When speaking with educators who identified as women and under-represented minorities, many shared stories of being mistaken for a nurse or custodial staff, rather than being seen as a physician. Others shared stories about how an educator’s authority was directly questioned or challenged by learners and patients. These situations can make the prospect of effective teaching challenging. Although there’s no one-size-fits-all solution for every situation, Dr. Houchens implored the audience to use these moments as teaching opportunities. While maintaining good therapeutic relationships with patients, colleagues and learners, individuals should professionally address such situations rather than turn a blind eye.
Feedback
A key part of the educator-learner relationship is also the expression of helpful, effective feedback. During the session, Rachel Levine, MD, MPH, an associate professor of medicine and associate dean for educational faculty development at Johns Hopkins School of Medicine, Baltimore, discussed this topic in detail.
Generally, giving feedback can be challenging, but it’s often more difficult in the context of academic medicine because feedback and assessment can be implicitly or explicitly linked. This context can result in learners worrying that every tidbit of feedback they receive may be reflected in their grades or affect their prospects of entering residency or fellowship programs. Dr. Levine asked the audience to reconceptualize feedback as a dialogue rather than a monologue, allowing context and relationship to be the dominant factors for enabling behavior change. Example: By focusing on the teacher-learner relationship, educators can promote credibility and trust while giving feedback, making it more likely the discussion will be fruitful, elucidating and well received.
Some key fundamentals of feedback discussed by Dr. Levine included basing feedback on direct observation, providing specific and targeted feedback that focuses on learner goals and avoiding providing excessive amounts of feedback in a given session. Also, educators should use non-judgmental language and interpersonal skills, such as active listening, to demonstrate respect and positive regard for all learners.
Many educators are familiar with the feedback sandwich, in which a criticism of a learner is given between positive opening and closing statements. However, this practice has pitfalls. It’s unilateral and does not loop the learner into the discussion. It may have the effect of learners not hearing important parts of the conversation because they are focusing on the criticism they know is coming. Additionally, the feedback may come off as disingenuous. The learner may feel the positive comments were artificial and manufactured to soften the blow of the criticism.
