What The Best Teachers Do

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NaBloPoMo 2018:  What I’m Learning

The post last night was a long time coming, maybe.  It took longer than I thought it would to actually write, edit, and publish, but it poured out in a flurry of energy that has built up over several months.  I received immediate feedback from members of my Counsel of Wisdom, supportive and encouraging, gratifying.

As I thought more, I realized that my best teachers growing up practiced emergent design and strategy.  Imagine you teach the same subject, the same skill, the same content, year after year.  Your approach is to do it the same way, expecting the same result.  Would you not get bored?  And if you’re bored, no question your students may want to gore their eyeballs out with their writing implements.  In medical school my classmate and I met a physician in his office for a lecture on his area of expertise.  We sat across from him in his big armchair behind a mahogany desk piled high with papers in disarray, the sun shining through the window at his back.  He spoke in a slow, bass monotone.  The words that dribbled forth practically fused together, such that I strained to distinguish and make sense of them.  And I kid you not, he literally put his elbow on the desk and rested his face in his palm while he spoke, as if he may have a near death experience from the sheer dullness of it all. That was not his best teaching moment, I’m sure he would agree.

My best instructors, on the other hand, engaged us learners in real time, with rapt energy.  They asked us what we knew about the topic, encouraged us to consider and describe how core principles applied in real life situations.  In classrooms, my best teachers were both goal-oriented and open-minded.  They had a clear learning objective but held the map only loosely. They allowed space for the learning journey and path to unfold before the class, always with an eye on the destination. We learners all got to choose the way, and we still ended up where we needed to be.  And every time I bet it was a little different for the teachers, so it was fun for them and they always learned, too.  I know that’s how it feels for me.  That’s what keeps any of us engaged and improving, I think—the confidence of knowing we hold the reigns coupled with the excitement of not knowing which new trail our class will blaze to apprehend the learning.

My Counselor friend described it as, “The map becomes a new and storied journey with each iteration of participant-cartographers.”  Is she not eloquent?  I have invited her to write a post with me soon.

Coach Christine reminded me, “What you describe is coaching at its best – the fundamental philosophy of the coaching I’m trained in is, the client is naturally creative, resourceful and whole. Not broken, doesn’t need fixing.  Capable of digging deep to find the answers within themselves, and /or where to find the help they need.”  Creative, resourceful, and whole.  I had not heard or seen those words in this context in a long time.  So grateful for the reminder—Thanks, Christine!

What are you teaching these days?  How might you hold your leadership map more loosely and allow those you lead to point to a new or different way?  What might you all gain in the process?

Love You Into Being

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A couple of weeks ago I met my new medical students.  These 10-12 trainees will be my small group for the next two years.  We will meet monthly to discuss the soft stuff of medical training—hierarchy, tribalism, death and dying, medical errors, difficult patients, etc.  Some call it “third year medical student support group.”  This is my 6th year of the pleasure and privilege (I inherited my first group halfway through, when their previous preceptor moved out of state).

With each successive group I am ever more amazed at the students’ level of insight.  They articulate compassion, humility, and maturity that I don’t think I had at their level of training. Or maybe it’s because we did not have classes like this to explore such things when I came up (or maybe I don’t remember?).  More and I more I see my role as facilitator more than teacher.  I am not here to impart medical knowledge.  Rather, it is my job to stimulate exploration, conversation, and meaning.  It’s so freeing, really—there is no standardized test to teach to.  And yet I see it as my responsibility to help prepare these gifted young people to face the greatest challenge and reward of the profession: human relationships.

I feel no fear or trepidation.  We cannot ‘fail’ at this class, any of us.  Because the point of it is simply for everybody to participate, contribute, consider, and learn—myself included.  Each month the students are given questions to answer in the form of a blog post.  For example, “Recall an example of inspiring or regrettable behavior that you witnessed by a physician.  Describe the situation, and its impact on you, the team, and/or the patient.”  I read them all and facilitate discussion, tying together common themes and asking probing questions.  My primary objective is to help them maintain the thoughtfulness and humanity that led them to medicine in the first place.  Medical training has evolved in the past 20 years, for the better in some ways, not so much in others.  One way we do much better nowadays is recognizing the hidden curriculum, and shining light on its effects, both positive and negative, through classes like this.

We all have those teachers who made a difference in our lives—or at least I hope we all do.  I have multiple: Mrs. Cobb, 4th grade; Mr. Alt, 7th grade math; Ms. Townsend (now Ms. Anna), 7th grade English; Ms. Sanborn, 7th grade social studies; Mrs. Stahlhut, 9th grade geometry; Mrs. Summers, 10th grade English; Coach Knafelc, varsity volleyball; Dr. Woodruff, primary care preceptor; Dr. Roach, intern clinic preceptor; Dr. Tynus, chief resident program director.  My mom is one of these teachers, also.  She leads nursing students in their clinical rotations.  I have seen her student feedback forms—they love her.  And it wasn’t until I heard her talk about her students that I realized why they love her and what makes her so effective—she loves them first.  Teaching is often compared to parenting.  Our parents, at their best, see our potential and love us into our best selves.  They cheer us, support us, redirect us, and admonish us.  They show us the potential rewards of our highest aspirations.  If we’re lucky, they role model their best selves for us to emulate.

All of my best teachers did (do) this for me.  I’m friends with many of them to this day, and I still learn from them in almost every encounter.  I love them because I feel loved by them.  They held space for my ignorance and imperfections.  I always knew that they knew that my best self was more than the last paper I wrote, the last test I aced, or the last patient encounter I botched.  To them, my peers and I were not simply students.  We were fellow humans on a journey of mutual discovery, and they were simply a little farther along on the path.

This is my aspiration as a teacher, to live up to the example of all those who loved me into the best version of myself today.  This kind of love allows for growth and evolution, from student to colleague, to friend, and fellow educator.  This is not something attending physicians typically express to medical students, positive evolution of medical education notwithstanding.  But when I met this new group, I was overcome by love for them.  So I told them.  “If you take away nothing else from our two years together, I want you to have felt loved by me.  I wish to love you into the best doctors you can be.  That is my only job here.”  Or something like that.  It was impulsive and possibly high risk.  But it was the most honest thing I could say in that moment, my most authentic expression of my highest goal for my time with them.  I only get to see them once a month, and I want them to be crystal clear about what I am here to do.  We have lots to cover these two years, so much to learn and apply.  And love is the best thing I can offer to hold us all up through it.