A holiday reading list on leadership and change

Dr. Gary Tithecott

In his keynote address at the UGME fall faculty retreat on December 10, Dr. Gary Tithecott addressed the topic of Leading change for success in medical education during challenging times. Dr. Tithecott is Associate Dean, Undergraduate Medical Education at Schulich School of Medicine and Dentistry, Western University.

During his presentation, Dr. Tithecott cited a few books and mentioned others as worth delving into. As I like to do here, I’ve created a “Top 5” list from those he mentioned (OK, it’s actually six books, as he recommended two from a single author). These books are practical and accessible reads with clear advice, he said.

There’s still time to add some or all of these to your holiday wish list.

 

 

 

Mindset: The New Psychology of Success by Carol S. Dweck

The traditional attitude – Fixed Mindset – dictated that your fate is determined by skill you have genetically and that you demonstrate, Dr. Tithecott explained. With a Growth Mindset , by contrast, asserts that with dedication, encouragement and effort you can learn from and with others to increase your ceiling.

Since one key responsibility for a leader is to develop other people, a Growth Mindset is essential, he said. Citing an article from Forbes magazine, he noted a Growth Mindset allows leaders to

  1. Be open-minded
  2. Be comfortable with ambiguity & uncertainty
  3. Have strong situational awareness
  4. have a greater sense of preparedness
  5. have clarity on what others expect
  6. Take ownership
  7. Grow with people
  8. Eliminate mediocrity and complacency
  9. Break down silos

Grit: The Power of Passion and Perseverance by Angela Duckworth

One key to success in leadership, Tithecott said, is in the power of working hard and sticking to it. For a leader it’s supporting someone to go outside of their box. He quoted Duckworth:

Grit, in a word, is stamina. But it’s not just stamina in your effort. It’s also stamina in your direction, stamina in your interests. If you are working on different things but all of them very hard, you’re not really going to get anywhere. You’ll never become an expert.

Leading Change  and XLR8 by John P. Kotter

OK, this is actually TWO books, not one. Noting that no talk on change and change leadership is complete without including Kotter, Dr. Tithecott recommended both Leading Change and the more recent XLR8.

He reviewed Kotter’s list of why change fails:

  1. Not Establishing a Great Enough Sense of Urgency
  2. Not Creating a Powerful Enough Guiding Coalition
  3. Lacking a Vision
  4. Under communicating the Vision by a Factor of Ten
  5. Not Removing Obstacles to the New Vision
  6. Not Systematically Planning for, and Creating, Short-Term Wins
  7. Declaring Victory Too Soon
  8. Not Anchoring Changes in the Corporation’s Culture

Leaders Eat Last: Why Some Teams Pull Together and Others Don’t by Simon Sinek

 The symbolism of leaders eating last – exemplified by the US Marine Corp chow line, described by Sinek – points to leaders who put their team first. This in turn, leads to more acceptance of the challenges of change, Tithecott said.

The Leader Who Had No Title by Robin Sharma

Leadership can be found in different places and doesn’t necessarily mean the person “at the top”. Where and how leadership for change can be developed can vary, Tithecott said, recommending Sharma’s book.

 

 

 

 

 

 

 

 

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KHSC Nominations open for Exceptional Healer Awards

Nominations for the third iteration of the Kingston Health Sciences Centre (KHSC) Exceptional Healer Awards are open with a deadline of December 14.

Launched in 2017, the Exceptional Healer Awards are sponsored by the KHSC Patient & Family Advisory Council and was designed to honour a physician who demonstrates in clinical practices the core concepts of patient- and family-centred care: dignity and respect, information sharing, participation, and collaboration.

Prior honorees include ophthalmologist Dr. Tom Gonder and anesthesiologist Dr. Richard Henry (2017, tie) and urogynecologist Dr. Shawna Johnston (2018).

The award has been expanded this year to include one for physicians and one for nurses.

Physician nominees must, as a faculty member at Queen’s, have a current appointment at KHSC and have been credentialed at KHSC for at least the past two years. Nurse nominees must be KHSC staff members.

Patients and family members can nominate a KHSC physician and/or nurse who have provided care to them in the last two years while KHSC staff can nominate a physician and/or a nurse on a patient care team.

The awards committee is looking for nominees who:

  • Demonstrate compassion as a skillful clinician by displaying personal qualities such as approachability, flexibility and empathy
  • Use novel or innovative methods in attempting to deliver compassionate care
  • Demonstrate a pattern of listening to and honouring patient and family perspectives and choices
  • Exhibit a value of integrating patients and families into the clinical care model to ensure they are equal, informed participants in their health care
  • Honour the uniqueness of patients and families by incorporating their knowledge, values, beliefs and cultural backgrounds into the planning and delivery of care

For the 2018 award, patients, families and staff nominated 21 physicians for the award. Thirty-four nominations were receive, with about 25 percent coming from KHSC staff.

Medical students and nursing students are eligible to submit nominations in the “staff” category.

Further information and links to the nomination forms can be found here: http://www.kgh.on.ca/healer

 

 

 

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The stories we tell…

I’ve been thinking a lot about stories lately.

It’s partly because of an independent study I’m completing at the Queen’s Faculty of Education on narrative inquiry. It’s partly because I’m increasingly conscious of several aging family members whose stories I want to record—and of other members whose stories have been lost. It’s partly because I’ve watched some excellent biographical documentaries on Netflix recently. It’s also partly because I just love good stories.

As an educator, I embrace stories and that’s easy to do since we’re surrounded by stories: The stories we tell. The stories we hear. The stories we learn—and learn from.

We all have stories we’ve seem to have known forever that we know we will share and pass along. This is because stories are personal, usually relatable, and “knowable”—it’s a way to memorize without strict rote memory.

We tell stories to impart lessons, to entertain, to remember. And sometimes all three.

Like the story I tell of leaving a political science essay to the last minute when I was in my second year at the University of King’s College. The one I stayed up until 3 a.m. writing, then got up at 5 a.m. to type it (on my electric typewriter, no personal computers in those days). It was on the Cuban Missile Crisis. Except in my sleep-deprived state, I didn’t type it that way. Instead, I wrote of the Cuban Missal Crisis.

And my professor circled “missal” every single time it appeared through the paper. (Which was a lot). I respected this man profoundly and his was my favourite course. I was mortified when he returned the papers and I saw all the  circles (every single time). Still, he gifted me with a B+ (which was rare for him), so the content, if not the spelling, was fairly sound.

Why do I tell this story? (1) It’s kind of funny. (What would a Cuban missal crisis look like? Too many prayer books? Too few? Typos within them?) (2) It cautions against procrastination. (Which is why I shared it with my daughter when she started university and use it to remind myself, constantly). And (3) it advocates good proofreading – which we should all do, all the time. Plus, it’s relatable to many who have “pulled an all-nighter” who nod and smile through the telling (or reading) of this anecdote.

Medicine, and medical education, relies heavily on stories. Every medical encounter I’ve had as a patient has started with my story – what brought me there. Taking patient histories is one of the first clinical skills our students undertake.

What are case studies if not stories? Some are bare bones, some rich and colourful in detail. Like patients. Like people. We can’t see (or read) all, but we can see (read) enough. Stories are entrées into another person’s life, their point of view, the path they are on.

What goes into a good story? There’s characters, and place, and time, and plot – something has to happen. And woven into this, deliberately or incidentally, is meaning.

Stories can be loud “A-HA!” moments, or a gentle unfolding. They can be meandering streams-of-consciousness (perhaps a bit like this blog post), or a clear, linear narrative. Or something in between.

The best stories are conversations. What are the stories you tell? What stories will be told about you? As a student, as a teacher, as a person?

Do you have a story you want to tell related to medical education? Drop me a line at theresa.suart@queensu.ca – it may fit here in our Guest Blogger posts.

What stories do you want to tell?

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Patients are key to our students’ learning

Students have been part of my health care journey long before I became an educational developer at Queen’s School of Medicine.

When my daughter was born in 1995 in Fredericton, NB, I had not one but two nursing students from the University of New Brunswick assigned to me. For each of them, I was their first ever patient. I was also their only assigned patient. As a first-time mom, this was both gratifying (they pretty much catered to my every need from running baths to making me snacks) and faintly terrifying (like when they, under their preceptor’s watchful eye, demonstrated to me how to give my newborn a sponge bath) and slightly uncomfortable (post-partum abdominal palpations aren’t fun at the best of times, let alone by a learner who isn’t quite sure what they’re looking for).

My mantra at the time was: “They have to learn somewhere – why not with me?”

And it’s true – there’s only so much to be learned in a classroom, a mock clinic, or simulation lab. Ultimately, our medical students consolidate all that learning during their two-year clerkship period where they engage with real patients, in real hospitals and real clinics, supervised by staff and resident physicians.

In my role as an educational developer, this is a part of their education that I don’t typically see first-hand. I’m generally classroom-based in the coaching I provide to faculty, and it’s hard to be an unobtrusive fly-on-the-wall observer of patient encounters when you aren’t a member of the healthcare team.

As a patient (and parent of a patient, and partner of a patient), however, I’ve had several opportunities to see our clinical clerks in action first hand.

I’ve watched a senior clerk valiantly (and ultimately successfully) conduct a physical exam on my pleasant-but-non-cooperative then-nine-year-old son.

I saw another clerk—working on a rotation with anesthesia—get a reluctant laugh out of my grumpy (from fasting) and nervous (because, well, surgery) husband during the pre-op airway examination and checklist.

Most recently, one of our clerks independently led off an appointment I had at my family physician’s office. I’ve hit a milestone birthday (full disclosure: 50) that can trigger a number of screening tests and things. The clerk was well-prepared, asked me good questions, and had good information. It was clear to me that they had at least scanned my file before coming into the room and had done their homework on the types of screening tests that might be relevant to me.

Along the way, I’ve also seen some of the various ways the clinical clerkship preceptors supervise and monitor our students’ learning.

For the clerk who examined my son: after a consultation outside the exam room, the clerk and physician came in together for the rest of the appointment. There was a Q&A amongst all of us which included gentle coaching and good feedback for the clerk.

Prior to my husband’s surgery, after the clerk’s exam, the anesthesiologist followed up with their own exam and pointed out a couple of things to the clerk – who then had another look down my husband’s throat which they and the physician then discussed.

For my encounter, I know my clinic has video monitoring (as there are signs posted in the examination rooms) and the clerk themselves noted they were going out to consult with the physician.

These are all different ways that clinic-based teaching and learning takes place. And that’s due in large part to patients who willingly engage in these encounters. As part of the UGME team, I feel a certain obligation and responsibility for their education and training.  Most other patients don’t have this same motivation and it’s their generosity that makes this learning possible.

Through not only their classroom based studies, but especially their clinical skills training over two years, their simulation lab work, and our First Patient Project, our students are ready to engage with patients and be part of the healthcare team in their clerkship years. A sincere thank you to patients in Kingston and at our regional sites who engage with them as they learn.

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20th Annual Travill Debate set for November 7

The 20th annual A.A. Travill Debate is set for November 7 in the Ellis Hall Auditorium, 58 University Avenue, beginning at 5:45 p.m.

This year’s topic is:

Be it resolved that… Publicly funded hospitals should not be able to have religious affiliation

On the “Yea” side, arguing for the proposition will be Dr. Andrea Winthrop and Meds 2022 student Nathan Katz while Dr. Michael Fitzpatrick and Meds 2021 student Sara Brade will argue the “Nay” side.

As described on the Travill Debate website, the debate will “run on a polite and rigorously timed schedule” which features:

  • 10 minutes for each member of the team, alternating back and forth – Yea and Nay – until all four participants have laid out their arguments.
  • Then two minutes for summary from one member of each side.
  • The Travill Debate Gavel is banged very loudly when the time limits are reached.
  • No Power Point or technological aids.
  • Humour is welcome. Formal attire and costumes have also been used to good effect.

This annual debate – featuring a controversial topic in medicine – was created in memory of A.A. “Tony” Travill. As described on the debate’s web page:

Dr. Travill came to Canada in 1957 after serving as aircrew in the RAF (WWII) and reading Medicine at the London Hospital Medical School. He did a residency year in Montreal and practised in Orillia with Dr. Philip Rynard (Queen’s ’26) before coming to Queen’s to study Anatomy under Dr. John Basmajian. After two years at Creighton University in Omaha, Nebraska, Dr. Travill returned to Queen’s in the Department of Anatomy in 1964, becoming Professor and Head from 1969-1978. His research interests were in embryology, teratology and education. Dr. Travill was a strict parliamentarian and noted Faculty Historian (Medicine at Queen’s; 1854-1920, the Hannah Institute for the History of Medicine, 1988: Just a Few: Queen’s Medical Profiles, 1991). He served the community as a Trustee of the Separate School Board and in 1964 was a founding member of the John Austin Society, the still thriving local history of medicine club. In particular, Dr. Travill had a passion for debate on current social, political and educational issues, and for many years he delivered a rigorous and challenging lecture to incoming first year medical students during orientation week.

As further noted by Dr. Jaclyn Duffin, then-Hannah Chair for the History of Medicine, in the original proposal for the memorial debate:

“As his friends and colleagues know, A.A. ‘Tony’ Travill was intelligent, quick, witty, a great teacher, who loved to talk—preferably to argue. Proud of his credentials in clinical medicine and his origins in practice, he rose to head a basic science department (Anatomy). He was an erudite historian, with distinguished publications… Travill also had a deep interest in Philosophy, especially logic, ethics, and epistemology. He loved to cast doubt, to stir up trouble, but he didn’t really mind losing.”

Please join us! All are welcome!

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Poetry, journalism, and a Pepsi commercial… or, a meandering parable about balance

I started writing poetry again recently. I do this, then abandon it, then reclaim it at various intervals. I’m always better with it.

This may seem to have very little – if anything – to do with medical education. And, you’re right in one sense. Join me on a little self-indulgent meandering to get to my point.

As I write this, it’s Thanksgiving Day – a day when people traditionally reflect on their blessings and things they’re grateful for. And, I’m on the cusp of a milestone birthday, so perhaps that has made me more introspective than other weeks, when I write about course evaluations and how we value them (we do!), or team-based learning and how it contributes to long-term learning and understanding more than straight lectures (it does!), or ways service-learning contributes to both social accountability and professional development (yes!). So, I find myself thinking about poetry.

On the road to becoming any professional – and medicine is no exception – we ask people to shed a lot of things along the way.

We ask people to shed attitudes that aren’t aligned with their goals. To ditch beliefs that aren’t compatible with where they’re going. To replace erroneous information or practices with those that are proven to be more valid.

The profession of medicine itself demands other things – things I watch colleagues work through and cope with – long days, longer nights, emotional and physical demands they may never have imagined at the start of their careers.

Because, really, none of us truly ever know what we’re getting into.

All of this coalesces in a kaleidoscope of who we were and who we are and who we will be. The parts and colours shifting as the years turn.

My first career was in journalism. In the spring of Grade 12, I was accepted into the four-year Bachelor of Journalism program at the University of King’s College. They only accepted 35 students a year, out of nearly 1,000 applicants, so this was exciting! As parents are wont to do, my father, an English teacher, mentioned my acceptance to a colleague he saw at a conference. That colleague was the late Don Murray, then a professor of Journalism at the University of New Hampshire. Professor Murray later sent me a number of articles and a book on journalism (that I still have and use to this day), but he passed along advice through my father that was even more valuable.

“They’re going to teach her how to write a certain way,” he said. “And that’s important, and she needs to do that. But tell her not to give up her other stuff. She needs to keep doing that, too. It will make her a better writer.”

I haven’t always adhered to that advice, but over 32 years after first hearing it, I know its value. So I put pencil to paper to work out ideas, and thoughts, and metaphors. But, really, I’m claiming a part of myself I refuse to shed. It’s something I need to keep to be me. To be better.

Are there things you’ve accidentally shed along the way that you didn’t need to? Are there parts of you you’d like to reclaim, to give you that edge, that solace, that space to be you, preserved in the full person you want to be?

As I write this, I’m reminded of the 2004 diet Pepsi “old van” commercial… where a thirty-something dad is asked if there’s anything else youthful he’d like to experience and he says his old van. He then imagines his 1980s-era rocker painted van and what driving that in his current life (like dropping his kids off at school) would be like (not good!). Then he drinks his can of pop and is happy with that.

Some things can’t – and likely shouldn’t – be reclaimed. But if there’s something like poetry, or running, or music, or nosing around in antique shops, or reading trashy fiction (however you define that), or some other seemed-not-that-important-at-the-time thing that you miss about being you, consider ways to recapture that. And fit that “old” part amongst the newer parts.

Just maybe not that van.

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Improving teaching, one slide at a time…

“How many slides can I have in my PowerPoint presentation?”

This is one question I get a lot as an educational developer, with a quick follow-up one about what’s the best way to put slides together.

Soon after it was first released in 1987, PowerPoint became both a boon and bane for teaching. (There are other software programs; PowerPoint just has well over 90% of the market). Computer program presentation software is certainly way more convenient than its predecessor overhead projector (and the accompanying slippery stack of slides), but it’s perpetuated some of the previous challenges with ill-conceived overhead transparencies while creating its own new issues.

Like how many slides is too many?

The standard advice is the 10/20/30 rule: 10 slides for a 20-minute presentation with 30-point font. This avoids the too-much issue: too many slides and too much information crowded on a single slide, but it’s simplistic advice that may not address your actual concerns.

I use four guiding questions to think about presentation slides:

  1. How are you going to use them?

  2. How are your learners going to use them?

  3. What else are you going to provide?

  4. Have you addressed the issues? (Accessibility, Copyright, Confidentiality, etc.)

 

How are you going to use them?

For example, are you using your slides as “attention getters” or information notes? Do you need an eye-catching image, or clear bullet points, or both? Are your images essential illustration, or distracting add-ons? If you’re showing a complicated image, is it to show “it’s complicated” or is it for detailed discussion and deeper learning?

How are your learners going to use them?

Take a step back and think about how your slides look projected on the three screens in the teaching theatres. Are your slides overwhelming or illuminating? Are your learners going to take notes on their electronic copy of your slides while you talk? Will these be their primary reference? Are your slides “must use” or “nice to have”?

What else are you going to provide?

Do you provide an electronic copy of your slides, before or after class? Are they complete or are there things omitted in your MEdTech published versions (either for pedagogical or other reasons, see next point!). If you’re using more visual versus text sides, are you providing accompanying notes? Do the students have other resources?

Have you addressed the issues? (Accessibility, Copyright, Confidentiality, etc.)

Issues about accessibility, copyright and confidentiality will vary based on particular circumstances. The best rule for layout is “keep it simple” – many of the built-in templates in programs don’t translate well to the screen and can be impossible to read for some people with particular vision problems. There can be issues of copyright for images – some things can be shown in class, but not saved to our learning management systems, for example. (And we have a copyright specialist here at Queen’s – Mark Swartz – who can help us navigate this). Also, regarding confidentiality, if screenshots of x-rays are used, for example, how is identifying information removed?

 

There are a vast number of resources online and multiple great reference books with tips and techniques for improving your use of presentation software. There is no single school of thought of best practices for teaching with this tool (although there are definitely pitfalls to avoid).

If you’re looking to improve your use of PowerPoint in the classroom, please feel free to get in touch. We can look at what you’re doing now, what your goals are, and talk strategies for changing things up as needed.

Meanwhile, if you have 14 slides for a 20-minute presentation, you’re likely ok. But if you’re planning 200 slides for a 50-minute lecture, chances are, that’s too many. Call me.

Reach me at theresa.suart@queensu.ca

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Don’t skip over getting ready

When I was a teenager, my Dad had a poster in his high school vice-principal office that featured a picture of a bird’s nest with blue eggs in it. The caption read: “most of life is getting ready.”

I really didn’t like that poster because it was all about patience and I was all about getting on with the next thing. I was always about what comes next: finish high school, go to university, get the job.

It took a long time for those lessons in patience to sink in and for me to accept that much of life is getting ready. And a lot of the getting ready is hidden, behind the scenes, like what’s going on in those blue eggs in that poster’s nest.

It’s a lot like how we spend our summers when we’re involved in teaching that follows the traditional academic year cycle (which excludes our clerks and clerkship faculty who learn and teach year-round).

At UG, especially for the upcoming pre-clerkship academic year, we spend a lot of the summer getting ready. The Education Team, Course Directors and teaching faculty are looking at course evaluation reports and looking at where improvements and changes are needed. The Curricular Coordinators are getting everything set in MEdTech so things run smoothly. And a multitude of other behind-the-scenes support team members are quietly getting on with getting ready. While the end results of all this preparation are evident, the tremendous amount of work involved usually isn’t.

For planning purposes, we need to think ahead, look at the big picture and always be thinking of the next thing. But for teaching and learning, being in the moment matters, too. And, sometimes, you’re in the moments that are about getting ready.

Sometimes we dismiss the “getting ready” stage as a holding pattern, as mere waiting. It’s not the “good stuff” or the “important stuff”. But getting ready is every bit as important as what comes next. Without getting ready, the good stuff can’t happen.

Think about the last big celebration you took part in (maybe for a birthday or special holiday). Did it involve presents? Did you take some time to find the perfect gift, picking out wrapping paper and bows, maybe a special card? Did the recipient take a moment to appreciate that effort or tear right in? Maybe you were the recipient. Did you savor the moment, or dive right in? My Mom always insisted we read the card first, how about you? Regardless of slow savoring or exciting unwrapping, it was a special moment, that made the preparation – the getting ready – worth it.

Sometimes getting ready is taking a breather (as we hope our pre-clerkship students are doing with their summer!) or augmenting skills, and sometimes is doing all the necessary preparation to make things run smoothly for the “big” event. It’s important to recognize that, from a pedagogical perspective, this getting ready – either course prep, or “introduction to” instruction – isn’t wasted time, but necessary steps along the way.

So be in the moments of getting ready.

Meanwhile, we’ll get back to work reviewing course evaluation feedback, revising preparatory materials and SGL sessions. Looking at which learning event worked well and which need some tweaking and which need a major overhaul. Are assessments well-mapped to learning objectives? Is the rubric clear or can we improve that? What about annotating those objectives….

(And, as always, if you’re in need of help with any of the above, get in touch. We’re here to help).

 

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This post is about nothing

I discarded quite a few topics for this week’s post as I didn’t want to “waste” a key topic on the “downtime” for many of our faculty and students of the summer break between semesters (excluding all those students and faculty involved in Clerkship, of course).

Sure, I could write about learning objectives, and active learning strategies, or assessment tools and rubrics, but these informational items would likely be missed by quite a few people off on summer pursuits.

And, really, I want you to miss them as anyone’s holiday break (however long or short) should be used to pursue as little as possible. A few years ago, when I was teaching at Loyalist College, I had students ask me what I wanted them to work on over a holiday break. It turns out my colleagues had given several detailed assignments. Firmly believing in the need to relax and recharge, I told them I wanted them to sleep in and eat cookies for breakfast. (I got pretty good instructor evaluations that year; I hope it wasn’t just about the cookies).

So for this post, I thought to myself: “I should write about the benefits of doing nothing”. A short Google search later, I’ve discovered this is hardly a unique idea – and there’s evidence-based research to back up these benefits.

In fact, in a 2014 Forbes article, Manfred Kets De Vries pointed out that “slacking off and setting aside regular periods of ‘doing nothing’ may be the best thing we can do to induce states of mind that nurture our imagination and improve our mental health”.

An Australian blogger drew attention to a study by Bar-Ilan University that demonstrated that daydreaming correlates with performance. “They found a wandering mind does not hamper the ability to accomplish a task, but actually improves it by stimulated a region of the brain responsible for thought-controlling mechanisms.” (Read more about that study here.)

Other research points to relaxing (i.e. doing nothing) being good for your heart, fighting the common cold, maintaining a healthy weight, sleeping better, and contributing to improved mental health.

Pico Iyer, author of The Art of Stillness: Adventures in Going Nowhere wrote of the virtue of doing nothing in a 2014 CCN article. He noted: “It’s an old principle, as old as the Buddha or Marcus Aurelius: We need at times to step away from our lives in order to put them in perspective. Especially if we wish to be productive.”  (Watch his Ted Talk, where he emphasizes the benefits of stillness, here: https://www.ted.com/talks/pico_iyer_where_is_home)

So, the next time I post, I’ll have more tips and tools for your educational toolbox. In the meantime, focus on wellness and, well, doing nothing. You can start with this slide show of Ten Ways to Enjoy Doing Nothing.

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The Twelve Roles of Teachers

(This post summarizes key points from AMEE Guide No 20: The good teacher is more than a lecturer–the twelve roles of the teacher by R.M. Harden & Joy Crosby)

In our talk of teaching, we often focus quite narrowly on classroom-based teaching – team-based learning (our SGL) and lecturing – and on clerkship seminars and bedside teaching. By doing so, we can overlook some of the other roles required in medical education.

In fact, there are 12 roles of teachers in medical education and each is worth exploring.

Harden and Crosby (2000) identified these 12 roles based on their analysis of “the tasks expected of the teacher in the design and implementation of a curriculum in one medical school”; a study of “diaries kept by 12 medical students over a three-month period”, which analyzed their comments on teacher roles; and from other literature on the roles of teachers in medical education (p. 336). They then validated the 12 roles they identified using a questionnaire completed by 251 teachers at the University of Dundee Medical School.

Harden and Crosby grouped their 12 roles into six areas of activity (two roles each) and further noted which roles required medical expertise and which teaching expertise and which involved direct student contact, with the remaining with students at a distance to the activity.

How many of these areas of activity and roles do you recognize in your own teaching practice?

Information provider – lecturer, clinical or practical teaching

“The teacher is seen as an expert who is knowledgeable in his or her field, and who conveys that knowledge to students usually by word of mouth,” they note, pointing out in all contexts the teacher selects, organizes and delivers information.” They stress that “The clinical setting, whether in the hospital or in the community, is a powerful context for the transmission, by the clinical teacher, of information directly relevant to the practice of medicine.” (p. 337)

Role model – on-the-job role model; teaching role model

“Students learn by observation and imitation of the clinical teachers they respect. Students learn not just from what their teachers say but from what they do in their clinical practice and the knowledge, skills and attitudes they exhibit,” Harden and Crosby wrote (p. 338). This role modelling extends to classroom-based activities, too:  “The good teacher who is also a doctor can describe… to a class of students, his/her approach to the clinical problem being discussed in a way that captures the importance of the subject and the choices available.” (p. 339)

Facilitator – learning facilitator; mentor

“The introduction of problem-based learning … has highlighted the change in the role of the teacher from one of information provider to one of facilitator. The teacher’s role is not to inform the students but to encourage and facilitate them to learn for themselves using the problem as a focus for the learning.” (p. 339)  Harden and Crosby note that the mentor role, while highly valued “is often misunderstood or ambiguous” (p 339) but suggest “the mentor is usually not the member of staff who is responsible for the teaching or assessment of the student” and that “Mentorship is less about reviewing the student’s performance in a subject or an examination and more about a wider view of issues relating to the student.” (p. 339)

Assessor – student assessor; curriculum evaluator

“The assessment of the student’s competence is one of the most important tasks facing the teacher,” they note. “Examining does represent a distinct and potentially separate role for the teacher,” they added, noting: “It is possible for someone to be an ‘expert teacher’ but not an expert examiner.” (p. 340)

“Monitoring and evaluating the effectiveness of the teaching of courses and curricula is now recognized as an integral part of the educational process. The quality of the teaching and learning process needs to be assessed through student feedback, peer evaluation and assessment of the product of the educational program.” (p. 340).

Planner – Course organizer; curriculum planner

For Harden and Crosby, curriculum planning and organizing courses goes hand-in-hand. The note that “Curriculum planning presents a significant challenge for the teacher and both time and expertise are required if the job is to be undertaken properly” (p. 341) while being an essential first step. This is closely followed by the importance of planning on the individual course level:  “The best curriculum in the world will be ineffective if the courses that comprise it have little or no relationship to the curriculum that is in place. Once the principles that underpin the curriculum of the institution have been agreed, detailed planning is then required at the level of the individual course.” (p. 341).

Resource developer – study guide producer; resource material creator

The increasing importance of the role of resource material creator helps students navigate in increased amount and quality of information available. “With problem-based learning and other student-centred approaches, students are dependent on having appropriate resource material available for use either as individuals or in groups.” (p. 341). The role of curator, through structured study guides, also helps navigate these resources: “Study guides…can be seen as the students’ personal tutor available 24 hours a day and designed to assist the students with their learning. (p. 341).

 

At different times, you may be called upon to fill any or all of these roles. If you’re interested in exploring any of them further, get in touch. I’m here to help you with all aspects of your teaching practice.

 

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