Teaching is an intrinsic part of working as a clinician, and some may take to it immediately. Others find it hard to meet the demands of the role.
David Evans, vice president for training and assessment, the Royal College of Paediatrics and Child Health (RCPCH), says that the development of teaching skills for doctors has improved in recent years. He trained during the 1970s and 1980s and remembers only too well one approach that doctors used to take to teaching. It was that of the doctor-teacher tyrant, the clinician who believed they were imparting wisdom, when they are actually imparting fear. “I learned by ritual humiliation on the ward rounds,” he recalls.
He also remembers the time when “see one, do one, teach one,” was the standard approach to developing skills. “That implied once you were capable of doing something you should be capable of teaching something, and of course that’s not true - teaching is a different skill from doing,” says Evans.
By the 1990s, attitudes to teaching doctors were changing, and medical schools were being asked to account for the quality of their tutoring. “Now there is definitely more emphasis on trying to equip doctors with teaching skills, rather than assuming that, if you’re a good doctor, you’re a good teacher,” says Evans.
When to start teaching
Those looking for a career in medicine should start developing their teaching skills as soon as possible in their medical career. “Teaching is an intrinsic part of everything we do so we need to start developing those skills straight away,” says Adrian James, registrar, Royal College of Psychiatrists, and the lead on policy, communications and member relations.
Teaching can start as early as medical school for doctors wanting to pass on their learning experiences. But, Helen Stokes-Lampard, chair, Royal College of General Practitioners, says: “it’s never too late to get into teaching and develop a more education-focused strand to your career, as opportunities arise on a daily basis – both with clinical and non-clinical staff”.
Steps to beginning teaching
There are several routes to help students and doctors start developing their teaching skills. Most medical schools have modules on basic teaching skills, and independent organisations provide training in teaching courses. Students can give talks and presentations to fellow students. And they can also get involved with meeting patients, under supervision, to advise them about their health and care, which is another aspect of a doctor’s teaching role.
Medical students and junior doctors need to be proactive about developing their teaching skills. “Take an opportunity to teach and other opportunities will follow,” advises Stella Vig, consultant vascular and general surgeon, Croydon University Hospital, and core surgery training and higher surgical training programme director, south London.
Junior doctors can offer informal teaching when working with medical students or have more junior colleagues around, by explaining what they are doing or thinking. And those who really get the teaching bug can apply for a formal teaching post perhaps in parallel with a higher teaching qualification, says Stokes-Lampard. Doctors can also learn from how other clinicians teach, and should dissect their techniques and consider what makes one teacher good and why another’s teaching is not as effective.
How to develop teaching skills
One of the main teaching skills doctors need to acquire is to be “focused on the learner”, says Evans. “Have empathy with the learner and remember there are many learning styles – for example, some people are visual learners, others reflective learners - it’s not ‘one size fits all’, and be prepared to adapt to an individual’s learning style.” To broaden your experience of teaching, he suggests teaching different groups, from lectures to small classes.
Teaching skills can also include anything from “developing your own emotional intelligence and communication skills through to established techniques used for running different sorts of educational sessions and developing teaching materials”, says Stokes-Lampard. Doing a medical education qualification “is a good way of ensuring you have a core skill set”, and many universities offer these from CertEd up to MEd /MSc levels, she advises.
Knowing your audience, having key goals for the lesson or lecture, and thorough preparation, such as knowing the layout of the room you are teaching in, and ensuring you have the materials you need, are essential requirements for effective teaching and learning, doctors say.
Asking for feedback from others can help to hone your teaching skills. “Find out what went well, what you could do better, whether you’ve sent the tone of the teaching session to high or if it was too basic, and learn from the feedback,” says Vig.
Improving your teaching skills
Even after having acquired teaching skills there is no room for complacency and it is important to continue to ask for feedback about your tutoring abilities. “There are a variety of ways to get feedback, such giving out feedback forms before the end of a teaching session,” says Evans.
You could also ask a colleague who you trust or think is a good teacher themselves to come and observe your teaching, and feedback to you, he suggests.
Keeping up your training is essential to remaining an effective teacher. “The best way to do that is to practise, attend updates and further education courses, and make sure you network with other educators,” says Stokes-Lampard.
Attending medical educational conferences can be a source of new teaching inspiration, and should not be confined to your specialty, advises Vig. “Rather than learning say from purely a surgeon’s perspective, you can learn a lot for a multiprofessional conference,” she says.
Becoming a member of an educational organisation can also help clinicians to continue their learning from the wider healthcare profession about teaching skills, she says.
As well as taking advantage of informal ways to improve their teaching, doctors who are trainers are also formally required by the GMC to show evidence of their ongoing learning. This means, Vig says, that the days of the doctor-teacher tyrant style of teaching “are over”.
Not everyone is a natural trainer, “and our profession needs to be clear about that,” she says. But training is available for clinicians who want to use their skills for management, research, and innovative service provision.
To keep your approach to teaching fresh it’s important to ring in the changes. “Look at different way of doing things, and try changing your topics over time,” says James.
He says that doctors who want to extend their teaching abilities should seek different audiences, for example over the years he has given talks to MPs. “Put yourself out there to different and demanding audiences,” he says. “It’s really important to learn, and you can teach and give talks in a variety of ways to different audiences.
“It’s tempting to stay with what you feel safe with. But you need to stretch yourself and get out of your comfort zone to improve your skills.”
Further advice on developing effective teaching skills is available here: https://www.bmj.com/content/344/bmj.e765