Let's face it, Teaching is not rewarded in the same way that Clinical Work and Research are in most large academic medical teaching centers. It may be that we simply are not able to measure outcomes in teaching the same way we can in the other two "legs on the academic stool".
Some faculty say, "teaching is its own reward" and I would agree. But how do you keep your teaching "fresh" in the face of all the other demands on your time. This was not the question I had planned for September, but a gifted "early career" teacher stopped me today and asked, "How do they do it! How do some of these guys teach year after year and act like they are teaching this material for the first time? How can I keep my enthusiasm? Sometimes I just feel tired"
So this question is to our faculty who have been doing this for a few years. How do you keep it "fresh" (or appear to)? Any tips you have for keeping your enthusiasm and avoiding burnout would be most welcome. Let's break our record of 10 responses.
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20 comments:
I have to admit, sometimes the material is actually new, as there are always advances in medicine. So, before any lecture, I do a literature search and include up-to-date information and references. Reading a new reference "freshens" my perspective and my lecture, making me appreciate the recent advances in my field.
The truth is I'm not always "on my game", but when I'm not I see the difference in the residents and it doesn't feel good, so I'm back finding new articles and I get re-motivated.
One advantage of being a Training Director is I get to assign myself different topics so I try to keep myself fresh by rotating my assignments over the years. I also will try to do the "hot topics" such as cardiac risks in stimulants or school violence to keep up interest. I often come back from conferences with new teaching ideas or appreciating how much the field has changed. Also I found the REAL modules helped me present several topics such as "Clinical Decision Making" and "Effective Presentations" I might not have presented in an organized way.
I think part of the reward from teaching has to be a motivation in your soul to teach and interact with others - something you really like to do. As in anything, if you really don't like it and get intrinsic rewards from it, you can't sustain it. Finding those intrinsic rewards sometimes takes time. Certainly sharing knowledge or skills is rewarding becuase you are actually using something you are good at. Getting recognition from the learner is invaluable - even just checking their understanding after you show them something. Having this reflected in some evaluation is even better (we need to train our students to give useful information back to all of our faculty). Finally, finding little tests that we can do to try a new approach and collect some data about how successful it is can be rewarding to the schoarly side of our interests. Paying attention to best practices observed/learned from others and using them to imporve your skills creates some interest. And as others have pointed out, the serendipitous learning from the students and residents is usually helpful and invigorating.
One thing that definitely helps is timely feedback from the learners. Feedback can help an instructor modify how things are presented, which can help prevent getting into a rut. It is also fun to try different approaches, for example, having students repeat what they have learned in layman terms, as if they are talking to a patient.
One of the first things we do when we "teach" is try and understand the gaps in the learners' knowledge. For the same topic, the gaps are different for each learner or group of learners (sometimes just subtly so).
Focusing on these gaps makes each session unique. Sometimes when things get repetitive and stale, it helps to take a step back and remember that we are not "teaching", we are helping students get motivated to learn.
One way to avoid burnout is to break out of your comfort zone and try a new approach to your regular teaching activities. Think about ways to make your teaching "active" for the learner. For a typical lecture this could be inserting an exercise to have the audience participate or using cases with questions for the audience instead of canned slides. For patient care encounters try teaching at the bedside. Bedside encounters are always unique and will push the teacher to be spontaneous.
I'm passionate about teaching, because I'm continually engaged in learning myself. Moreover, I strive to "reach out" and connect with my students in order to build rapport and invite communication. A learning environment based on mutual learning and communication is exciting and productive.
I really like Neil's comment about focusing on the learners knowledge "gaps" rather than on what I want to teach or am used to teaching. Even though there will be patterns I guess it seems better to focus out
For me, it's not about teaching. It's about learning. What can I do to create conditions, experiences, activities and frameworks that will help the student learn? What will be the nature of the reflection and interaction between us? What strategies do I have available to respond to variations in the situation at the moment. How prepared am I to improvise with my experience, knowledge and skills? These are the things that I think about. Content expertise is really not the central issue, although it is important. It's about learning.
I am involved in undergraduate education and am constantly debating the how to's : Get faculty create worthwhile lectures and not textbook re-hashes, create interactive learning experiences, deal with a multi-level class, and meet the students needs for academic freedom in choosing their method of learning.
So far most of what I read is related to clinical teaching... any comments on the school side of med school?
There is a great web site at the University of New Mexico School of Medicine, Office of Teacher and Educational Development-- it has lots of free useful approaches to teaching in every setting at all levels. Check it out - http://hsc.unm.edu/som/TED
I find that learning new things about teaching itself always renews me. If I learn something about teaching or learning theory, or if I hear about a new intervention then it causes me to reflect on what I am doing, and that always gets me excited to try something new.
Also, I always try to take a different point of view on educational interactions, especially if they are one on one. Instead of thinking about how I relate to the subject matter, or how the student relates to the subject matter, I think about how the student relates to the setting, especially if the setting is completely new to them, and how I function in that setting, or even how knowledge might seem different in different settings. This really gets me out of my "talks in a can" sort of mode and makes me more aware of what my student may be taking away from our interaction.
This is of course more difficult to do for a classroom or large lecture sort of setting, but the same sort of thinking can be applied, especially if one is using cases as a method to teach.
I try to remember that, although it may be the 20th time I am teaching this material, it is the first time these students are hearing it and they deserve the same enthusiasm and freshness that I gave it the first time. It's a lot like being in a play. The actors do it over and over, but for the audience, it is the first time they are seeing it. I try to make it the first time every time I teach. I also try to generate a lot of enthusiasm in the first few minutes because enthusiasm has a positive feedback loop. The more energy I can generate in the first five minutes, the more the students get engaged, and the more energized I feel. For me it's important to take five minutes before walking in to the room to regroup, remember what I'm doing in the next hour or two and why, generate fresh enthusiasm, and walk into the room without all of the other stuff that is on my mind.
One thing I have realized that is essential when I teach is a group of colleagues that I know appreciate teaching as well AND that I make an effort to regularly interact with those people. This sounds so simplistic, but teaching in isolation seems a ticket to burn-out. There is an inherent social nature to the "act" of teaching; so it seems essential to me to have social interactions outside the actual teaching act and a group of colleagues that support each other in their teaching.
I try to remind myself is that a presentation I may have done 5 or 10 times before is brand new to my audience (this will be there first time). Trying out new ways of delivering the material also makes it more interesting from the presenter's perspective. I like trying out different ways of presenting the material and see what kind of a response I get. I find the residents I teach appreciate the variety of approaches instead of coming to a conference expecting the "usual" powerpoint talk.
I'd offer two things here. First, to stay motivated (or avoid burnout) in a seemingly thankless endeavor, I keep a file of "brag rights" where I collect emails and cards from students for whom I've made a difference. When the going gets tough, I read one or two of them to remind me of what is important.
About keeping it fresh, I find that comparing "notes" with colleagues who are teaching similiar content always gives me ideas that give new life to an old presentation. Of course, there's no substitute for updating to cutting edge material.
I struggle with this. I just tell the the students and residents. I'm not having a "A" day. I then try and pull away from the madness and sit down with them over coffee and do flash cards for fun (rare diagnosis) or review a case and allow personal experience with similar cases drive the conversation/directions. I think (hope) they like the endearment and honesty.
The most important thing I do to keep my energy up is to check in with the students at the beginning of a teaching session. I ask about what rotation they are on and how are things are going. By doing this, we build a relationship.
Even if I am facilitating an interactive session, I go through the material I am presenting again, to make sure that it is current, to make sure that it is clear, and to re-evaluate whether what I plan to include is practical and relevant.
I also solicit feedback from students at the end of a session. By jotting down specific feedback, I have a better idea of what to improve upon for future sessions.
The other thing that I think is key is to be mindful of what types of teaching are most enjoyable to you. I enjoy facilitating interactive sessions, and I enjoy precepting if there is a set curriculum, as when I have a longitudinal student during the first two years. Recently though, precepting more advanced students is more difficult for me, at times, because my patient schedule is not adequately adjusted, and I am trying to balance the self-expectations regarding patient care and those regarding teaching.
It is important to remember that it is okay to choose different aspects of teaching at different times of one's life and career. I think burnout can occur when one doesn't listen to the fact that certain types of teaching are not the right choices at a certain phase.
Everyone has made great comments on how to keep a fresh perspective on teaching. Hard to add to these, but I wanted to reiterate a few that work for me:
1.) always re-fresh the material; "canned lectures" should not be part of your vocabulary. There is always some new approach to "old" material and you won't know until you research it. Put a new slant on.
2.) remembering that to the audience the material may not be old at all. They want to hear what you have to say; they want to interact with whom they see as the expert--you. Remember that.
3.) keep in mind that the best way to learn is to research and teach it, share it with others. Open up every "lecture" to questions, and opinions. That will certainly keep you on your toes and keep you digging for new material.
4.) and remember you are a role model to many individuals in the audience. You want them to teach others--
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