By Andrea Guerin, Year 2 Director and Clinical Geneticist
When growing up, the career choices offered are often dichotomous, do you want to be a lawyer or a firefighter, nurse or entrepreneur, doctor or teacher? In reality, most jobs are a blend of a few different skills. In medicine, doctors can be scientists, can run a business, and for most of us, being a teacher is a large part of our job. At first blush, being a Geneticist and a teacher doesn’t seem to have much in common, but my training in Medical Genetics has significantly influenced my role in education. Here are five examples I’d like to share:
Geneticists are wordsmiths. Language is very highly selected, “cause” not “reason”, “typical” not “normal” and “chance” not “risk”. The language I use with my patients is specific and inclusive, positive and hopefully, precise. Words are important, to convey meaning without an agenda, to educate without prejudice. I use the same thought in the classroom. I am mindful of the implicit biases that can be drawn from words. Words are powerful and their power needs to be recognized and headed.
Medicine is learning a new language. So is education. I’m not going to lie, I had never designed a small group session before coming to Queen’s and I certainly did not know what a Directed Independent Learning event was. When I came, I was disoriented, DILs, SGLs, RATs, GTAs. The terminology was overwhelming. But, like learning the language of medicine, I learnt the language of education too. We’ve added a few more in the past year in undergraduate medical education CBME, EPA, with only more to come.
Technology is forever changing, but good ideas stand the test of time
When I started my residency 10 years ago the understanding of genetic testing was very different. Many tests were not available. Testing was laborious, going from gene to gene, with months of anxious anticipation in between. Now, a decade later, I can order a test that looks at all the necessary genes of the body that have a purpose. Results can be available more quickly. Interpretation is more of a challenge, as we learn more, it becomes more evident the gaps in our knowledge and tying findings to patient symptoms can be a challenge. The concept of having parents and environment contributing to the health of the child is an old one, with influences from Ancient Greece to India. This testing is a reinvention of an old idea — we have only identified the individual factors (genes) that support what has been seen for thousands of years.
When I went to medical school, problem based learning was new. Powerpoint was a staple of lectures. There were almost no laptops. We would never have thought to work in groups while in the same classroom. That was an activity reserved for afternoon sessions, segregated into rooms under the watchful eye of a faculty facilitator. Marks were given from formal assessments, not team assignments or readiness assessment tests. That’s not to say assessments were not happening, they were just less formalized. It was a gut feeling. Did the clinical skills tutor think you were professional? Did the small group facilitator see that you participated? Now, assessments, both summative and formative are happening all the time. The actual process has become more concrete and transparent, but the idea has not changed.
It’s all developmental
Genetics is one of only a few specialties where the patient population spans from before cradle to grave. When I see a patient with a concern, I endeavour to find out when it started. An understanding of development, both physical and emotional, is key to my practice. You must walk, before you run.
Education is no different. The expectation must be adjusted to where the student is in their education journey. It’s okay to not know the differential in the first year, but in fourth year, students must be equipped with the knowledge and expertise to generate a differential and initiate management. Expectations need to match where the learner is, just like my patients.
No person is an island
Genetics is a team sport. In clinic, amongst clinician and researchers spanning the province, country or world, we work together to solve diagnostic mysteries and provide good patient care.
Education is the same. Teachers, admin support, education support, technical support and student support and feedback are essential to the teaching process. Behind every teacher, there is a team supporting them in their journey.
Comfortable with the uncomfortable concept of unknowns
After years of education, I will never be done learning. There is always more to learn, and no physician, despite years of practice and experience knows everything. When I counsel patients I always raise the possibility of an unknown. A confusing result, a question left unanswered. There is no crystal ball.
Education continues to surprise me, but I am open to the concept of something new, unknown. Can we produce excellent physicians using different teaching methods? Of course we can. Each of my colleagues had different curricula, different forms of instruction. There is more than one way to teach — the “best way” is still unknown.