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welcome woodburned

 

Learning is up to the learner, but teaching is up to the teacher

 

It’s one thing to teach, and quite another to learn. Learning is up to the learner, not the teacher. Just like the old saying: “You can lead a horse to water, but you can’t make him drink.”

But…here’s the thing: You can make him thirsty!

So the question is, how do we create environments that make learners “thirsty”? In other words, how can we foster learner engagement? Herewith, my personal Top 10. Some are prosaic and some can be incredibly challenging. And that’s a good thing, because we are all learners and we’re all teachers.

1. Start as you mean to go on: Begin every workshop, class, course, etc. with a question. Establishing right at the outset that our learning journey will be collective and collaborative is key, and especially early on I make a point of explicitly praising and otherwise rewarding any and all signs of positive engagement on the part of individuals/groups.

2. Incentivize participation: We want learners to take risks and make mistakes. When a person volunteers for something high risk, reinforce the desired behaviour. I don’t advertise it ahead of time, but whoever comes to the front of the room to do a role play with me is going to go back to his or her seat with some small token. It doesn’t even really matter what it is (think $ store).

3. Provide normative feedback: Using in-class mobile polling or an audience response system (like iClickers) lets learners compare their own knowledge/opinions/beliefs/assumptions with others in the room.

4. Establish relevance: Learners what to know “what’s in it for me?” Creating learning activities that help people bridge curricula to their own lives = good. Co-constructing learning activities that address/solve real-world problems = better.

5. Show your sense of humour: It’s hard to be serious all the time. Make it fun and mix it up! Shared laughter builds group cohesion.

6. Affirm autonomy: Let’s face it. Some days we are more fired up than others about our life’s work, and it’s no different for our students. When individuals or groups just don’t seem to be getting on board, I find that stating out loud (with 100% sincerity and with 0% judgement) that how/when/if folks engage is entirely their choice seems to free up some good energy for engagement.

7. Deploy multiple “engagement channels”: Individuals come to learning environments with a range of different learning preferences and a range of preferred ways of participating and engaging. Some people like the limelight, others need time to process and formulate a thoughtful response, and many are more comfortable sharing in a smaller group. The more choices we can offer about how to participate the better, including: verbal/written, large group/small group, synchronous/asynchronous, classroom-based/online, and more.

8. Evoke affect:  Research about emotion (affect), memory, and implications for learning suggest that teaching needs to go beyond engaging at a purely intellectual (cognitive) level, and touch peoples’ feelings (for example, Sylwester, 1994; and more recent perspectives that encompass academic technology and affective/cognitive learning, Calvo & D’Mello, 2011). Create learning activities that pair new knowledge and skills acquisition with positive affect, like surprise, delight, excitement, curiosity for deeper and more durable learning.

9. Show them you care: Authentic care and concern can go far in building good will and fostering mutual respect and support for one another’s learning and achievement.

10. And last but not least – know when to break the rules (and go ahead and break them). Like the time I called it a day and took the group shopping. 

 

 

Related articles

Five Reasons why Reality TV is not a Waste of Time: How reality TV can inform teaching best practices

Seven Essentials for 21st Century Education and Teaching: Stuff it took me 20 years to learn and I’m still trying to figure out

Rules of Engagement: The “Top 4” preconditions for learner engagement

 

 

 

Toy Circus

 

 

 

 

 

 

 

 

 

 

Stuff it took me 20 years to learn – and I’m still trying to figure out

 

1. Learning is volitional. It cannot be mandated. We can teach, but each person decides for him- or herself what will be absorbed and integrated.

 

2. What’s taught in the classroom is only the starting point for knowledge-acquisition and skill mastery. Deep learning happens when class is over – the space for real world application and practice.

 

3. Motivation to learn influences how much work a person is willing to put into self-directed learning and mastery.

 

4. People are most motivated to learn things that are of direct interest and relevance.

 

5. Motivation is a state, not a trait. Motivation is largely a product of how we (instructors) engage students.

 

6. We can amplify students’ engagement by giving them an authentic and substantive voice in co-creating curricula.

 

7. Paragogy and heutagogy, emerging theories of teaching and learning, point to decentred learning, self-determination, and peer-to-peer learning as core to 21st Century education.

 

What might paragogical teaching look like in a post-secondary classroom? In this Acclaim interview with Maegan Stephens (Public Speaking as an “Interactive Democracy”), Professor Stephens describes how:

I give them a ballot of issues to vote on, including the content of the speeches they will give, how they will be graded, and class policies on cell phone use and on attendance. I also ask them if they would prefer to spend class time doing activities, watching speeches, hearing me lecture, or a combination.

I try to ask as more as more of a moderator and facilitator than as a lecturer. This kind of interaction, advances the aspects of debate and speaking oriented pedagogy on day one. It is not so much about flipping the classroom as it is about reversing the authority and changing the professor student dynamic, and encouraging my students to take more responsibility for their classroom.

 

 

Love it. Can’t wait to try it.

 

 

 

 

 

Neon game

 

 

 

 

 

 

 

 

 

 

Follow these 10 tips for good grades…and improved learning

 

1. Read the course syllabus carefully. Keep it handy throughout the term and check it weekly to be sure you’ve completed all of the required readings and assignments.

 

2. Anticipate that there will be stressful periods in the academic term. Put assignment due dates into your calendar, and set interim goals for completing larger projects. If you don’t have or use a personal calendar, now is the time to get started to help you plan ahead.

 

3. Make a point of contributing in every class, even if it’s just to ask (versus answer) a question. This helps the instructor get to know you personally and signals that you’re actively involved and trying hard.

 

4. Take notes, even if the instructor posts slide decks to the course website. Notes help you absorb new information, and they complement slide decks and readings. Note-taking is an important skill and takes practice; the more you do it, the more effective and useful your notes will be for you.

 

5. Check in with the instructor if you aren’t sure of anything. Better to find out ahead of time, than via a low grade due to a misunderstanding on your part about course content or assignments. Don’t be shy – faculty genuinely want their students to succeed and are eager to help.

 

6. If you are emailing your instructor, be sure to communicate like a professional. That means using correct spelling and a somewhat formal tone. (Also, keep in mind that if you send the faculty an email Friday afternoon you might not hear back until the following Monday.)

 

7. Before submitting ANY written work, double (triple) check your spelling, grammar, syntax, formatting. If writing is not your strength, access a tutor to help with editing.

 

8. Keep in mind that if you’re struggling in the course, that’s not necessarily a bad thing. We all struggle when we’re learning new things. And learning new stuff is why you’re in school.

 

9. If you are REALLY struggling, ask for help. Is it because of the course content? Other things happening in your life? Time management? A health or mental health problem? There are lots of supports available to students through educational institutions and in the community – but they only work if you access them.

 

10. Last but not least, follow three simple steps for success in school (and in life).

 

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Reflections on motivation and why people change

 

How to motivate change is a big question for clinical educators and practitioners because someone else’s behaviour change is, in the end, wholly out of our hands. Over my 15 + years of practicing and teaching Motivational Interviewing, I still find myself getting stuck in the “righting reflex” when I see a person making (what I consider to be) unwise decisions.

It all comes down to individual motivation and commitment, and that’s a scary prospect when the stakes are high. We see someone following a risky trajectory and we want to grab the steering wheel. How bad do things have to get before an individual figures it out for him- or herself?

My own experience is that everyone has a particular “pain” threshold: biologically, psychologically and socially. In other words, a state of being that I might find totally unendurable physically, mentally or inter-personally may not be so bad for someone else. We each bring a singular standpoint and value-set to the decisions we make and how we live our lives. 

And here’s the thing:

People only change when the pain of change is less than the pain of staying the same.

 

In other words, motivation is tied to individual perception and experience of suffering. For example, from a teaching standpoint, it can be heartbreaking to see a promising student at risk of failing a course due to not attending class or completing assignments. But the important thing is…how does the student see it?

A “red flag” from a Motivational Interviewing perspective is when I am more invested in change than the person I’m working with (in this case, the student). I can better enhance motivation by stepping back, exploring possible reasons for change, and offering what I’m hearing about the pain of staying the same. Underlining a person’s perception of some of the costs of negative behaviours can open the door to a productive conversation about possible solutions.

 

As Andy Warhol put it:

When people are ready to, they change. They never do it before then, and sometimes they die before they get around to it. You can’t make them change if they don’t want to, just like when they do want to, you can’t stop them.

 

Related articles:

Reflective Listening: The most valuable tool in the tool box?

Reflective Listening Reflections

 

robots dancing

 

 

 

 

 

 

 

 

 

 

Please turn off all mobile devices…in your dreams

 

The “two turntables and a microphone” line sounds a whole lot better when you sing it, especially if you’re Beck. But the general idea relating to teaching and presenting is our need to balance multiple instructional strategies in order to keep learners engaged. Just like a great DJ keeps a dance floor full.

 

Given the ready distraction of mobile devices, along with an increasingly normative expectation for immediate text/email responding, today’s educators and presenters have a hard row to hoe in holding a group’s undivided attention. The cellphone issue gets lots of attention in conversations about classroom comportment and etiquette.

 

And yet…I can’t help asking…

Do people tune out, text, talk and email when they are super-interested in what’s happening in their learning environment?

 

In other words, if people aren’t dancing, whose fault is that? I hate to blame the DJ, but the truth is that some pancake turners are more attuned to the energy in the room than others. They know when and how to change things up.

 

I have observed an inverse relationship between the use of mobile devices by participants and the number/frequency of instructional strategies/approaches used. I’m just saying.

 

 

Happy Assorted Biscuits

 

 

 

 

 

 

 

 

How well do we integrate all three in our teaching/learning environments?

 

 

On a Porter Airlines flight the other day I read an interview with branding guru Ron Tite in the in-flight magazine, re:porter. In the article, Tite notes that you can add value to consumer and corporate brands in three ways: via education, inspiration or entertainment (ideally combining all three).

 

This got me thinking about teaching and learning tools, and the extent to which we educators successfully integrate each of the elements (education, inspiration, fun) into our classroom delivery and student engagement strategies.

 

The education part implies some form of didactic instruction. Easy enough. Inspiration is harder, and often arises from hands-on practice – whether through student interactions, simulation, critical analysis or collaborative learning. What about fun? How do we build in play, humour, joy, excitement, passion? Attending to the meta-learning environment, fostering a sense of community, safety, risk-taking and engagement would seem to be preconditions for having fun in the classroom. As does the extent to which I’m enjoying myself too. It seems to me that a combination of all of these elements is integral to transformative learning.

 

We talk about scaffolding learning to help engineer success experiences for students. Let’s also consider how to scaffold learning to engineer fun experiences!

 

 

 

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What do you collect when it comes to knowledge, skill and learning?

 

Our collections of knowledge are built over months, years and decades. We are all collectors of a singular miscellany of knowledge and skills. What is prized by one may not be assigned equal value by another. A quick example: I had a neighbor who did his doctoral thesis on medieval witch trials…in a specific region of Poland. (I think someone needs to do a doctoral thesis on doctoral theses).

 

Some people are intentional, assiduous collectors – their mind a perfect gallery. Some accumulate by chance and circumstance – a drawer of buttons and bits of string, but also containing rare and necessary objects.

 

Some learning costs us dearly and we value it accordingly: “This took me years to master.” When it costs nothing, when it’s effortless, do we assign a lesser value? (“It just comes naturally.”)

 

Some display their wealth of knowledge in opulent pride (which can be off-putting). Others hoard their wealth in private, only offering a rare glimpse or glimmer (which is intriguing). Who overestimates the value of what they’ve learned? Who underestimates it by far? Who suddenly changes their mind and their path and decides to start over?

 

The most prized collections are not easily achieved. Always alert for the dusty treasure in a forgotten corner. In the end what is amassed? An incalculable value.

 

 

Girl Crying Girl

 

 

 

 

 

 

 

 

 

Where does it hurt? That’s the key diagnostic question whether you’re a presenter or a clinician

 

A common clinical dilemma in counselling practice is when the practitioner is more invested in change than the client. This is manifested in clinicians working harder than their clients and caring more than they do about change. How and why does this happen?

 

I think this disproportionate effort stems from two things:

  1. Practitioners are trained to identify issues of concern and have a heightened awareness of the long-term implications and consequences of negative health behaviours.
  2. Because of their training and awareness, practitioners often feel that they know what is best for their clients.

The first point is helpful; the second…not so much.

 

It’s like the quotation:

“Advice is what we ask for when we already know the answer but wish we didn’t.”  In other words, people are the experts in their own lives.

 

So what does all this have to do with presentation secrets?

In a teaching context, the instructor – just like the clinician – is expert in his or her specific knowledge domain and strategies for internalizing and enacting knowledge and skills. It’s when we take the stance of “I know best” that we run into trouble in the classroom. All people (whether patients or students) are in charge of their own lives and actions; learning is volitional and learners will always be self-determining in what and how much is learned.

 

Here’s the secret:

Always start with the problem that the learner identifies as relevant and pressing. Affirm autonomy. Offer solutions in the spirit of collaborative problem-solving. Tailor the content to the real-world needs of the individuals with whom you are engaged.

How do you know if you’re doing it right? Hearing “Yes, but…” is the clue that you’ve gone off track. Figure out the pain point and offer ways to make it better. Then leave it up to the real experts: the people you are entrusted to serve.

 

 

 

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A small investment that can add big value to your training or workshop

 

People attend courses and workshops for a variety of reasons: some are there to learn, some are forced to attend, and others are curious-but-skeptical. Yet whatever the reason, how can we add value in the form of creating a compelling and memorable experience? An experience that effectively reaches beyond the workshop into the “real world” inhabited by our learners?

An obvious way to help bridge the learning-practice gap is to offer a package of professional, relevant and well-designed handouts. We trainers reassure ourselves that this invaluable resource will serve as an oft-consulted reference for learners post-session. Yet, how many of these things have you unearthed and pitched out in an office-purge years later? It’s a natural tendency to “file it and forget about it”. So…What else is needed?

I have attended two recent faculty development sessions where the speakers employed an ingenious and appealing strategy. So brilliant, so obvious, why have I never done this before? I am decided that I will now incorporate this into every single workshop:

Give each and every participant a small, meaningful token – a symbol – of the underlying meaning or “spirit” of your session.

Don’t tell them ahead of time. Do it near the end of your workshop or talk. Involve them in an activity demonstrating how they might use it.

 

Example:

In the Motivational Interviewing workshops that I facilitate, we talk about the skill of affirming as one of four foundation skills in this counselling approach. Last week at a session I gave for Queen’s University Health, Counselling and Disability Services clinicians, I handed out “saphires” (plastic, from a discount store) to each participant, and asked them to consider an affirmation that they could offer to a challenging student they are working with. Long after the workshop, that “jewel” on a practioner’s desk is a tangible reminder of mindful practice, and more evocative (and concise) than the 40 page handout I provided! (Or even the one page ” MI Tips ” for that matter).

Learners give their time, attention and wisdom to us when we co-construct learning communities. In the spirit of reciprocity, I have decided that going forward, a symbolic token to take away represents a significant value-add for learners and a reminder of what we have collectively shared.

 

squirrel left

 

Do one thing this year that scares the hell out of you

 

When I think about learning and all it implies, my mind automatically goes to unicorns and rainbows. Phrases like “transformative learning”, “learning community”, “lifelong learning”, “learner-centred”, etc. conjure up an idyll of intrinsically motivated and enriching experiences and endeavors. Don’t get me wrong – this is legitimate and genuine and real. But it doesn’t tell the whole story.

Yesterday I attended a talk focused on institutional commitments in a learning-centred organization. The speaker ended with a powerful call to action: her own. She committed to identifying and doing “one thing this year that scares the hell out of me”. And then she invited everyone in the audience to do the same. This got me thinking: deep learning happens when the going gets tough. Doing something that scares you is a 100% guarantee that you will learn something new.

In his book The Talent Code, Daniel Coyle talks about the phenomenon of deep learning. In this mode, peoples’ acquisition of a new skill resembles a herd of deer on an icy, slippery slope: tenuous, tentative, struggling, messy. In other words, deep learning is hard and it’s scary, but it may be the most effective route towards mastery.

A few years ago I gave my undergraduate university class a critical analysis assignment, consisting of three parts: (a) Read a challenging scientific research article (selected by me); (b) Submit a critique of the article, no more than three pages in length; (c) Locate two related research articles from an academic database. I loved this assignment because it so effectively assessed essential professional skills of understanding and critiquing research literature in the field, as well as navigating academic databases and locating relevant research. Practicing professionals need to be able to do this.

My students, on the other hand, hated the assignment. They were up in arms! Some said they had to read the article six or more times before they even understood it. Others struggled with how to even begin to critically analyze a scientific article published in a peer-reviewed journal. And still others had successfully avoided exposing themselves to Scholars Portal, and wanted to keep it that way.

Faced with an onslaught of indignation and outrage from approximately 60 people, I went into reflective listening mode: “So, what you’re saying is, this assignment was incredibly challenging. You hated reading a boring article ten times before it even began to make sense. Scientists aren’t too good at making the products of research accessible. Life would have been so much better if the assignment I gave you involved no more than a couple of hours work the night before.” Nods of agreement and reluctant smiles.

But here was my pivotal question to the group:

“If I had given you that easy assignment (welcome as that may have been), tell me this, would you have learned anything?”

Umm…no.

“And what about this terrible assignment…did you learn anything useful?”

An unequivocal Yes! … even though it was pretty aversive.

And then the conversation shifted – big time.

We talked as a group about why they had come to university in the first place. We talked about the experience of learning. About how, when things are hard, that is exactly when learning happens. Instead of a mutiny on my hands, the experience was an epiphany for all of us.

 

I have to keep reminding myself of that lesson. The challenge to commit to one really tough thing this year and follow through is the challenge to commit to the slippery slope of deep learning.

And maybe among the herd of deer on that icy slope, there will be a couple of unicorns.

 

 

ideas lightbulbs

 

 

 

 

 

 

 

 

 

 

 

“What I don’t know I don’t know” – That’s the most essential learning

 

In nearly every course or workshop I teach on Motivational Interviewing (MI), there are nearly always practitioners who express some variation of “I already do MI naturally”. In other words, why spend time “learning” about something that I already know how to do? A reasonable response, if accurate.

I say ‘if accurate’ because research on MI practice suggests a disconnect between what practitioners say they do versus the MI skills they can actually demonstrate. We’re talking video recordings of actual client sessions, coded by skilled clinicians trained in the use of a standardized instrument. So while there may be a small proportion of therapists who really are “MI naturals”, it’s likely that most practitioners, whether they know it or not, can not or do not demonstrate the skills of MI without training, coaching, practice, coaching, and practice.

 

Motivational interviewing is essentially a way of being with a client (Dr. William Miller, the originator of MI, calls this “MI Spirit”), comprised of partnership, acceptance, compassion and evocation. It seems intuitive, but the “Righting Reflex” is hard to resist. Additionally the processes of MI – engaging, focusing, evoking and planning – are accompanied by a range of skills and strategies. Integrating both spirit and skills demands artful practice, and integrating MI with other approaches (for example Cognitive Behavioural Therapy, CBT) involves even greater therapeutic sophistication.

No practitioner ever reaches the apex of clinical perfection – it doesn’t exist! Just like the clients we serve, practitioners are engaged in an ongoing process of development. And it’s the basics (reflective listening is a good example) that can be the most challenging.

 

People come to a learning environment with four general categories capturing both pre-exisiting knowledge and knowledge deficits:

  1. What I know that I know: Everyone comes in with something of value
  2. What I know that I don’t know: Everyone has areas they can identify as avenues for further learning
  3. What I don’t know that I know: Everyone has knowledge and skills of which they aren’t aware
  4. What I don’t know that I don’t know: We all have a blind spot when it comes to what we still need to learn. When we can shine a light on it, that’s the “aha” moment! 

 

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Patient safety includes patients’ subjective feelings of safety

I have participated in and taught about interprofessional collaboration (IPC) for many years, but last week I experienced it firsthand from a new perspective… as a patient.

Here’s a quick replay:

It is 6:15 AM. No coffee. Emerging from the changing room in a hospital gown and disposable slippers I re-enter the Admitting waiting area with others similarly attired, accompanied by our respective escorts. The only exuberance is among a group of three teenage girls, whose noisy laughter and nonchalance exudes the indestructibility of youth.

From Admitting, on to the Pre-Op waiting area. One by one patients are called, and then it’s my turn. Past the swinging double doors, down a wide corridor, more people in surgical scrubs, into the Operating Room. It’s kind of freaky being the one with the IV: “Just hop up here onto the operating table.”  A narrow bed in the centre of that big room, with really bright lights just like on TV. Ummm…sure. Too late to back out now.

Have you noticed how right away you can feel a room’s atmosphere (positive or negative)? Well in that moment of total vulnerability, I sensed the camaraderie of a super-high-functioning team. I felt respect, cooperation, kindness and compassion. Not just toward me but to each other. More than anything anyone actually said or did, the underlying atmosphere was like a warm blanket of reassurance and comfort.

Health and counselling practitioners universally affirm the importance of positive regard, mutual respect, trust and acceptance in relation to our patients or clients. Last week was a good lesson about how profoundly our interprofessional relationships – those same elements of positive regard, mutual respect, trust and acceptance – are visible, impactful and meaningful. Just like kids know when their parents are fighting (even in the absence of verbal cues), patients know when there is discord in the team.

As I discovered firsthand, IPC is not just about patient safety, it’s also about patients’ subjective feelings of safety. A skillful surgeon is key. An outstanding team takes it to the next level.

 

P.S. The biopsy was negative.

bowling trophy figures

 

 

 

 

 

 

 

 

 

It’s all about creativity, reflexivity and connectivity

Teaching as informing is a short-term solution to a long-term problem. Today, providing information is secondary to engaging peoples’ interest and motivation so much that they will want to seek out more and more, beyond the boundaries of the boardroom, lecture hall or online discussion forum. It’s about meta-teaching…teaching others to become their own teachers.

Daniel Pink, in A Whole New Mind, describes how the information age has undergone a seismic shift to the conceptual age. Meaning that the left brain skills of information management/analysis have been surpassed by the right brain skills of creativity, reflexivity and connectivity.

We’ve progressed from a society of farmers [the agricultural revolution] to a society of factory workers [the industrial age] to a society of knowledge workers [the information age]. And now we’re progressing yet again – to a society of creators and empathizers, pattern recognizers, and meaning makers [the conceptual age].

In the conceptual age, educators and presenters need to go way beyond informing because:

a. The information that the presenter deems essential may not align with the relevance and priorities of the audience; so that means little incentive for long-term retention.

b. People generally don’t remember much of what they hear. Or if they do, the half-life of information is pretty short, so there isn’t much impact to be realized if our focus is on the content of a presentation.

c. Even if the information is relevant and memorable, our knowledge landscape is a moving target – information changes so rapidly that what is current today quickly becomes out of date.

And that is where transformative learning comes in…

Introduced by Jack Mezirow in 1997, transformative learning is about engaging peoples’ underlying assumptions and facilitating change in frames of reference. Think of it as that “aha!” moment, when a whole new concept seems to snap into place and suddenly we see things from a new and broader perspective. Signal moments in learning are accompanied by affect – delight, surprise, disappointment, satisfaction, excitement – extending beyond solely cognitive-based insight or understanding.

A defining condition of being human is that we have to understand the meaning of our experience. For some, any uncritically assimilated explanation by an authority figure will suffice. But in contemporary societies we must learn to make our own interpretations rather than act on the purposes, beliefs, judgments, and feelings of others. Facilitating such understanding is the cardinal goal of adult education. Transformative learning develops autonomous thinking.

How can we as educators make this magic happen in our day-to-day work? Well, transformative learning presupposes transformative teaching (if teaching is the right word in this context) (a.k.a. transformative faculty development?). And in turn, transformative teaching implies…teaching about teaching. Meta teaching.

Both the words and the music. Play that funky music.

 

 

 

Auto repair

 

 

 

 

 

 

 

 

 

 

The foremost decision is the decision to provide treatment

 

Last week I met a colleague who leads a community college program on auto maintenance and repair. This arena of study and practice has always seemed fairly straightforward to me: learn the mechanics of engines and other things that make cars work, and learn how to fix them. I confess it was surprising to me when he shared that the most important skills his students need to learn are critical judgment, reflection and decision-making. That’s partly because car design has changed so dramatically over the last two decades that cars have become complex electronic as well as mechanical systems. Just like in health care, for a good mechanic the foremost decision is whether to provide treatment.

 

Who knew that our most important teaching goals and teaching challenges – his in auto repair and mine in counselling and health behaviour change – were so aligned?

 

This reminded me of another conversation I had with a surgeon a couple of years ago. We were talking about laparoscopic surgery, and I wondered whether today’s medical students had a learning advantage due to their years of experience playing videogames. The doctor stated that it doesn’t take long to teach anyone to how to perform laparoscopies (although video game players might learn a little faster). He said that what takes years to teach and learn is when not to do the surgery.

 

When and how to intervene may be the most challenging things for anyone to learn because the skills are so complex. Education for diverse fields of practice – from car repair to medicine and lots in between – demands that students master three essential foundation skills:

 

1. Critical reflection: Meaning-making and interrogating the limits of one’s knowledge and skills; considering costs, benefits and outcomes of different possibilities

 

2. Attention: Including listening, observation and data-gathering, from a stance of care and concern

 

3. Decision-making: This includes decisions regarding a specific course of action, as well as decisions about what additional information might be needed; acting with integrity and ethics.

 

A nice article on how diagnosis is more art than science features wisdom from “master diagnosticians”, and underlines the importance of the above three skills, along with humility and a commitment to continuous learning:

 

“If you want to be a master diagnostician,”  says Dr. Lewin,  ”you’d better be prepared to be a master student.” It’s a lesson Dr. Goodgold, now in his fifth decade of practice, still takes to heart.  ”Being a good diagnostician means being good at solving problems. It starts with being intellectually honest.  You must admit to yourself that you don’t know everything. Not a week goes by that I don’t see something new. I must continue to be a student of medicine and science.”

[…]

Consider the wisdom of Sherlock Holmes, who was modeled by his creator, Sir Arthur Conan Doyle (a physician turned fiction writer), after one of the most renowned diagnosticians of his day: Dr. Joseph Bell, professor of medicine at the University of Edinburgh.  ”I see no more than you,”  the super sleuth explained to his sidekick, Dr. Watson,  ”but I have trained myself to notice what I see.”

 

 

 

 

 

 

 

 

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