I am supposed to be doing scientific work right now, but I am not. Sometimes I think I spend too much time with science and not enough time taking care of people. Part of that is because I am “the new guy” as far as the medical field is concerned. (Medicine just cannot get used to the idea of people doing other things, especially patient care related before you become a doctor) Consequently, I am never put to use in my full potential at work. It frustrates me to no end. Especially when I can predict mistakes that will be made and powerlessly watch them happen.
So how does this fit into education? Well that is actually rather simple. One of my more recent assignments at work was teaching English speaking students. Which works out well for me, because while I do understand Polish, it is a difficult language (so say the experts), and most often I sound like a window licking retard (I am sure somebody is taking up a collection to buy me a helmet). I am also allowed to call myself retarded and make fun of it. So no comments about how insensitive the Latin (and Italian) word for slow is. But when it comes to English and teaching, well… There is no stopping me.
I find it interesting that people who work at an academic medical center have difficulty teaching. It is not like they never do it. In fact, it would be more unusual on any given day not to have students. I have no idea why people who do not like to teach ever apply at these centers, but they seem to in abundance.
One of the things I often hear from my coworkers is that they are not teachers. There is no class on how to teach in medical school, there is no lecturing on teaching techniques or learning styles, but every doctor is a teacher. Just as every nurse is a teacher, and yes, even every paramedic is a teacher. After all, if you cannot teach, how do you get patients to follow advice and prescriptions? How do they learn how and when to properly take medication and use the medical devices given to them? How do you get them to “buy in” to their treatment plans? Whether you like it or not, you are a teacher. The only real question is “Are you a good witch or a bad witch?” I mean… “Are you a good teacher or a bad one?” What’s more, any “senior” provider, whether by years of service, title, or educational degree has a responsibility to teach their more junior colleagues, whether you are in an academic facility or not.
Apparently people like when I teach. (I admit to being a reluctant teacher, I started because of a challenge, not a desire) Sure there is the odd student, who simply doesn’t like me, and nothing I can do will ever change their mind, but for the most part, my reviews, whether from students in Poland, Ukraine, Romania, The USA, or Afghanistan, are very positive. But I am not here to boast, I am thinking about what makes an effective teacher.
Meyers-Briggs consistently labels me as an ENFJ, more commonly called “a teacher” but I prefer the less often descriptor of “champion.” While I am not entirely sold on the value of psychology, the description is uncannily accurate. But if you ask me what makes me an effective teacher, my answer is not some psychological predisposition, it is actually just remembering all the bad teachers I have had and not doing what they did. As I often do, I take things to the extreme and purposefully do the opposite of what they did. You will never see me talk for more than 45 minutes in an hour. I don’t read PowerPoints with “walls” of text. I like to show students I remember and identify what it was like to be a student. I like to incite their emotions because it is commonly known in educational circles that when people connect something with an emotion they better understand and remember it. The same fucking thing happens when you use swear words. I’ll bet of everything I wrote so far, your foremost thought right now is that I just dropped the F-bomb. Perhaps there is something to psychology. (When I used to read Firehouse magazine, in their classified section they always had an advert that was printed with red letters on a yellow background that said “I bet you read this first.” Despite trying for years, I could never not read it first.)
Back on point: I like to enable students. I like to have them feel like they are successful. Because like attracts like. I once saw a T-shirt that said “I am a bomb disposal technician, if you see me running, try to keep up.” But early in my fire service career, I was told by a great firefighter whom I looked at as perhaps one of my greatest mentors, “Never run on a scene. Calm inspires calm, panic inspires panic. If you want to bring order to the chaos, you must be the embodiment of order and control. Even if you do not know what to do next, you must always appear to without doubt.” I think the same applies to teaching. If you show students (or patients) they can be successful, that they can do it, they usually go on to be even better than taking the industrial age approach of trying to motivate them by negative reinforcement. In fact, I noticed that that negative reinforcement mimics the exact same type of behavior as abusive spouses and parents. Nothing good can ever come from abuse. If it could, it would not be called abuse! So how does any teacher expect a positive outcome from abusing students? The only thing they learn is what to do to please the teacher. Things like abstract thinking and concept integration are totally lost. They don’t remember, I doubt they ever learn, what was taught. They learn and remember what it took to make the teacher happy.
You see the same thing in raising kids. Behavior that you want repeated needs to be recognized and rewarded immediately. Human kids are primates. Human adults are primates. One of the things I learned in anthropology is that all primates whether human, high order, or low order, all respond to the same stimuli in the exact same way. Speaking of anthropology, incidentally there is a lot of modern focus on role-playing and simulation in medical education and “play behavior” is the most effective educational behavior in all primate and many mammal populations. It would seem absolutely insane not to use the most effective method of teaching primates as often as possible.
If you are reading this, if you have not taught a class, you definitely experienced one where somebody talks at you for hours. I had a physiology and neuroscience professor in medical school who could lecture for 4 hours without taking a breath, much less a break. After about 20 minutes, I don’t remember anything that was said. (The more complicated and unfamiliar a topic, the more breaks you need to take.) Since she would call on students not paying attention to her often with impossible questions not even related to the topic, I perfected the ability to sleep with my eyes open resting my head on my arm in a way that made it look like I was hanging on every word. (But I was in a much nicer world than neuroscience.) So I like to engage people right from the start and I spare nobody. At some point everyone will be asked what they think, or to try to logically figure out the next step that I haven’t talked about yet.
One of the things I found enjoyable in my younger years was classical performing arts. (Band, acapella choir, classical dance, I have spent years doing them all) I still love them, but now I am a spectator, not a performer, except when I am teaching. Don’t judge, it is a captive, paying audience! I mention this because I meet a lot of doctors and teachers who are very introverted. Sometimes they just claim they don’t like public speaking. (I failed public speaking in high-school by the way, it wasn’t that I didn’t like it, I just like to pick what I am speaking about and generally prefer an audience that isn’t full of outright hostile bullies with a teacher hoping I will confess my deepest darkest secrets as a way to “get over the stage fright.” Again, bad teachers can teach you a lot about teaching too.)But medicine is just not a good fit for introverts, which is what most scientists are. It is a people person job. We take care of people! We do not practice medicine on textbooks, in secret dark back alley shops hoping nobody will see us. We aren’t judged by how well we cite statistics and guidelines. We are not sued because the patient was happy and thought we were their trusted friend. There is a lot to be learned from “showbiz” in teaching though. For example, a classically trained artist can perform in any environment, but you have to be very well established to improvise. Orators practice their speeches prior to giving them. We call this rehearsing. Even priests rehearse! Why do many teachers not rehearse? Are they all at the level of mastery of improvisation? I think not. Don’t forget some of us are though; I am quite capable to give a lecture or speech with less than 10 minutes’ notice and have a great many times. But for the most part, I rehearse. It really does help.
Also like show business, you need a good costume. Not only what you wear, but also the way you act and your body language. Just like the calm of being on scene, you must perform in a way that inspires students. Especially if you don’t like the topic you are teaching or the patient you are interacting with.
All of this is a lot of work. Most teachers know for every hour you spend in class, you spend several hours preparing and several hours after with other related activities. If they don’t know, they are about to find out.
My final thought for now is on the philosophy of the teacher. Also being involved in Japanese martial arts from time to time, I have learned and adopted the “sempai/kohei” philosophy, the experienced person who guides the less experienced person. Not the authoritarian tyrant that dictates to the unworthy student. (What the Russians call villnious nastavnik, the villainous schoolmaster, forgive my poor translation of the spelling. Go ahead and cue music Pink Floyd’s Another Brick in the Wall.)
So this is my thoughts today on teaching, while procrastinating from work I really need to get done today. OCD is not my mental disease. It’s not ADD either, I am just bored it seems like I just did the same thing last week. (Mostly because I did.)
Bottom line. If you work in medicine or healthcare, whether you like it or not, you are a teacher. You might not want to be one, you may not like doing it, but it doesn’t change the fact. You don’t have to want to be a great award winning teacher; just don’t do to your pupils what bad teachers did to you. Put on a show worth the price of admission, play to your audience. If your students are not paying attention or engaged and your patients don’t follow your advice, it is because your performance sucks.