broadened application and diminished specificity of ‘chalk talk’ in medical education literature necessitates a re-evaluation of its definition and application. Therefore, the purpose of this piece is to clarify what we mean when we say, ‘chalk talk’. The origin of the term ‘chalk talk’ is credited to Frank Beard, an illustrator and editorial cartoonist. Beard became famous for transforming images on the chalkboard in real-time while telling stories in a captivating fashion. In his 1896 book Chalk lessons, or the blackboard in Sunday school, Beard defines chalk talks as ‘embrac[ing] symbolical, figurative, and allegorical teaching in pictures and alliterations.’ By the early 1900s, chalk talks had become a popular attraction at informal religious gatherings and especially among Chautauqua assemblies. The Chautauqua movement, named after its first assembly, held at Chautauqua Lake in New York, organised educational and cultural programming at sites across the United States and Canada. Specifically, Chautauqua assemblies brought together popular lecturers, preachers and musicians to entertain and educate large audiences, often families. The exact timeframe for the crossover of ‘chalk talk’ into medical education parlance is unclear, though William Osler integrated chalkboard-based illustrations into his lectures as early as the 1870s. Let us concede the obvious: medical educators teach in environments where markers and whiteboards replaced chalk and blackboards decades ago. Moreover, instructors are increasingly using digital whiteboards to facilitate asynchronous, self-directed learning. So, one could argue that ‘chalk talk’ is a completely outdated term that should be replaced with an alternative label. However, we acknowledge that ‘chalk talk’ is firmly entrenched in our collective medical education vocabulary but should be reframed with a modern lens. Thus, when we say, ‘chalk talk,’ we mean a teaching style that prioritises learner engagement and utilises hand-drawn text and novel visual elements to simplify concepts and encode deeper learning. By reframing ‘chalk talk’ as a teaching style, our definition addresses two important concepts: first, the cognitive psychological basis for why chalk talks are valuable, novel and especially memorable Received: 20 January 2023 Revised: 22 February 2023 Accepted: 26 February 2023