Medical education is a professional education

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Medical education is professional education where we are teaching medical students to go beyond our conceptions of what we think they should know and instead should search for what they actually need to know in their daily clinical practice in the future (Markert, Ronald J. )

I am currently involved in teaching psychiatry to medical students .Over the years of my training and practice , my conception of teaching has changed . I am now learning to focus on the students and work with them to select learning goals and objectives . Familiarising myself with the medical students learning objectives and curriculum allows my teaching to be more focussed on the students needs and less driven by my personal views on what I regard as the students need to learn .

When teaching is based on factual content and teachers control the students access to information , there is a high probability of producing surface learners .On the other hand educational sessions where students are encouraged to explore and discuss underlying concepts will help develop higher order thinking skills and promote deeper learning .

It is vital to place the students at the heart of the learning experience . We should set aside some time to understand the prior knowledge of students , their expectations and past experiences in learning so that we can utilise the existing knowledge to our advantage .The cultural perspectives of students should also be borne in mind .

During my teaching sessions , I clarify the expectations of the learners and focus on the students priorities and tasks .In designing tasks and assessments , I try to employ thought provoking tasks and questions which call for critical thinking and problem solving rather than using questions which just test simple recall . Students also learn better when tasks allow them to express personal values.

Research shows that learning activities which require active student processing improve recall by as much as a factor of ten are more enjoyed and create deeper learning .There is no one perfect way to learn something and a variety of tasks and experiences are needed to satisfy individual need .

Students must be made to feel welcome during their learning experience . This experience is crucial as encouragement received during their placement has a positive effect on students' attitudes towards the speciality .

The process of modelling is particularly effective in teaching students professional attitudes and skills .The teaching clinician should be a suitable role model for the students . They should aim to be a skilled professional working effectively with patients , carers and teams to provide the best available evidence based care in a challenging and dynamic field .

While it is necessary for the teacher to be an highly knowledgeable in their discipline ,it is equally important to be enthusiastic and interested in your discipline . The teacher should try to make the relationship between learning and real life clear which in turn will enhance an intrinsic interest to learn .

The emotional climate must be ideal where learners feel safe to speak and receive positive reinforcement . We should work hard to create an environment where curiosity is encouraged , problems related to the discipline are solved by mutual interaction and students are able to apply the knowledge to real life scenarios .When the students realise that the teacher cares about their speciality of interest and also the students ,they will be highly motivated to learn and genuinely interested .

Effective learning is also dependent on the teachers continued professional learning . Teachers /Clinicians should continually update their knowledge as well update their skills and understanding of the learning process in a variety of ways both formal and informal.

The process of student learning will involve errors . We should make sure there are sufficient opportunities for self assessment , correction , peer discussion etc., .

Feedback is a vital part of the learning process . Good feedback needs to be constructive and instructive so that students do not feel that they are criticised but realise it is part of their learning . It is important to provide the students with something on which they can reflect and build upon using the experiential learning cycle . This will also reinforce good practice and promote deep learning .

We have been trying to use some of these principles in undergraduate teaching in psychiatry for students in Bristol .

During the 8 week placement in psychiatry , students have a number of teaching sessions - lectures , workshops , ward based teaching etc.,

We have tried to link the workshops with the introductory sessions and the clinical work (i.e. seeing patients) that the students are doing, in a more explicit and hopefully meaningful way. This maps onto Kolb's learning cycle (Kolb cycle)and create a more helpful learning experience for the students .

The idea is that the students will be getting some knowledge base in the introductory sessions (knowledge transfer), will be able to apply this to clinical experience seeing patients on the wards (experiential) and then present and reflect during the workshops. At the end of the session we review learning objectives and identify unmet learning needs with the students and ask them to come up with some personal action points . We are continuing to evaluate this process.

Learning to learn is a skill in itself . It makes the students more responsible for their learning . Some may struggle with the process but once acquired learning will be an enriching experience and not a chore .

To conclude with the words of Patricia Cross - "The task of the excellent teacher is to stimulate "apparently ordinary" people to unusual effort.  The tough problem is not in identifying winners:  it is in making winners out of ordinary people.". All teachers need to work towards this goal .

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