Effective teachers have always been a source of inspiration, and early in my academic and medical odyssey, I made a conscious effort to emulate them. Becoming an effective teacher goes beyond individual mannerisms, techniques, or props. It goes to the essence of what effective teaching really is.
And it’s not just the good teachers that we learn our craft from; the bad teachers are also effective educators, if one strives to never conduct themselves in a similar manner — but perhaps that’s an essay for another day.
My training was similar to most residents in that I was surrounded by a dichotomy of teachers, polar opposites actually. And also, like most residents’ experiences, there was one that stood out and brightened an otherwise bleak and challenging experience.
While on call as the chief of the obstetrical service, I was summoned to the bedside of a laboring patient with persistent variable decelerations. My cervical exam confirmed the patient was completely dilated with the leading edge of the vertex at a +2 cm station, and the fetus was occiput anterior and rotated less than 45 degrees. The second-year resident felt an assisted vaginal delivery was indicated and asked if I’d supervise her application of forceps. Dr. Woods, our staff physician, was seated in a chair just outside the door where he could hear everything as it transpired. Satisfied the resident knew the proper procedure and that all the essential criteria for a forceps delivery had been met, I then observed her properly apply the first blade followed by the second blade. Once proper placement and fetal station was confirmed, she exerted the proper axis of traction and effected the birth of a healthy baby boy. I then departed the delivery room and settled into the chair next to Dr. Woods. In front of the lingering nurses at the desk, he praised my teaching and commented favorably on letting a second-year resident perform the application and delivery.
Less than an hour later, I was called back to labor and delivery. Dr. Woods, appearing not to have moved from his seat, simply nodded and deflected his head to the room I had left earlier. Blood-soaked pads lined the placenta basin and the tone of the resident’s voice was telling. The already repaired second-degree laceration appeared hemostatic, but the suboptimal lighting failed to illuminate the suspected laceration deeper in the vagina that needed prompt attention. The decision was made to take the patient to the OR for a more thorough exam under anesthesia and repair of the suspected laceration.
While the nursing staff made the necessary arrangements, informed consent was secured and the patient was transferred to the OR. Before scrubbing, I took the seat next to Dr. Woods and presented my plan. He looked down the hall and confirmed there was no one around before he quietly and gently said, “If you’re going to allow a lower-level resident to perform a forceps delivery, you darn well better make sure there’s no deep lacerations before you depart.” He then looked me in the eye and continued. “You didn’t do your own exam afterward did you, Lloyd?” My crimson complexion confirmed what he already knew.
The fact that he praised me in public and chastised me in private was a lesson I hadn’t fully appreciated before that night, but the lesson surely helped lay the foundation for my future teaching endeavors.
Regardless of your teaching style and methodology, the following 10 additional tips can assist any educator in honing their craft and thereby improve the educational experience of the student or resident.
- When teaching, engage as many as possible in whatever discussion is taking place, not just a favored few. Always strive to equally distribute your attention.
- Do not shy away from corrections, and when a correction is indicated, do it kindly.
- If you’re tempted at times to stray into esoterica when teaching, resist the urge. Rather, emphasize the basics as much as possible and utilize the esoteric sparingly.
- Humor can be a valuable adjunct to effective teaching. Afterall, the learning experience must be engaging, and humor, when properly utilized, assists in keeping the student fully engaged.
- Always be cognizant of the time and the obligations your students might have. One of the keys to succeeding in almost any task is effective time management. Your students will appreciate your being on time and concluding teaching encounters in a timely manner. When you’ve said what needs to be said, stop talking!
- Be encouraging at all times.
- Students also learn through observation. Strive to interact appropriately with nursing and ancillary services. Make it a point to address them by their names. Never express frustration or anger after an encounter. When entering a patient’s room, let your students observe you introduce yourself to gathered family members one by one.
- When utilizing the Socratic method, always address questions initially to the lowest level of trainee in the room. Avoid the temptation of asking complicated questions of only the upper-level trainees. It’s essential to help the youngest members of the team develop analytical thinking skills involving complex issues.
- Build confidence, don’t undermine it.
- Lastly, don’t just teach medical or surgical management skills and therapeutics. Give pointers on navigating the world of teaching rounds. For example, if you ask a student how they knew something or another, in their exuberance they might blurt out, “Oh I just read that this morning.” Point out that a better way to respond would be to simply say, “I remember it from my reading.” Teach students how to survive in a sometimes hostile environment. Perhaps share with them a copy of the classic article “How to Swim with Sharks: A Primer” by Voltaire Cousteau.
In elevating your teaching to the next level, you will discover — or rediscover — the joy of teaching while serving as a mentor and role model to the next generation of physicians and educators.
What have you appreciated about your past experiences with educators and mentors in medicine? Share your stories in the comment section.
Lloyd Holm is a retired obstetrician who lives in Cottage Grove, Minnesota with his wife, Gretchen. He has authored two novels and a children’s book and his writings have appeared in the Omaha World Herald, The Female Patient, Iowa Medicine, Contemporary OB/GYN, Hospital Drive, the American Journal of Obstetrics and Gynecology, and Obstetrics and Gynecology. While a member of the teaching faculty at the University of Nebraska Medical Center in Omaha, he received the Dean's Award for Excellence in Clinical Education and The Hirschmann Golden Apple Award. Dr. Holm was a 2021-2022 Doximity Op-Med Fellow, and is currently a 2022-2023 Doximity Op-Med Fellow.
Illustration by Jennifer Bogartz