Why I Teach – Lainie Yarris, M.D., MCR

In October 2012, six members of the School of Medicine faculty were recognized by their peers for excellence in teaching. This Q&A series profiles recipients of the 2012 "Faculty Excellence in Education Award" and asks them the question, "Why do you teach?"

Dr. YarrisMarch 27, 2013

This month's Q&A features Lainie Yarris, M.D., MCR, associate professor of emergency medicine.

Dr. Yarris is a 2002 graduate of the School of Medicine's M.D. program. She joined the Department of Emergency Medicine in 2005 as an education fellow and in 2007, became a full-time faculty member. Dr. Yarris is a small group facilitator in the Principles of Clinical Medicine preceptorship program, and teaches medical students and residents in emergency medicine. She is the co-director of the Emergency Medicine Education & Education Research fellowships, program director for the Emergency Medicine Residency Program, and directs the Education Scholars Program, a faculty development program for educators. She is on the editorial boards for the Journal of Graduate Medical Education and Academic Emergency Medicine, and her main education research interests involve feedback in medical education, simulation and faculty development.

Dr. Yarris's husband is also an emergency physician, and points out their three children (ages 4, 8 and 11) know that other kids don't necessarily have parents that sleep during the day, talk about strange things at dinner, and don't let them do anything on the playground. She enjoys spending time with her children, cooking, knitting, yoga, and training for triathlons with her husband.

Q&A with Lainie Yarris, M.D., MCR

Why did you first become attracted to an academic career?

I first became interested in academics in medical school. I had so many amazing teachers and mentors at OHSU, but there are teachers you learn from, teachers you admire, and then teachers that you want to be like. I realized early on that those whom I wanted to be like each provided fantastic care to their patients and role-modeled empathy and effective communication, but also were lifelong learners and were passionate about teaching. Although I graduated from medical school over 10 years ago, I still think of my early pre-clinical mentors as the individuals that played the greatest role in shaping my interest in a career as an academic educator. In particular, my experiences with my first clinical preceptor (Scott Fields, M.D.), my first PCM small group leader (Lynn Loriaux, M.D., Ph.D.), and my first mentor in emergency medicine (Pat Brunett, M.D., FACEP) all played a crucial role in my decision to pursue academics.

Why do you teach? Can you provide an anecdote that illustrates this?

There was a time in my career that I thought I would go into community practice, because I do truly love the clinical practice of emergency medicine, and find direct patient care meaningful, challenging and rewarding. However, I have realized that sharing and processing patient encounters with learners makes me more mindful of the meaning in our everyday practice – without learners I might get caught up in the chaos and pace of emergency medicine, and neglect to appreciate these moments. Even more, I find parallel meaning in the practice of teaching – working with medical students and residents pushes me to be my best, and I have found tremendous rewards in the natural mentoring relationships that develop in academic medicine, both as a mentee and a mentor.

Have you modeled your teaching style or philosophy on anyone?

I'm sure that in my roles as preceptor, small group facilitator and attending I subconsciously channel those who taught me. There are so many fantastic teachers at OHSU! I think my teaching style and philosophy were also influenced by Judy Bowen, M.D., and the training I received as an education fellow. However, I think my style and philosophy were also influenced by situational factors – I joined the faculty in an institution where I trained for both medical school and residency, as a young female in a field where women were still underrepresented. Although I found both my department and OHSU to be extremely supportive, I also found that some of the styles that I had found effective and admired as a learner didn't feel natural to me – I was struggling with feeling like an imposter, and had the perception that as a brand-new attending I didn't have the experience or expertise to teach much to our talented group of residents. However, I did find that I could relate to them, and that we could learn together. Furthermore, Dr. Bowen's teaching on theories of learning empowered me to understand that I didn't have to be a content expert in order to identify a learner's knowledge gap, or help identify where their diagnostic reasoning processes broke down. This prompted me to adopt an informal, collaborative teaching style that felt comfortable and genuine to me.

Are great teachers born, or are they made?

As a strong advocate for dedicated professional development for educators, and the director of a post-graduate education fellowship, I believe they are made! While there are definitely innate characteristics that make certain individuals well-suited to a teaching role, I think every educator can benefit from training and ongoing practice with opportunities for formal feedback.

What are the great challenges to teaching in the 21st century?

As a medical education community, one of the great challenges we face is redefining the role of educators in academic medicine, so that we inspire talented individuals to pursue academic careers, provide training to allow them to succeed as teachers and scholars, and both recruit and retain the best and the brightest. Other challenges include rethinking the traditional model of medical education to align with current understanding about how doctors learn, and incorporating technology into our teaching and learning in an effective way. Reforming our assessment strategies and redefining our notion of "competency" are also challenges many are struggling with currently.

Does the wide-ranging diversity of your students affect how you teach?

 I think the diversity of backgrounds, life experiences and career goals that I see in my students reinforces the importance of being flexible in my teaching approach, and makes it crucial to start by identifying where the learner is before making assumptions about where I think they should go. My role is much more a partner and coach than an authority figure or source of information, and sometimes what I want to teach them is very different from what they actually need to know. Remembering this helps increase my effectiveness as a teacher.

What do you think education will look like at OHSU in the future?

 I can't wait to see! I hope to see more interprofessional learning, less lecture hall time, more integration of basic science, pathophysiology, and clinical training, and innovative use of social media and new learning platforms.

What advice do you have for people who would like to follow in your path?

Spend some time thinking about your core values, or what's truly important to you in life. Select a career path that is most congruent with these values. Once you determine the path that feels right to you, don't be deterred by the challenges you anticipate facing. As a medical teacher, you have more control over your career than you think you do. When I started my fellowship, I was excited for the opportunity to develop a niche in medical education, but I was also concerned that I was embarking on a career path that wasn't possible or practical for me. The idea of balancing my family, individual interests and career was daunting. I have discovered since then that for me "balance" is less important than work-life integration, and my happiness is not dependent on the amount of free time I have, but more related to having a sense that my days are filled with activities that I find meaningful.