Teaching philosophy

Growth mindset

“Success is stumbling from failure to failure without losing enthusiasm” – Winston Churchill

Embracing failure is an incredibly difficult task for medical professionals. We are often the high-achievers in our peer groups, and are frequently praised for being the “smart” ones. Failure is a rare occurrence that is viewed as a high-stakes event; a personal letdown. This fixed mindset connects failure of a task or project to failure of the person, and leads to many unhelpful behaviors such as avoiding challenges (fear of failure) and hiding weaknesses (fear of not looking smart). Learners with a growth mindset seek out challenge, push their limits, and accept failure as part of the growth process. They do not worry about how smart they look, and so they do not hide their weaknesses. Educators must actively work to instill a growth mindset in their learners. To walk this walk, I have created my own personal CV of failures that I share with learners. It is by no means an exhaustive list, but it gets the point across. You can read it too! Find it here.

Cloak of competence

“Your fear of looking stupid is holding you back.” - RuPaul

The aforementioned fixed mindset causes learners to constantly worry about what their superiors and peers think about them, a behavior known as impression management. This behavior is reinforced throughout medical school when every assessment point is high-stakes (e.g. making a mistake on rounds could cost you the Honors grade, and hence your residency of choice). When learners think that being perceived as intelligent is important, they always play to their own strengths. They hide their weaknesses and uncertainties under a cloak of competence to avoid having them discovered. This is unhelpful for the learner on many levels. First, they will avoid new challenges and struggle to become self-directed learners. Second, they may undercut others for impression management purposes, a stereotype known as the gunner. Third, they avoid asking questions for fear of showing that they do not know something, and miss out on opportunities for learning. The best educators are those who create a safe learning environment in which students will remove their cloaks of competence and feel comfortable showing their weaknesses for the sake of improvement.

The Medici effect

“Innovation is taking two things that exist and putting them together in a new way” – Tom Freston

Great educators continually innovate to improve their own teaching practices as well as the education systems in which they work. The Medici effect is a term derived from a book of the same name in which innovation happens at the intersection of different disciplines. I have seen this in medical education at multiple intersections: quality improvement and assessment dashboards, clinical teaching and smartphone apps, artificial intelligence and narrative evaluations. I believe educators should deliberately seek out these intersections and help their learners to do the same.

Evidence-based learning

"Rereading text and mass practice of a skill or new knowledge are by far the preferred study strategies of learners of all stripes, but they're also among the least productive." - Peter C. Brown

Learners should be empowered to use techniques that are most likely to lead to long-term retention of information. Unfortunately, most learners have been using unproven techniques such as block learning, reading and re-reading, and cramming. Educators should model more effective techniques such as spacing, interleaving, retrieval practice (testing for learning), and elaborative interrogation to promote long-term retention of knowledge. This often requires both curriculum change and culture change, as learners may not initially feel the benefits of these approaches. Educators should be transparent with learners about why these techniques are beneficial, and then teach learners to use them.

References

- Dweck, Carol. Self Theories

- McGaghie WC. 2018. Evaluation Apprehension and Impression Management in Clinical Medical Education. Academic Medicine.1.

- Williams RG, Klamen DA, McGaghie WC. 2003. SPECIAL ARTICLE: Cognitive, Social and Environmental Sources of Bias in Clinical Performance Ratings. Teaching and Learning in Medicine. 15(4):270-292.

- Johansson, Frans. The Medici Effect

- Sumeracki MA, Weinstein Y. 2017. Six Strategies for Effective Learning. Academic medicine : journal of the Association of American Medical Colleges.

- http://www.learningscientists.org

- Brown, Peter; Roediger, Henry; McDaniel, Mark. Make it Stick: The Science of Successful Learning