Anthony Sanfilippo

I’ve often wondered what makes Mike Krzyzewski so incredibly successful.

For those of you not familiar, he is a highly accomplished college basketball coach. In the 34 years he has coached at Duke University, his teams have won 76% of their games. He has won 4 national championships, 13 ACC championships, been named Coach of the Year 5 times. He has coached the US Men’s National Team twice and won gold medals both times. Incredibly, he’s been admitted to the Basketball Hall of Fame, before he’s even retired! Conclusion: the man knows what he’s doing.
Remarkably, he has remained steadfastly loyal to his school and to the college game, having turned down numerous offers to coach professionally. It’s reported that he most recently turned down $15 million dollars per year to coach the Nets. Conclusion: the man likes his job.

What’s always been a little perplexing is that he doesn’t look like a coach, or even an athlete. In fact, he looks more like a barber or accountant (no offense to barbers or accountants). As a 67 year old son of Polish catholic immigrants and West Point graduate who never played beyond the college level, he would seem to be as culturally, generationally, physically removed as one could imagine from the uber-talented, remarkably athletic young men who come under his tutelage.

Coaching 2Jabari Parker is one of those young men. This 18 year old native of South Chicago is considered by many to be the most talented college player in the nation, and the next rising star of the game. Seems he thinks the world of his coach. To quote: “Coach K and I have a great friendship. We have a father-son relationship. I love the man. And I’ve put my complete trust in him.”

In considering all this, I can’t help but draw a parallel to those of us engaged in the education of medical students. We also find ourselves challenged to connect with exquisitely talented young people who’s educational and cultural experience is very different than our own. How do we connect? How do we ensure we’re helping them reach their full potential? What might we learn from Coach K?

Coaching 3For most of these weightier educational issues, I turn to one of my favourite sources – Sports Illustrated. In “The Education of Jabari Parker” (Feb 24, 2014), Jeff Benedict provides an account of the relationship between these two. Reviewing that article provides some intriguing parallels to the principles of medical education. For example:

1. They have established common goals. This happened at their very first meeting and, interestingly, was motivated by Jabari’s mother who told the coach in no uncertain terms “Jabari needs to know how you are going to play him and what goals you want to set.” The wisdom of a mother! Clearly, the coach and the student are on the same page. They have a common understanding of what they hope to achieve. Developing a medical education program and curriculum similarly begins with established objectives and the acceptance of those objectives by all teachers and learners. It’s been my experience that most of the tensions and problems we encounter with our teaching sessions and assessments relates to a lack of clarity with respect to objectives.

2. The coach provides useful, relevant feedback with direction as to how errors can be corrected. After reviewing game videos: “Look at your feet. They are in the wrong position.” “Look at your hands. They are not ready.” Followed by the justification: “It’s not personal. It’s the truth.” Jabari’s response: “I never realized I looked that bad. I gotta change that.” Coach K seems to understand that simply telling a student they are not performing adequately is not only useless, but damages the teaching relationship. Students accept criticism if they know how and why they went wrong (hence the importance of understood objectives) and are given the necessary instruction and opportunity to correct the problem.

Coaching 4
Al Tielemans/SI

3. The coach understands the student on a deeper, personal level and uses those insights to help him improve. The coach recognized early on that Jabari’s desire to fit in was causing him to play hesitantly and below his potential in order to avoid standing out among his teammates. He also picked up on an unwillingness to admit to nearsightedness, again motivated by a fear of appearing different than his peers. We recognize that medical school is much more than a time during which information is learned and skills acquired. It is also a time of personal growth for our students, during which they develop the self-awareness and professional confidence that will enable them to become effective physicians. Excellent educators recognize limitations or personal barriers and are able to help students grow despite them.

4. They are open and honest with each other, and out of that honesty comes trust. Benedict describes an incident where the coach confronts the student: “I think you love it here so much that you want to be good, but not too good…I’m a little bit angry with you…I don’t think you’re giving me all you can give me. Agreed?” “Yes,” Parker replied. Another time, the coach is suffering through a personal loss that affects his attention and interest. He’s open about his grief, and about his distraction. To quote the coach: “Overall this will be a great experience for them because they see someone who in their minds is very powerful who can’t be penetrated…and they see me being penetrated to where I’m moved to tears.”

Most physicians seem to have the desire and instinctive ability to pass along what they know, and what they can do. These qualities underlie the apprenticeship model that characterized pre-Flexner medical education, and continues to drive our clinical training, both in medical school and residency. A fundamental limitation of this model is that the “upper limit” is the expertise of the teacher. The introduction of educational principles and the focus on the professional development elevates the relationship to one which provides the learner not simply with knowledge and technical skills, but with insights, self-awareness and inspiration that propels them forward and sustains them through their careers

Mike Krzyzewshi is, first and foremost, an educator, and he has something to teach all of us who hope to influence the young and gifted among us.