The fifth in a series of six short articles for delegates who have attended the Oxford Medical Training Teach the Teacher Course for Doctors.
Top Tip #5: Challenge and support.
Great teachers work with their learners for feedback and challenge.
It is helpful for a learner to know what they are doing well in order to maintain motivation and confidence. It’s imperative, on the other hand, that they are aware where they must make improvements to their knowledge, skills and attitude. Otherwise, how will they know where to focus their attention? Any doctor who is unaware of their limitations is an unwelcome, even dangerous presence in healthcare.
One approach which a teacher can utilise to develop their learner’s awareness is through ‘Confronting’. Confronting is one of Heron’s six interventions described in Section 4.02 of Teaching Skills for Doctors – the book you received when you attended your Teach the Teachers Course a couple of months back. This particular intervention is one which can cause a degree of confusion to the inexperienced teacher. Confronting interventions include:
- Challenging thinking, behaviour or attitude
- Direct questioning
- Disagreeing
- Correcting
- Giving direct feedback.
Some may confuse the concept of Confronting with aggressive behaviour. They concern themselves that this will leave them open to accusations of bullying. There are, for example, some student doctors with track records of brilliant, knowledge-focused, academic performance who have never been challenged. Throughout university they were always top of the class. How then to talk to them about their shoddy patient communication or lack of technical dexterity without causing offence? An ineffective teacher may find themselves avoiding saying what needs to be said in order to avoid awkward situations.
Great Teachers, on the other hand, recognise that they have a duty to bring such shortcomings to their learner’s attention. They realise that failing to raise awareness is a failure in their teaching. They also know that it is possible to undertake Confronting interventions without any hint of aggression. Confronting is the act of brining something to the learner’s attention to increase their awareness. In the vast majority of cases, it is the manner of the Confronting that will make the lasting impression on the learner.
The Great Teacher knows that numerous factors, ranging from tone of voice, location and the utilisation of good feedback or review models can make all the difference. They also make good use of other interventions. Catalytic interventions include asking questions to encourage the learner to think for themselves. Cathartic interventions range from empathising to the use of humour to release tension. Supportive interventions include the use of praise and recognition of effort or progress. Great Teachers are both challenging and supportive.
It can also be helpful to consider any collection of teacher(s) and learners as a team. For people to feel and function effectively within a team they need clarity in terms of common goals, the processes which will be used, roles and responsibilities. To function as a team people also need to form relationships.
Factors which support positive working relationships include trust, openness, candour, tact and respect. Great Teachers work with all of these elements. They work with their learners. They discuss their approach with their learners, agreeing how they will work together in advance and regularly reviewing how they are progressing. Great Teachers are more than just masters of reviewing, critiquing and giving feedback to their learners – they are master of reviewing with, seeking critique and feedback from their learners.
We’ll trust you have enjoyed this Top Tip for Great Teaching Practice and we look forward to supporting your development further either now, or in the future.
Stephen McGuire -Head of Development
