CHAPTER 12. MILES TO GO – BEFORE TEACHING BECOMES LEARNING

Chapter 12. Miles to go-before teaching becomes learning

Dr. Yeshwanth K. Amdekar, DCH, MD (Pediatrics), FIAP

Education is not learning of facts but training the mind to think

Albert Einstein

Student, you dont study to pass the test but study to prepare for the day when you are the only one between the patient and his grave

Mark Reid

Introduction

There is often a slip between cup and lip. Teaching is meant to learn but it may not happen. International program for students assessment at the age of 15 years has been conducted every three years since year 2000. Results of this program in the year 2018 revealed that India ranked 72nd out of 73 participating countries. It is obvious that a gap exists between teaching and learning and we need to define this gap and take corrective measures. We must get inspired to make a change and we owe this to the next generation.

What is teaching?

Teaching is a learned activity for students that includes learning for the teacher as well. It is an act of great optimism but it is incredibly complex. It should not be a mere source of information or knowledge that student can obtain even without a teacher. In fact, a teacher is expected to stimulate and equip students to think so they are able to seek, analyse and implement what is gathered. Purpose of teaching is to shape character, caliber and future of students. Quality of future doctors depend on our teaching today.I cant teach anything to anyone, I only make them think,said Socrates.

What is learning?

Learning is a process that starts at 32 weeks of gestation. It is the time when nervous system is primed to start learning. Learning is meant to acquire new information or modify and reinforce existing information. It is not a rote learning but meaningful learning. Understanding information is what is effective learning. Formal conventional learning often occurs through monologue that does not facilitate ideal learning. Informal interactive discussion between students and guided by a teacher is the best way to fulfill the very purpose of learning that is student-centered and not teacher-centered.

Who is a teacher?

Teacher is a person who creates a change that facilitates learning. In fact, one can learn from anyone who fits in the above definition irrespective of his professional status. In medicine, patients are the best teachers who suffer so that we can learn from their sufferings. Paramedical staff including nurses and ward boys as well as senior resident doctors can be good teachers and senior students can teach a junior student. In fact, formal designated teacher learns from students when they ask difficult questions. Even dead can teach as postmortem often reveals what was missed. I recall having learnt from a ward boy how to place the patient in the right position when performing a lumber puncture and from a nurse how to give an enema. Thus, there are opportunities to lean all the time only if we wish to learn – age and time is no bar and this is the need for every doctor to keep learning as medicine is dynamic with change being the constant. Thus, doctor is always a student and it is true for every teacher as well.

Types of teachers

Unfortunately, we call an individual a teacher only when he is designated or authorized or supposed to teach. Naturally every one of us must have met different types of teachers right from school, college and elsewhere. In general, there are three types of teachers. First type of teachers were those who were in our school or college, second type were those who taught us but third type were those from whom we learnt I have a fond memory of third type of teachers and I am forever grateful to them. It is said that mediocre teacher tells, good teacher teaches, excellent teacher demonstrates but outstanding teacher inspires and motivates.

Quality of an outstanding teacher

A teacher must have good knowledge, competence and communication skills but equally important are factors like passion, perseverance, aptitude and attitude. He should be able to foster clinical thinking and cultivate curiosity, inspire hope, ignite imagination and instill love for learning. A teacher in medicine must deliver clinical facts (science) but also address human facts (art). It is a philosophical exercise besides biological one. He should develop sense of responsibility and ethical standards in students to fulfill Hippocrates oat. Of course, he has to be a good human being – honest, sincere, accountable, empathetic, and patient and above all a good listener.

How does an outstanding teacher teach?

He makes learning process interesting to engage attention of students. He does not simply impart factual knowledge but explains intricacies involved in a topic under discussion. He is able to make difficult problems simpler by giving examples in real life that students can easily grasp. He promotes interactive discussion amongst students so that every one learns. He scrutinizes own performance through a feed-back from students.

Is teacher born or made?

I am not sure whether it is a natural gift. However, even if one is gifted, it needs refining with continuous learning because gift may otherwise remain dormant. Australian professor John Hattie in his book visible learning says teaching is an art any one can learn for which one needs four psychological assets – interest, practice, purpose and hope – to achieve success. Interaction is the key and role model is an integral art. Practice makes one perfect but it has to be a deliberate practice that is effortful, mistakes-ridden and repetitive. What it means to a teacher is to observe own mistakes and employ special efforts to correct them. It leaves a question to ponder whether teachers need formal training. Personal notes Besides excellent teachers from whom I learnt both art and science of medicine, I recall several others, though not designated as teachers, who taught me medicine and different aspects of life. As mentioned above, Rajaram was a ward boy who taught me first hands-on lesson in performing lumber puncture in an infant. Our ward sister-in-charge showed me how to give an enema to a child. I have formed an organsation called clinical pediatrics for teaching of medical students free of cost with the help of my colleagues who have taught me a lot as each one of them excel in one way or another. They are all practicing

pediatricians and not formally designated teachers but teach with enthusiasm and passion.Finally, I continue to learn from my child patients and so I have dedicated all my books to children who suffered so that we could learn. Of course, I owe to my parents and school teachers for inculcating good values in life.I recall a school principal who told me that if teacher alone talks in the class, no one learns but if students talk in the class everyone learns. What he preached was learning through interactive discussion and not monologues. We have been following the same in our teaching sessions. A doctor looked perplexed while viewing laboratory reports and so, patient asked whether there was anything serious.

Doctor said Not sure because I had left this part of study in option. Study of medicine continues through life and no portion can be optional.One of my undergraduate students had asked me why they had to study many subjects but each subject was being taught by different teachers, why not from same teacher? He had a valid question. I explained to him that each specialist was able to explain intricacies better in his domain.I pondered with his question that also emphasizes that every teacher in medicine should possess basic knowledge.

Take home message

Teaching is a noble profession. We need to promote it.Focus on quality is a key factor and quality assessment tools must be in place so that teachers performance is monitored. Students must assess teachers performance as well. System must offer opportunities to passionate teachers wherever they may be even if they are not designated as teachers. It will benefit all. High performing educational systems in the world select best teachers and look after them well. They must be paid as per their performance. Only then best teachers will enter teaching profession.

CHAPTER 12. MILES TO GO – BEFORE TEACHING BECOMES LEARNING