What I think…straight up.

It appears that Friday mornings are going to be the routine time for big reflection this semester.  Case in point…I have just gotten out of recording the GRAD 602 Session 3 Podcast with Britt and Enoch, and I’ve been reading some of the early blog responses to last night’s class.  A theme has emerged that resonates deeply with me…in a way that will probably keep me looking fairly pensive for the rest of the day.

Is it ok to experiment with our burgeoning teaching skills on students?
As you all now know (and some of you already knew), I was a board-certified OB/GYN and after delivering 1000 babies in Cincinnati (1009 actually…I had to keep track for certification), I returned to rural Virginia to practice gynecologic surgery.  And while I quit practicing medicine for so many reasons (and NOT because my license was revoked for being a drug addict, as some physicians on our sister campus recently assumed–hearing that particular false rumor was as eyeopening as it was hurtful, quite frankly), the decision to not be a doctor anymore affected me even more than I anticipated.  As Jeff Nugent occasionally says, I am, even three years out from quitting, still a recovering doctor.  When I’m not thinking about it, I still catch myself talking about medicine in the present tense…How “we” do this or that.
Lucky think about such a long recovery, though, is the opportunity to reflect and reflect hard on situations and things that abstract far beyond medicine.  One of those things happens to be the concept of trying new things on people.  When people bring that up I have an awful lot to say.
Experimenting (“Learning”) on patients is an ancient tradition in medicine, particularly in surgical fields.  I mean, you can watch a million videos, attend a million pig labs and cadaver labs (well, not actually, because those labs are extremely expensive and the animal rights activists are going to get you for the pigs eventually) but it is NOT even a million miles close operating on a live human. Simulation-based education is getting better and it has a lot of promise, but it’s not there yet and it’s not even an option for most physicians…yet.   
Of course you can always have an experienced physician standing over you as you practice on live humans, but they have to let you make mistakes so that you can learn.  The trick is that these experts don’t let their students make any mistake that they (the experts) can’t fix…that’s one crazy complicated “trick” to live by, let me tell you.  It’s a trick that I was never willing to let happen, which is why I might go down in history as one of the worst chief residents of all times.  I mean some doctors might be able to look into an open belly and see liver and intestines, but I look into a belly and I see that woman’s eight year old daughter, her pain-in-the-butt job as a clerk at Walmart, and the family vacation she has planned to the Outer Banks in four weeks. No one was allowed to make a mistake in my OR except for me, and it’s not like I was ok with that either. In fact, one intern once told me that all the junior residents had come together and decided that they were alright with me treating them so harshly when they made mistakes because they understood that for as horrible as I was to them, I was ten times more horrible to myself.
Those of us in residency who were “the black clouds” or the magnets for disasters were also considered the strongest surgeons…we knew how to improvise during a power outage or calmly organize a C-section while riding on a stretcher with a seizing patient.  Making mistakes and surviving unexpected situations are the hallmarks of the best educational experiences–and that includes learning how to teach–be it learning how to teach a specific topic, a specific student group, a subject, or teaching in general. If you can’t make the mistake, if you can’t risk the unexpected situation–then you will not be a strong…whatever.
So how do you get through the learning curve fast, and how do you handle it when you flub up?  Here’s my list:
1.  Do your homework.  Just because watching the video isn’t the same as being in the situation doesn’t mean you don’t watch the video.  In the context of teaching that means reading the books, taking the classes, and observing the masters.  If anyone wants books on different exercises or techniques that might help you get out from behind the lectern, I’ve got those and I can hook you up.
2.  Team up with your colleagues who are also learning.  This was something that I missed so desperately when I was a surgeon in the middle of nowhere.  There wasn’t another gynecologist around for 40 miles.  When I wanted to try something new, there wasn’t anyone to give their advice or remind me to do something I was about to forget…this was one of the major reasons I left practice–I couldn’t learn anything new because I didn’t have a partner and I was absolutely unwilling to go too far with my trial and error–if I couldn’t fix my own potential mistakes, I would not let myself take the risk.  The lack of colleagues was paralyzing for me, so don’t let it be paralyzing for you, because you are not alone.  You are surrounded by partners.  You want to try something new in your class? Team up with another instructor–maybe you both try it in your respective sections and compare notes, maybe they come in to your section to watch and then help bail you out if you freeze up…whatever works.
3.  Be honest with the people you are experimenting on.  
  • Example 1. I and a couple of other instructors are doing a pilot study on how to teach mobile learning literacy to undergraduates.  The students know they are being experimented on–we have been very honest about that.  They are in on the plan and they are a highly resilient bunch of kids who are helping us learn as much as we are helping them learn.  
  • Example 2: Many of you Grad 602 students have much more traditional teaching experience than I do.  I mean, I taught residents (poorly) for two years as a senior resident.  I taught patients (more effectively, but still in transmission mode) every day for 9 years.  I coached people in the weight loss program I developed for 2 years.  But I have never ever stood in front of a class as an official instructor.  Last night during that warm-up exercise, when you guys told me I wasn’t making sense and I needed to rephrase the question…and I told you hadn’t the foggiest idea what I was asking you in the first place…that was a huge moment for me.  To be able to tell you that and to have you laugh in a way that told me that you were ok with my (serious) imperfections as a discussion leader, that was a big deal.  Being honest is an ok thing–in fact, it’s probably an essential thing.  And the essential ethical thing when you are experimenting on your students. 

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