Diagnosing the Educator

We often hear about diagnosing a learner, recognizing areas of strength, and identifying any potential gaps in knowledge or communication skills. Rarely, however, do I diagnose myself as an educator. A recent experience reminded me that checking in on my areas of growth benefits my learners as well.

I had just finished a busy week on inpatient service. From my perspective, our team had operated like a well-oiled machine. We did family-centered rounds at the bedside with the family and the nurse. We heard great feedback about how all parties felt involved. We saw fascinating rare diagnoses and more influenza than you can shake a stick at. We set goals, defined roles, gave real time and formalized feedback. It was medical education at its best! Or so I thought.

I sat down to review my evaluations for the week and received a piece of feedback on an evaluation that left me, frankly, flabbergasted. “I did not find it educational to listen to rounds on patients I was not following.”

If I lived in a TV comedy, the record-scratch would be inserted here. I read the line many times over because I could not believe that this was possible! Did we just experience the same week? As an educator I look around and see learning opportunities everywhere. Even if we see 5 patients in a row with the exact same diagnosis, which is not hard to imagine in a busy pediatric hospital in peak respiratory season, each encounter offers an opportunity to dive more deeply into differentiating physical examinations, learning communication strategies, and so much more.

My first instinct was to flip this feedback onto the student: maybe the student did not embrace their role as an adult learner. Or maybe they weren’t listening hard enough. Then, I wondered if there were actually missed opportunities here for me. At the beginning of service weeks, I work with trainees and students to identify learning goals for our time together. What I do not routinely do is ask them how they best learn. Regardless of whether learning styles have merit or not, understanding how my trainees view their optimal learning helps me to understand what I may need to highlight. I might have understood that this student felt they didn’t learn well by just listening. I could have underlined that there is much more to do than listening on rounds. We can observe body language to see what it tells us about how a patient is feeling. We can grab a marker and do our best to relay the plan in simple language on the whiteboard. We can engage all our senses (maybe not taste, admittedly) and find learning everywhere.

Much like the signposting we do for giving feedback, signposting for learning will be a new process for me. Moving forward, I will take a moment to prompt this learning. “What did you take away from seeing Dr Singh work to calm that mother’s fear?” “Was there anything you observed when watching the infant breathe that you think clued folks in that her respiratory needs have escalated?” Not every piece of learning requires a student to be hands-on or the primary person carrying the patient. Everyone benefits from remarking upon the learning to be had.

My view that learning is everywhere remains strong. There was a time when I, too, was tired of feeling like I was engaging in something that I felt was far off from what my future beheld. (I’m looking at you, operating room.) When I put myself into my trainees’ shoes, I understand how they could view rounds as a waste of time. With this honest feedback, I can sharpen my skills to make learning even more explicit. For me, this was the right time to diagnose the educator.