Professionalism in teaching

On Friday, November 16th, I had the pleasure of attending a workshop sponsored by the OHSU Graduate School of Medicine called: “Professionalism in Medical Training: How We Can Challenge the Hidden Curriculum.”  The session was facilitated by Karen Adams, MD, Andrea Cedfeldt, MD and Josh Kornegay, MD.  Not only did the content and activities of the workshop engage participants in a thoughtful consideration of issues related to professionalism, the facilitators also “walked the talk” by facilitating a session that inhabited the behaviors and responsibilities that were advocated in the workshop.  The session focused on professionalism in Medical Training, and I couldn’t help but make connections to professionalism in teaching.  Although the majority of the workshop was spent in small group and large group discussion, the facilitators also presented findings and analysis from research in the field of professionalism.  The list of medical professional responsibilities that was shared, in particular,  could transfer directly to teaching (in any discipline), which were:

1.  Professional Competence
2.  Honesty with patients
3.  Patient confidentiality
4.  Maintaining appropriate relations with patients
5.  Improving quality care
6.  Improving access to care
7.  Just distribution of finite resources
8.  Scientific Knowledge
9. Maintaining trust by managing conflicts of interest
10. Professional responsibilities
 

 

I like the clear language and focus on the patient evident in these responsibilities. What would it look like if we were to substitute the word “student” for patient, conceptually in this list?

  1. Professional competence for teaching faculty means understanding the basic tenets of pedagogy and assessment, adult learner theory and what it means to teach ethically in culturally appropriate ways in diverse classrooms.
  2.  Honesty seems simple at first glance, however, it’s not simple, nor easy to be honest when providing feedback to students regarding their performance, especially when it’s clear that they are putting forth their best effort and falling short, or when feedback becomes complex because of the context of the performance.
  3. Maintaining Confidentiality   Medical professionals are constantly aware of the constraints around PHI (Protected Health Information) however, FERPA (Family Educational Rights and Privacy Act) creates a class of protected information related to education.   With all of the cloud-based technologies and digital communication tools, protecting student confidentiality has grown more complex.
  4. Appropriate Relationships  There have been many stories in the press regarding faculty who have not maintained appropriate relations with students, but to truly be professional in these relationships, faculty must walk the line between caring for students’ best interests and taking a personal interest in their lives, a key component of constructivist teaching, while maintaining a professional role as the teacher.
  5. Quality Education   Ever since the release of the “A Nation at Risk” report, and the standards movement was launched in 1983, there has been a lively debate about what a quality education, K-20, looks like.  However, any definition of quality should involve clear expectations, an understanding of the instructional context for teaching, multiple opportunities to learn and appropriate formative and summative assessment.
  6. Access to Education   In theory, one of the basic tenets of democracy is equal access to education.   In reality, the opportunities for quality education are largely dictated by socioeconomic factors.   As professional educators, we need to continually examine the ways that our systems and programs exclude or include students from diverse backgrounds, including students with disabilities and “unconventional” students who are challenged by the circumstances of their lives to participate in education.
  7. Just as with the considerations for equal access to education, the same concept applies to the just distribution of finite resources.  When academic programs, scholarships and other financial resources for students are limited, or re-allocated, professional educators need to look closely at the relevant data to determine who will be impacted by those decisions.
  8. It might be surprising to some to consider that there is now considerable scientific knowledge about best practice in teaching.   For example, The Education Resources Information Center (ERIC) is the “world’s largest digital library of education literature” and there are literally decades of qualitative and quantitative studies regarding teaching and learning.   Perhaps the most exciting area of research in education is in the field of neuroscience, which has already provided critical insights into how the brain learns.
  9. At first glance, faculty are not confronted with “managing conflicts of interest” in the classroom.  However, the administrative pressures on faculty and teachers to “pass” students because of financial considerations for the institution (tuition dollars) or to “teach to the test,” so that students can pass professional examinations, can provide ethical dilemmas, especially when faculty are pressured to act in the best interest of the institution or program, instead of the best interest of the student.   There has been considerable conversation around “failing to fail” students who are not performing and the implications on both the individual student and the profession.
  10. Last but not least professional responsibilities for faculty are influenced by the personal factors discussed at the workshop, including : quality of life,  balance between personal /professional life,  burnout/depression/stress and addiction/substance abuse.   Faculty who see large numbers of students each day, with substantial clinical and/or administrative responsibilities can find it difficult to engage in the professional, collaborative processes and activities required in academic contexts.

In his book “The Courage to Teach: Exploring the Inner Landscape of a Teacher’s Life,” Parker Palmer writes: “Good teaching cannot be reduced to technique; good teaching comes from the identity and integrity of the teacher.”   As students, we don’t necessarily remember the teacher who gave the most lively and engaging lectures, or the faculty who had the best portfolio system or most compelling use of media and text.   Instead, we remember the teachers and faculty who had an impact on our lives as well as our education.   Faculty who enter the classroom as emotionally and psychologically healthy individuals, conduct themselves ethically and with integrity and are guided by genuine compassion and empathy, are the true professionals, challenging the hidden curriculum in the classroom as well as in the clinic.

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