0
1
Editorial   |    
Teaching by Great Teachers
Laura Weiss Roberts, M.D.
Academic Psychiatry 2011;35:275-276. 10.1176/appi.ap.35.5.275
View Author and Article Information
Dr. Roberts is editor-in-chief of Academic Psychiatry.MOM

Correspondence: RobertsL@stanford.edu (e-mail).

Received July 6, 2011.

An erratum to this article has been published | view the erratum

Many of us, Dear Reader, love to teach. It was our love of teaching that brought us to academic medicine, and it is our love of teaching that continues to make us feel lucky to work in this profession. Among the many dedicated educators in academic psychiatry, some are truly exceptional. These individuals are the great teachers in our field whose work is set apart by its mix of perspective, rigor, charisma, creativity, and technique. The work of these great teachers is distinct most importantly for its effect on learners, ranging from salutary to transformative. Three articles in this issue of Academic Psychiatry (13) have been contributed by some of the truly great teachers we know. These teachers describe their passion for medical education and, as our readers will discover, they do so with a delightful diversity of writing styles. Joel Yager (1) presents a vision of the future of psychiatry insightfully, wittily, and wisely, with just enough irreverence to remind the reader, aka the learner, to pay close attention to his message. Glen Gabbard (2) has a heavier tone, communicating his heartfelt meaning in a serious and introspective way. Drs. Fidler, Trumbull, Ballon, Peterkin, Averbuch, and Katzman (3) together parade a series of innovative educational situations and theatrical exercises that result in an exhilaration from the quickly-changing scenes shown in sequence. Each manuscript tells a story. One imagines that these writing styles with which the authors have chosen to tell their story and to educate us are similar to the ones they use for seminars, supervision sessions, or attending rounds. In teaching, both in person and in the written word, these authors are offering up a bit of themselves. The great educator Parker Palmer (4) made the point that the great teacher brings his or her whole self into the room. He argued that separating the person from the message, the individual from life, is living a divided self (5). Similarly, David Leach (6), an influential leader and visionary in graduate medical education, noted that we teach through who we are. Residents notice whether teachers are "fully present to patients and to themselves," he said, and "Good teachers teach from personal wholeness and guide the resident toward personal wholeness." Leach (6) furthered Palmer's concept in suggesting that to teach "is to create a space in which obedience to truth is practiced."

Indeed, in our view, teaching and learning are one shared endeavor, and great teachers inspire learners through a mutually-interactive process that informs and creates community. It is in this context of mutualism that the aspiration of "obedience to truth" is possible. The authors in the article-cluster "Teaching by Great Teachers" emphasize this concept, and the readership of Academic Psychiatry can appreciate their inclusion and participation in such a community. So: what makes a teacher great?

Human characteristics that contribute to excellence in teaching include joy, compassion, respect for others, honesty, altruism, wisdom, creativity, integrity, self-awareness, and unpretentiousness (7). Skills in communication, organization, and in anticipating learner needs and viewpoints are also valuable, and some might suggest essential to the graceful and effective teacher. Yager (1) and Gabbard (2) both emphasize the importance of humanistic qualities in teaching. Yager (1) refers to a "bottom line" of psychiatry's core values of honesty, integrity, compassion, and respect for patients. Among other qualities, Gabbard (2) emphasizes the centrality of compassion, altruism, and self-sacrifice in teaching. These virtues will endure, he suggests, and, in conjunction with teaching evidence-based medicine, will serve as cornerstones of ethics in psychiatric education (8). Fidler et al. (3) emphasize the value of creativity and engagement, and their work suggests how the juxtaposition of different kinds of experiences with clinical medicine can facilitate and consolidate learning.

An evidence-base for understanding the attributes that contribute to excellence in clinical teaching includes surveys of learners. One recently published and comprehensively conducted literature review addressed this question (7). This analysis suggested that excellent teaching, although multifactorial, transcended ordinary teaching and was characterized as inspiring—supporting and actively involving learners, communicating well with learners, and eliciting an emotional response in learners (7). Evidence from the literature further suggests that great teachers work hard and give much of their time to learners. One case–control study of physicians in internal medicine compared excellent role models with those not identified as such (8). Factors independently associated with excellence in this study, for example, included spending more than 25% of time teaching, spending 25 hours-or-more per week teaching, and conducting rounds while serving as an attending physician.

Great role models stress the importance of the doctor–patient relationship in their clinical teaching and highlight the psychosocial aspects of medicine. As the authors (8) wrote, many of the attributes associated with excellence in role-modeling represent modifiable behavior and skills that could be acquired: in other words, with time and with the right advice, preparation, and environment, more physicians could become great role models and also, perhaps, great teachers. Great teachers in human history taught through iterative reasoning and argument, through stories, parables, and proverbs, and through self-reflection and meditation. Sir William Osler, perhaps the greatest teacher in medicine, taught primarily by example. Today's great teachers are the same: they use themselves, they share themselves, and in so doing, they inspire, impart, and influence. These great teachers do good—they serve others and their profession, and we, as the Editors of Academic Psychiatry, are deeply appreciative of this service. Yet, almost as a postscript, we wish to note that all of the great teachers we have ever known will readily admit that they have gained most from their work—that they have been greatly and richly taught by their students and that they look forward to learning more tomorrow. This perhaps is what truly makes a great teacher.

Yager  J:  The practice of psychiatry in the 21st century: challenges for psychiatric education.  Acad Psychiatry   2011; 35:283–292
[PubMed]
[CrossRef]
 
Gabbard  GO:  Why I teach.  Acad Psychiatry   2011; 35:277–282
[PubMed]
[CrossRef]
 
Fidler  D;  Trumbull  D;  Ballon  B  et al.:  Using the arts for teaching psychiatry.  Acad Psychiatry   2011; 35:293–297
[PubMed]
[CrossRef]
 
Palmer  PJ:  The courage to teach: exploring the inner landscape of a teacher's life .  Hoboken, NJ,  Wiley,  1998
 
Palmer  PJ:  A hidden wholeness: the journey toward an undivided life .  New York,  Jossey-Bass,  2004
 
Leach  D:  The power of community in academic medicine.  Humanism and Medicine Lecture ,  Annual Meeting of the AAMC,  2002
 
Sutkin  G;  Wagner  E;  Harris  I  et al.:  What makes a good clinical teacher in medicine? a review of the literature.  Acad Med   2008; 83:452–466
[PubMed]
[CrossRef]
 
Coverdale  J;  McCullough  L;  Roberts  LW:  The ethics of psychiatric education.  Psychiatr Clin N Am   2009; 32:413–421
[CrossRef]
 
Wright  SM;  Kern  DE;  Kolodner  K  et al.:  Attributes of excellent attending-physician role models.  N Engl J Med   1998; 339:1986–1993
[PubMed]
[CrossRef]
 
References Container
+

References

Yager  J:  The practice of psychiatry in the 21st century: challenges for psychiatric education.  Acad Psychiatry   2011; 35:283–292
[PubMed]
[CrossRef]
 
Gabbard  GO:  Why I teach.  Acad Psychiatry   2011; 35:277–282
[PubMed]
[CrossRef]
 
Fidler  D;  Trumbull  D;  Ballon  B  et al.:  Using the arts for teaching psychiatry.  Acad Psychiatry   2011; 35:293–297
[PubMed]
[CrossRef]
 
Palmer  PJ:  The courage to teach: exploring the inner landscape of a teacher's life .  Hoboken, NJ,  Wiley,  1998
 
Palmer  PJ:  A hidden wholeness: the journey toward an undivided life .  New York,  Jossey-Bass,  2004
 
Leach  D:  The power of community in academic medicine.  Humanism and Medicine Lecture ,  Annual Meeting of the AAMC,  2002
 
Sutkin  G;  Wagner  E;  Harris  I  et al.:  What makes a good clinical teacher in medicine? a review of the literature.  Acad Med   2008; 83:452–466
[PubMed]
[CrossRef]
 
Coverdale  J;  McCullough  L;  Roberts  LW:  The ethics of psychiatric education.  Psychiatr Clin N Am   2009; 32:413–421
[CrossRef]
 
Wright  SM;  Kern  DE;  Kolodner  K  et al.:  Attributes of excellent attending-physician role models.  N Engl J Med   1998; 339:1986–1993
[PubMed]
[CrossRef]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 7.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 7.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 63.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 63.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 48.  >
Topic Collections
Psychiatric News
PubMed Articles