What makes for a great teaching session? In medical school, we make prodigious efforts to answer that question. We collect reams of information, ranging from the extensive student feedback collected about all aspects of their learning experience, to analyses of objective measures of student success in both internal and external examinations. There is also much written about educational methodology, and which approaches are felt to optimize effectiveness. We establish policy and take effort to ensure those are applied throughout our curriculum.

But beyond all this, there is something about a successful teaching session that defies formal analysis and simply goes beyond the aggregate of measurable parameters. To use a phrase originally applied by a Supreme Court Justice to the understanding of pornography, “you know it when you see it”.

My walking route from the hospital to the undergraduate office takes me by the main lecture hall in the School of Medicine Building at least a couple of times each day. I often stop as I go by to see what’s happening. Sometimes, I’ll drop in and look in on the teaching session for a few minute

It is easy to spot a session that’s going well. There’s a certain energy in the room that is immediately apparent. The students are engaged, attentive, anticipating what’s to come. But even easier to read is the teacher. Whether it’s a basic scientist or clinician, something special happens when a natural teacher encounters a group of eager learners. Like the activation of a long dormant instinct, the encounter seems to set off a response in the teacher that energizes the session. It is no longer a recitation of facts and directives but rather a sincere effort to pass along acquired wisdom. Students, for their part, sense the effort and value of what the teacher is trying to do. They reciprocate with attention that energizes the teacher, setting up a feedback loop that makes the whole thing work.

I’m pleased to report that, by both the objective and “know it when you see it” assessment, the vast majority of the teaching sessions we provide are highly effective. It is also apparent to me that the vast majority of our faculty truly enjoys their teaching experience and finds it personally satisfying. That fact, more than anything, is the source of our success as a medical school.

And it happens a lot. Over the course of our four-year curriculum, over 700 full time and part time faculty members provide teaching sessions to our students, most of them practicing physicians with schedules full of more immediately urgent and financially rewarding pursuits. So how does it happen, and happen so frequently?

In an insightful commentary entitled What Makes a Good Teacher? Lessons from Teaching Medical Students” (Academic Medicine 2001:76(8);809) Ronald Markert identifies several factors that he believes characterize the best teachers. Although all are valid, two have always stood out to me as particularly relevant to the physician teacher. Quoting from Dr. Markert’s article:

 

A good teacher wants to be a good teacher. Teaching has to be its own reward. While recognition for outstanding teaching is commendable, faculty who are motivated only by formal honors will not achieve teaching excellence.

The focus of instruction should always be on student learning, not faculty teaching. Too often faculty members concentrate on what they want students to know. However, medical education is professional education, and we who teach medical students should go beyond our conceptions of what we think they should know and instead should search for what they actually need to know as practicing physicians.

 

Teaching, at its core, is a distinctly human interaction. It requires a connection, a mutual, unspoken relationship between two parties, one possessed of knowledge and the generosity to share, and one receptive to that knowledge. Essential to the learner is trust. They must assume their teacher is not only knowledgeable but is also motivated by their best interests.

Doctors are natural teachers. I believe this is, at least in part, because the selfless sharing of information and focus on the needs of the learner so well-described by Dr. Markert are also features of the physician-patient relationship. They also instinctively understand the concept of assumed trust, as critical to the teaching role as it is to provision of care to patients.

This week at medical school convocation, the graduating class will honour three such great teachers whom they have identified to receive the Connell Award. Named in honour of two previous heads of medicine, this award recognizes outstanding contributions to mentorship, lectureship and clinical teaching over their medical school experience. This year, Drs. Susan Moffatt, David Lee and Barry Chan have been selected and are, indeed, very worthy recipients.

 

 

Congratulations to them, and to all our faculty who contribute their time and natural talents to not only educating our students, but modelling for them the commitment and teaching skills that they will carry into their careers.