Clinical teachers: the good, the bad, and the ugly
Do you often feel neglected by your clinical teacher on
the wards? And do you feel that attending a ward round at 8 am is too much
to ask a medical student? Deborah
White and coauthors offer a helping hand
Some of us wrote a couple
of years ago about the good, the bad, and the ugly with respect to
lecturers.1 We are a bit older now, hopefully a bit wiser, and have
progressed from the lectures of the second year to the clinical teaching of
the fourth year. Some of this teaching is great, well organised and
enthusiastic, and taught by clinicians who are inspiring, approachable, and
generous with their time. However, some of it is not.
Of course, there are many reasons why our clinical
teachers are not always everything we, or they, would wish them to be. They
have sick patients to look after, administrative tasks to tackle,
continuous professional development and appraisals to undertake, not to
mention the ward sister to appease.
Asking clinical teachers to self evaluate their
teaching skills, therefore, might seem somewhat inflammatory. But formal
assessment of teaching ability might not be many years away, and, anyway,
we thought this might be fun.
So, if you’re reading this and have a role in
teaching medical students, try our simple self test, and pick the answer
that best describes you. Find out whether you are a mostly As, a mostly Bs,
or a mostly Cs clinical teacher. Any similarity to actual clinical teachers
or learning experiences is purely coincidental.
Quiz for clinical teachers
(1) Two fourth year students join your 8 am surgical
ward round. Do you
(A) Greet them with enthusiasm and explain that the
ward round will be fast and furious. You encourage questions and try to
involve the students as much as possible—it’s a good
opportunity for them to learn about things like fluid balance and
postoperative complications
(B) Look amazed that students are actually out of bed
this early and give them the notes trolley to push. You throw a couple of
questions their way but don’t wait to hear the answers
(C) Ignore them but shout if they get in the way?
(2) You’re doing some bedside teaching with a
group of third years. One of them declares himself to have absolutely no
idea about the answer to a question you ask. Do you
(A) Tease the answer out of him in such a way as to
make him realise that he knows more than he thought, and understand how he
can work things out even if he doesn’t know the answer straight away
(B) See if anyone else in the group knows the answer
before explaining it yourself
(C) Roll your eyes and snap, “Do they teach you
anything apart from communication skills these days? Go and look it
up—that’s if you know where the library is?”
(3) You’re a senior house officer in the
doctors’ room chasing some blood results when a fourth year appears
and asks if there are any patients on the ward that it would be interesting
for her to see. Do you
(A) Say, “Nice to see a keen student, why
don’t you go and see Mrs Jones and we can discuss her management?
There are quite a few useful learning points”
(B) Smile and say, “Not really, you could go and
talk to Mr Smith if you like, or head off to the library if you’d
prefer”
(C) Sigh and say, “Don’t think so, ask the
nurses?”
(4) Two third year medical students turn up in your
operating theatre. They seem uncertain of what to do. Do you
(A) Welcome them to your theatre. You go over why the
patient is being operated on, and enthuse that they scrub in to get a
better view. While your specialist registrar is closing up, you go for
coffee with the students and chat with them about their career intentions
(B) Think, “Time to make myself look good in
front of the senior house officer and the nurses.” You attempt to
involve the students by asking them some questions, but you’re
not surprised when even your specialist registrar doesn’t know the
answers
(C) Think, “This is why I wish I worked at a
district general hospital. Every week I am sent two muppets by that so
called medical school. They just stand there increasing the microbial
levels in my theatre”?
(5) You are scheduled to give the fourth year students
a tutorial on skin disease. Do you
(A) First find out from the online medical school
resources what they already know and what they need to know. You then plan
a tutorial that includes elements of revision as well as new material. You
also find a patient who is happy to be used as a teaching case for the
tutorial
(B) Pull a PowerPoint file out of the dermatology
library. It’s meant for the senior house officers, but there are some
pretty pictures and lots of information in it, so you’re sure
they’ll like it.
(C) Find someone else to do it?
(6) You’ve just received the case studies handed
in by your final year medical students. Your feedback will consist of:
(A) Constructive criticism of each case study, plus
suggestions for improvement. You’ll make sure each student gets a
copy of their feedback and meet with them individually to discuss their
progress
(B) Scribbling a mark on each case study and hoping
your secretary will pop them in the internal mail to the medical school
office
(C) Nothing. You put the case studies at the bottom of
your to do pile and forget all about them?
(7) A student is about to start their general practice
attachment with you. Do you:
(A) Write to them to welcome them to the practice,
enclosing their day by day timetable and the practice information booklet
(B) Rely on the medical school to give them appropriate
instructions
(C) Look surprised when they arrive at your practice
and say, “I thought you were starting next week”?
How did you do?
Mostly As—Fantastic.
You really enjoy teaching students and they love being taught by you. Your
enthusiasm may be too much for some of your students, but most of them
really appreciate it. Sorry if we forget to say thank you more often.
Please keep up the good work, and hopefully some of it will rub off on your
colleagues.
Mostly Bs—You try
to fulfil your teaching commitments, but teaching is not high on your list
of priorities or something that you particularly enjoy. And maybe your
medical students have not inspired you to be an enthusiastic teacher of
late. Perhaps a review of that timetable, just to make sure no one who has
left is still down to teach, and a bit more enthusiasm at those lunchtime
tutorials and you too could have the students praising you at staff-student
liaison meetings.
Mostly Cs—Teaching
comes after organising the staff Christmas party on your list of
priorities. Maybe you have had some of those medical students who do not
seem to feel it is part of their job to learn, so you are hardly feeling
that it is part of your job to teach. Enthusiasm can go both ways, however.
Perhaps you should pop along to one of the meetings for clinical teachers
organised by the medical school course coordinators and see if you can pick
up a bit of inspiration.
Deborah White
Email: debs.white@doctors.org.uk
Shirley Moore
Emma Surgey
Tom W M Walker, fourth year medical students, University of Aberdeen
studentBMJ 2005;13:309-352 September ISSN 0966-6494
- Moore S, Walker T, White D. Lecturers: the good, the
bad, and the ugly. studentBMJ 2002;10:120-1.
