The Role of the Educator

Abstract

In 1910, Abraham Flexner, changed a primarily proprietary-driven profession into a hospital-based, patient-centered, research-oriented and education-focused profession. With the publication of the Flexner Report, the trilogy of graduate medical education (GME) was born: patient care, research and teaching. Of the three, teaching continues to be undervalued but can be very rewarding for medical educators. There are as many methods of teaching as there are teachers but one of the earliest forms of medical instruction, was the apprenticeship model. The Halstedian approach to surgical education epitomized the apprenticeship model of teaching. This Germanic style of residency training started at the Johns Hopkins School of Medicine in 1889 and remains the cornerstone of all surgical training programs. Over time, though, this model has become impractical and unsustainable. Simulation-based medical education (SBME) provides a new foundation upon which structured surgical training can take place intentionally, consistently, efficiently and safely. Some challenges to surgical training, in general, include a required, shorter resident work week, higher volume, more complex patients and an emphasis on improving efficiency and decreasing error. The process of teaching takes time, as teachers require time to identify learners’ needs and time to evaluate their deficiencies; time to develop a curriculum; time to actually teach (including providing feedback); and time to evaluate the teaching process to make improvements. Teachers should not ignore the broad contexts and diversity of their learners so that they can most effectively communicate their message. Teachers should always be medical professionals in everything they do, from demeanor to dress. Our actions model essential messages of commitment to our patients and to our learners so we should always promote messages of improving patient care, professionalism, integrity, and accountability. Teachers need to be continuous learners themselves in order to provide proper communication, feedback, and evaluations for each new generation. The coin of realm for residents is experience, real, hard experiences that provide trainees with knowledge and skills. As teachers, we must provide them with observable and supervised experiences, but, residents must take time to reflect on these experiential opportunities and internalize their meaning in order to achieve success.

No significant learning occurs without a significant relationship.

James Comer, MD