ERIC ED369734: Doctors' Stories on Teaching and Mentoring. Fastback 369.

36 Pages·1994·0.58 MB·English

by  ERIC

DOCUMENT RESUME
SP 035 155
ED 369 734
Dollase, Richard H.
AUTHOR
Doctors' Stories on Teaching and Mentoring. Fastback
TITLE
369.
Phi Delta Kappa Educational Foundation, Bloomington,
INSTITUTION
Ind.
ISBN-0-87367-369-7
REPORT NO
PUB DATE
94
NOTE
36p.
Phi Delta Kappa, P.O. Box 789, Bloomington, IN
AVAILABLE FROM
47402-0789 ($1 members, $1.25 nonmembers).
Non-Classroom Use (055)
Guides
PUB TYPE
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EDRS PRICE
Clinical Experience; *Clinical Teaching (Health
DESCRIPTORS
Professions); Conceptual Tempe; Cooperating Teachers;
Educational Practices; Family Practice (Medicine);
Higher Education; *Medical Students; *Mentors;
*Physicians; Preservice Teacher Education; Problem
Solving
ABSTRACT
This pamphlet presents the thoughts of six physician
mentors in family practice and their third ar medical students, as
they reflect on their practice and on thei. teaching or learning of
clinical skills. An examination of the role of the family-practice
physician as mentor may help teacher educators and cooperating
teachers gain a valuable perspective on the common tasks and
challenges that these two caring professions face in preparing the
next generation of their members. The pamphlet analyzes the mentor's
(1) the mentor's philosophy of care and how the
role in terms of:
(2) the nature of
mentor communicates his or her vision to students;
the physician's teaching and mentoring, particularly in regard to how
the physician gives "bad news" and deals with difficult patients; and
(3) helping prepare the newcomer to tolerate uncertainty and to
reflect more critically on the daily experiences of medical practice.
Lessons for teacher education are discussed, emphasizing that:
competent cooperating teachers, like good medical mentors, are
dedicated professionals who follow best practice and provide
continual support and increasing autonomy to their students;
cooperating teachers must make more explicit the model of problem
solving and decision making they employ; and cooperating teachers
need to develop ways to promote student teachers' critical
reflection. (JDD)
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Reproductions supplied by EDRS are the best that can be made
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FASTBACK
369
"PERMISSION TO REPRODUCE THIS
MATERIAL HAS BEEN GRANTED BY
TO THE EDUCATIONAL RESOURCES
INFORMATION CENTER (ERIC)
Doctors' Stories
;.4
On Teaching
And Mentoring
Richard H. Dollase
U.S. DEPARTMENT Of EDUCATION
Office of Educational Research and Improvement
EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
C This document has been reproduced as
received from the person or orpanizetton
originating it
C Minor changes have been made to improve
reproduction quality
Points of view or Opinions Stated in this dotu .
ment do not necessarily represent official
OERt position or policy.
PHI DELTA KAPPA EDUCATIO AL FOUNDATION
-476'Y
RICHARD H. DOLLASE
Richard H. Dollase is director of the Teacher Education Program
He teaches a varie-
at Middlebury College in Middlebury, Vermont.
curriculum,
ty of undergraduate courses in educational foundations,
and teaching methods and also supervises social studies student
teachers. In addition, he teaches a seminar substantially devoted to
ethical issues in health and medical decision making.
Dollase serves as a project director for a number of conferences
and summer institutes on teacher education and the liberal arts, spon-
sored by the National Endowment for the Humanities and the Na-
tional Science Foundation. Recently he helped to establish a
school-college partnership with Middlebury Union High School and
other area schools.
Dollase is the author of several articles and curriculum materials,
including his co-authored four-volume series, Black in White Ameri-
of Beginning Teachers: Visions and Real-
ca. His recent book, Voices
ities, was published by Teachers College Press in 1992.
Series Editor, Donovan R. Walling
Doctors' Stories on
Mentoring
Teaching and
by
Richard H. Dol lase
Card Number 94-65071
Library of Congress Catalog
ISBN 0-87367-369-7
Foundation
Delta Kappa Educational
Copyright © 1994 by the Phi
Bloomington, Indiana
4
This fastback is sponsored by the Ohio
State University Chapter of Phi Delta Kappa,
which made a generous contribution toward
publication costs.
The chapter sponsors this fastback in hon-
V. Wigtil, professor and depart-
or of James
Ohio State
ment chair, College of Education,
University. He has served the chapter in var-
including two terms as
ious capacities,
president.
Table of Contents
Looking into Medical Education
7
Teaching on the Go
1 1
Ethical Questions: Giving Bad News and
Dealing with Uncertainty
15
Working with Difficult Patients
18
Educating Patients
21
23
Evaluation of Medical Students
27
Lessons for Teacher Education
28
Best Practice
32
Opportunities for Critical Reflection
34
References
*tio
Looking into Medical Education
of teacher education, an analysis of how
in this time of reassessment
students for the real world of
family physicians help train medical
substantive preparation
practice may be valuable in improving our
educators can gain from listening
of beginning teachers. The insights
mentoring medical students in family prac-
to "doctors' stories" about
tice is the focus of this fastback.
gain a vision of and foster the
A mentor can help the young adult
Robert Coles says of his
development of a professional identity.
William Carlos Williams, "For me, to
mentor, physician and poet
about his writing and this life
know Dr. Williams, to hear him talk
working people of northern New
of medical work among the poor and
markedly. Once headed for teach-
Jersey was to change directions
school" (Coles 1984).
ing, I set my sights for medical
Seasons of Man's Lfe (1978):
Daniel J. Levinson asserts in The
the most complex. and develop-
"The mentor relationship is one of
early adulthood." Levinson be-
mentally important a man can have in
for young women in the
lieves a mentor is equally important
welcomes the individual into the
professions. He says, "The mentor
adult into its values, cus-
world of work and introduces the young
characters." The mentor also serves as
toms, resources, and cast of
emulate. He
the beginner may admire and seek to
an exemplar that
times of stress."
"counsel and moral support in
or she provides
7
the mentor:
Levinson also speaks to the value of mentoring to
significant rela-
Being a mentor with young adults is one of the most
is a measure
tionships available to a [person) in middle age. There
of doing
a sense of meeting an obligation
of altruism in mentoring
is involved:
something for another being. But much more than altruism
making productive
the mentor is doing something for himself. He is
and skill in middle age. He is learning in
use of his own knowledge
is maintaining his connection with
ways not otherwise possible. He
in himself. He needs
the forces of youthful energy in the world and
recipient needs him. It is
the recipient of mentoring as much as the
known.
time that this simple truth becomes more widely
undertake a number of
In medical education, third-year students
health clinics in
four- to I2-week rotations at teaching hospitals or
and family
such fields as emergency medicine, pediatrics, surgery,
third-year students
practice. In the family-practice rotations, the
who serve as men-
apprentice in the field with experienced physicians,
these physicians tutor medical stu-
tors. Like cooperating teachers,
evaluate their progress
dents, observe the neophytes in action, and
and competence.
essential professional
This apprenticeship is the basis for teaching
world" of medicine.
skills and for socializing newcomers to the "real
physician as men-
An examination of the role of the family-practice
and cooperating teachers gain a differ-
tor can help teacher educators
the common tasks, problems, and
ent and valuable perspective on
in preparing the next
challenges that these two caring professions face
generation of their members.
family physicians is unique
The mentoring of third-year students by
rotation do medi-
in medical education. Only in the family-practice
closely and continuous-
cal students have the opportunity to work so
develop a personal
ly with a skilled medical specialist and to
educators is:
relationship with a mentor. A key question for teacher
the professional growth
How does such a mentorship program promote
mentor?
of both the medical student and the
8
will be on:
The focus in analyzing the physician's role as a mentor
the mentor communicates
1) the mentor's philosophy of care and how
of physician's teaching and
his or her vision to students, 2) the nature
physician provides help
mentoring, particularly in regard to how the
news" and dealing with difficult pa-
to the beginner in giving "bad
tolerate uncertainty
tients, and 3) helping prepare the newcomer to
daily experiences of medical
and to reflect more critically on the
practice.
female) who served as
In 1989 six physicians (five males and one
medical school in the Northeast were
mentors for a public university
Five of the six phy-
interviewed and observed at their office or clinic.
predominantly white, working-
sicians maintained medical practices in
and cities. Several of these
class, or lower-middle-class small towns
Asian immigrants as
practices had Spanish-speaking and Southeast
moderate-size city near a major
clients. One doctor's practice was in a
white, middle-class
metropolitan center. His patients were mainly
professionals.
observed interacting with
All of the experienced physicians were
their third-year students
patients in the examination room and with
students also were observed
in their offices and hallways. Third-year
in the presence
performing the medical interview by themselves or
they were at the beginning or
of the mentor, depending on whether
end of their family-practice rotation.
medical students share
Throughout this fastback physicians and their
their teaching or learn-
their stories, reflecting on their practice and on
reflective
method of inquiry, ,
ing of clinical skills. As a practical
bin often messy world
storytelling helps unlock the richly complex
physician is at work heal-
of the doctor's office, where the practicing
retelling their stories, the cen-
ing, teaching, and making a living. In
view of what is important"
tral focus is on portraying the "insider's
The doctors' stories also reveal
in medical practice (Lightfoot 1983).
uncertainty, instability, unique-
what Schon terms "the complexity,
central to the work of professional practice"
ness, and value conflict
(Schon 1983).
9
9
with a family-
For many third-year medical students who are placed
clinic, this field place-
practice physician or at a health maintenance
with a physician who will work
ment is their first sustained contact
practice serves a
with them daily on a one-to-one basis and whose
psychological needs.
diverse clientele with a variety of physical and
observing the physician
Initially, the cycle of the rotation involves
third-year students undertake typical medi-
at work. Gradually, the
in the presence of the
cal procedures, at first performing these tasks
the several steps of the medical
mentor and eventually completing
the physician.
interview on their own and reporting their findings to
follow a standard prac-
Third-year medical students are required to
accountable for
tice. Written records are kept, and the students are
field. They gain a technical
acting according to best practice in the
They
understanding of best practice through methodology courses.
in the clinical site, where they are continually
engage in best practice
is more to best practice than
critiqued by the mentor. However, there
standard procedure. What also
technical competence and following a
how the medical doctor
of medicine
counts is the "human face"
structure the
views his or her role as a care-giver and attempts to
patients' hopes and
doctor-patient relationship in order to respond to
fears, as well as their physical needs.
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