How to… teach

Authors


Dr A Garden, Centre for Medical Education, Faraday Building, Lancaster University, Lancaster LA1 4YB, UK. Email a.garden@lancaster.ac.uk

Teaching junior colleagues has been considered part of the role of a doctor since the time of Hippocrates, when the new practitioner swore to ‘To consider dear to me, as my parents, him who taught me this art’. In the United Kingdom, the General Medical Council states ‘Teaching, training, appraising and assessing doctors and students are important for the care of patients now and in the future. You should be willing to contribute to these activities. If you are involved in teaching you must develop the skills, attitudes and practices of a competent teacher’.1 Most clinicians are happy to accept this responsibility but are often not confident about their skills, attitudes and practices as a teacher. The first occasion when I taught a group of medical students is etched in my brain—I am sure I was more apprehensive than them!

Things you need to know to teach

Session objectives

Have a clear plan for the session—whether it is to impart knowledge or teach a clinical skill. Knowing what you plan to teach will permit you to know whether you have succeeded—and also to plan the resources you need. While bedside teaching is dependent on women in the ward on the day, a little planning ahead can make a huge difference to the success of the session.

It is also essential to be aware of the overall objectives of the trainees’ programme of study. This will allow you to produce teaching that is relevant, appreciated and not covered elsewhere!

The teaching style that best suits the session objectives

Lectures, small group teaching, group work facilitation and other methods require different skills. While we all have our favourite methods, a good teacher works to develop skills in all and use the one most appropriate.

The resources available to you and to the students

What information you impart will depend on whether the students have access to books, journals, the Internet and other resources on the topic, or whether you are the sole source. Students will retain much more information if they are encouraged to read in advance and subsequently discuss the topic (see Figure 1).

Figure 1.

 The learning pyramid.

How you teach clinical skills will depend on whether the students have access to models or any form of simulation.

The subject—and the level to which the trainee needs to know it

We all love our subject and tend to want the trainee to know all we know! Trying to teach too much is a common problem. Figure 1 reminds us the trainee will only retain approximately 5% of what they hear in a lecture. It is much better to aim to teach less—and to do it in a way that encourages retention. An undergraduate student needs to know much less about interpreting partogrammes than a senior specialty trainee!

The students

A little time spent ascertaining the prior knowledge of a student about a subject will allow you to target your teaching at the right level—and saves wasting precious time!

The patient—if it is bedside teaching

It is obvious that knowing all the clinical details about a woman who has agreed to help with a teaching session is essential. It is also important to know the woman—how she will react to being to be ‘taught on’; whether she minds being examined by more than one trainee; and what her reactions will be to hearing about the likely outcome of her condition. Does she speak the language in which you will be teaching? If not you should consider having an interpreter present.

Things you need to do to teach

Prepare for the session

It’s amazing how often we don’t plan the basics—how many students; what you are going to teach; how you are going to teach it; and how you are going to know if you have been successful

Involve the woman

The woman who has agreed to be part of the teaching session is part of the team. She will enjoy it more (and perhaps agree to take part again) if she is involved in the process. Simple things such as involving her in the discussion or keeping your hand on her shoulder while addressing the students can achieve this end. Not only does the woman appreciate it, but it also models to the trainees the right attitudes towards the women we are responsible for taking care of.

Feedback to the students

Students learn better when they get feedback on their progress regarding their knowledge, skills and attitudes—promoting good practice and correcting where wrong. Additionally, encouraging trainees in this way encourages them to consider the profession of obstetrics and gynaecology!

Encourage the students to learn

We will never teach students all they will ever need to know. The increase in biomedical and clinical knowledge is immense—we only need to consider what has changed since we started clinical practice. We need to enable our students to be life-long learners, teaching them how to find information and how to know if it is information they can trust. This will enable them to be safe practitioners throughout their career

Reflect on how the session went

How did that go? Did I achieve what I set out to do? How could I improve on it? These are not just questions for our clinical practice; they are questions for our role as teachers.

Develop myself as a teacher

Even if we don’t have access to training courses, there are simple ways available to us all to develop our teaching skills. These include critically observing colleagues’ teaching and asking colleagues to sit in on our teaching to give us feedback.

Things you need to be to teach

Enthusiastic

Enthusiasm for our subject is infectious!

Encouraging

Teaching by intimidation never promoted learning: encouragement, feedback and, if necessary, finding out if the students have problems are much better stimulants to learning!

A role model

We teach our students and trainees much more than facts—they also pick up our behaviours. If we turn up late, they will assume that is acceptable. The way they behave with the women they care for will reflect what they have seen in us.

Conflict of interest

I confirm that I have no conflicts of interest in submitting this paper.

Funding

The author has received no funding for this article.

Additional reading

AMEE (Association for Medical Education in Europe) Guides (available at http://www.amee.org.uk) especially:

  • • Norcini & Burch (2008) AMEE Guide 31: Workbased assessment as an educational tool.
  • • Ramani & Leinster (2008) AMEE Guide 34: Teaching in the clinical environment.

ASME (Association for the Study of Medical Education) Guides (available at http://www.asme.org.uk) especially:

  • • McRorie (2006) ASME Guide 4: Teaching and Learning in small groups.
  • • Kaufman & Mann (2007) ASME Guide 9: Teaching and Learning in Medical Education: How theory can inform practice.
  • • Long & Lock (2008) ASME Guide 22: Lectures and large groups

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