What is it I do, exactly?

I found this week’s article, “A framework of teaching competencies across the medical education continuum” by W. M. Molenaar, very thought-provoking. I was especially interested in the six Domains of education they described: Development, Organization, Execution, Coaching, Assessment, and Evaluation. As junior faculty in one of the clinical departments (psychiatry) it is quite striking how rarely one hears specific terms used to describe the education activities that faculty members participate in. Without a language and a framework for these activities, sometimes it becomes difficult to understand, or even track, what exactly it is I spend my time doing.

Sometimes people say to me, you do a lot of teaching, don’t you? As I read this article, I thought about the fact that while it is true that I do a great deal of direct teaching (“Execution” it would be called in this framework), many of my Education responsibilities actually fall into other categories, and it is these activities that often take up a great deal of time.

Consider our psychiatry patient-doctor program, for which I am responsible. At the beginning of the block, I meet with the students as a group for an introductory session, which is direct teaching or “Execution”: but that is only part of what I do.

I have developed and revised curriculum for this block, which would be “Development”. Lately I have spent a great deal of time meeting with people about trying to get on-line tutorials for this block on to some sort of user-friendly technology, a task I would consider to be “Organization”. I plan and deliver an annual tutor workshop, which is a form of “Coaching” for those who provide most of the direct teaching and supervision in the program. I review the overall results for the block (this is “Assessment”, and it is the lightest responsibility of them all, as nobody ever fails), and the evaluations the students complete on their supervisors (“Evaluation”). I am hoping to do some research on my latest innovation in the curriculum for this unit, an objective on self-reflection which I hope could be useful in teaching professionalism.

Co-ordinating the patient-doctor teaching is just one example of the many education-related activities I undertake in our department. I believe my contribution to our department’s education mandate is significant, but it has not always been easy to say what I do and why it is more than just “teaching”. Hopefully using this framework to explain my activities to myself and to others can help me to set goals, focus my efforts and continue my professional development as an educator.

being an adult learner

Five characteristics of adult learners (Knowles)

1. Adult learners move from dependence to self-direction in learning.
2. Adult learners have a rich reservoir of experience to apply to their learning.
3. Adult learners value learning that is relevant to their daily life.
4. Adult learners have a greater focus on problem-centered than on subject-centered learning.
5. Adult learners are motivated by internal rather than external motivators.

Thinking about this as an adult learner, I am particularly struck by number 2 and number 3. With this masters, I have been very concerned about relevance, and it is my experience that dictates what I find relevant.

"Today’s physicians continue to witness significant change in the nature of health care delivery. The roles of all health professionals, hospitals, patients, funding bodies, and governments are evolving at a hurried pace. Practice is changing daily, with literally thousands of medical journals documenting our evolving understanding of biological, social, and clinical sciences. Patients are treated in more diversified settings. They spend less time in hospitals, and those who are there are older and sicker. We live in an era with a rising emphasis on accountability and a declining appreciation of professionals and various authorities. Never has the true nature of a physician been such at risk. The question arises, as it did at the Royal College at the beginning of the 1990s: “How can we best prepare physicians to be effective in this environment and truly meet the needs of their patients?”" (Page One, CanMEDS 2005).

My question: what does it mean, "Never has the true nature of a physician been such at risk?" What is the true nature of a physician anyway? And is that even proper English?