Ágoston Kecskés

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January 19, 2012

Blog Entry #13: The humanist clinician-teacher

A convincing argument can be made to support the claim that good teachers must be – at the risk of sounding unsophisticated – ‘nice.’[1] There are many reasons for this. First, patients expect their physicians to involve them in their healthcare decisions so physicians must model this interaction for their trainees. The days of the patronizing, patriarchal physician are dead and gone. Second – and more germane to the topic of medical education – medical students expect – or at least hope – that their preceptors will treat them with dignity. It’s considered increasingly taboo for attending physicians to ‘overwork’ their medical students and residents. The support for this trend, for example, is medico-legal, ethical, and even economic.

But learners also function more effectively when they enjoy the company of their teachers. Most learners’ favourite teachers were also individuals with whom they got along personally. Most learners’ favourite lectures were entertaining. And why shouldn’t they be? Presumably, medical students are studying because they love medicine. So why should exploring that which you purport to love be mundane? And if it is mundane, then why should you expect it to ever improve? Students also perceive their teachers’ specialties and patients as extensions of the teachers themselves. Teachers that humiliate their students, for example, risk turning their students not just against themselves but against their specialties and patients as well. Certainly a bit of stress can help motivate students to ‘work harder’ but students shouldn’t have to fear or deliberately avoid their preceptors.

In some ways, an effective bond between a teacher and learner can overcome the individual deficiencies of both. For example, a good clinician-teacher may not have all the answers, but his/her enthusiasm may motivate the learner to seek out the answers for him/herself. Students are also far more likely to make a genuine effort to please a teacher they like than one they fear. This can easily translate into less adverse events, better follow-up, and greater patient satisfaction.

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[1] Claude Beaudoin, Brigitte Maheux, Luc Côté, Jacques E. Des Marchais, Pierre Jean, and Laeora Berkson, “Clinical teachers as humanistic caregivers and educators: perceptions of senior clerks and second-year residents,” Canadian Medical Association Journal, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232732/; accessed 19 January 2012