Skills we want our students to have

wood_carver-573x341This post was inspired in part by this article on the 10 skills that every student should learn. These are some of the skills that we’re intentionally trying to help our students develop, as a way of integrating them into the culture of professional clinical practice.

  1. Reading carefully. If you can read you can learn anything, it is the gateway to all knowledge.
  2. Touch type. Not being able to type is the modern equivalent of not being able to write.
  3. Write persuasively by developing and supporting arguments with evidence. Our students must develop the skill of communicating in the language of the profession. Writing also means being able to structure their work, because there is meaning in structure. It helps to develop logical thinking, beginning with an introduction, developing the argument, and concluding it. Drafting is an important means of refining their understanding, and discarding ideas that don’t fit. Simplify the sentence so that it conveys only what is necessary. Being concise and clear in presenting their thoughts.
  4. Conduct research. Identify missing knowledge or information. Question everything. For everything that they do or say, they need to have a reason. Why do a grade 3 and not a grade 4 mobilisation? Why at L3 and not at L5? Why stretch the soleus and not the gastrocnemius? A healthy skepticism should inform their learning. Think like scientists. Be comfortable saying: “I don’t understand, can you explain that again?”. Developing their own questions as a way of finding answers to fill in gaps in their own knowledge. Challenge authority. Question the way that the world is (or the way it is presented to you) with the intention of figuring out ways to make it better.
  5. Use technology as part of their learning environment. Developing skills in managing information. Searching, filtering, aggregating, summarising, synthesising, and sharing information. Identifying credibility in a source. Know when to stop looking.
  6. Collaborate. Working together to solve complex problems.
  7. Accountability. Make a statement of belief, backing it up with evidence. Stand by your statement. Commit to it.
  8. Care. Care about what you’re learning. Care about doing your best.

I’m sure that I could carry on with this list, seeing that there are clearly many other skills that we aim to develop. But for now, I think that this is a useful point at which to pause and reflect.

Results of my Delphi first round

I’ve recently finished the analysis of the first round of the Delphi study that I’m conducting as part of my PhD. The aim of the study is to determine the personal and professional attributes that determine patient outcomes, as well as the challenges faced in clinical education. These results will serve to inform the development of the next round, in which clinical educators will suggest teaching strategies that could be used to develop these attributes, and overcome the challenges.

Participants from the first round had a wide range of clinical, supervision and teaching experience, as well as varied domain expertise. Several themes were identified, which are summarised below.

In terms of the knowledge and skills required of competent and capable therapists, respondents highlighted the following:

  • They must have a wide range of technical and interpersonal skills, as well as a good knowledge base, and be prepared to continually develop in this area.
  • Professionalism, clinical reasoning, critical analysis and understanding were all identified as being important, but responses contained little else to further explain what these concepts mean to them.

In terms of the personal and professional attributes and attitudes that impact on patient care and outcomes, respondents reported:

  • A diverse range of personal values that they believe have relevance in terms of patient care
  • These values were often expressed in terms of a relationship, either between teachers and students, or between students and patients
  • Emotional awareness (of self and others) was highlighted

In terms of the challenges that students face throughout their training:

  • Fear and anxiety, possibly as a result of poor confidence and a lack of knowledge and skills, leading to insecurity, confusion and uncertainty
  • Lack of self-awareness as it relates to their capacity to make effective clinical decisions and reason their way through problems
  • A disconnect between merely “providing a service” and “serving”
  • They lack positive and supportive clinical learning environments, have poor role models and often aren’t given the time necessary to reflect on their experiences
  • The clinical setting is complex and dynamic, a fact that students struggle with, especially when it comes to dealing with complexity and uncertainty inherent in clinical practice
  • Students often “silo” knowledge and skills, and struggle to transfer between different contexts
  • Students struggle with the “hidden culture” of the professional i.e. the language, values and norms that clinicians take for granted

These results are not significantly different from the literature in terms of the professional and personal attributes that healthcare professionals deem to be important for patient outcomes.

The second round of the Delphi is currently underway and will focus on the teaching  strategies that could potentially be used to develop the attitudes and attributes highlighted in the first round.

Posted to Diigo 06/30/2010

    • Faculty members with strong research records and below-average teaching routinely get to be full professors, while outstanding teachers with below-average (and sometimes average) research productivity don’t get tenure
    • Depressingly many research papers are published that have little or no impact on technology or society and are never cited by anyone other than their authors
    • If university administrators were being honest, they would state that they need massive amounts of external research funding to function, the chancellor of a university that proclaimed teaching to be of secondary importance would have to face some hard and unwelcome questions, so what happens instead is rationalization
    • There is no logical reason to expect productivity in research and effectiveness in teaching to be closely related, since research and teaching have different goals and require different skills and personal attributes
    • The goal of research is to advance knowledge, while that of teaching is to develop and enhance abilities
    • Excellent researchers must be observant, objective, skilled at drawing inferences, and tolerant of ambiguity; excellent teachers must be skilled at communication, familiar with the conditions that promote learning and expert at establishing them, approachable, and empathetic
    • Having both sets of traits is clearly desirable but not at all necessary to succeed in one domain or the other
    • Moreover, first-class teaching and first-class research can each consume well over 40 hours a week, so that time spent on one activity is inevitably time taken from the other
    • It should therefore come as no surprise if studies reveal no significant correlations between research productivity and teaching effectiveness
    • Argument: Research productivity correlates positively with teaching effectiveness. Fact: Wrong. Correlations between numbers of papers and grants and measures of teaching quality such as student evaluations, peer evaluations, and learning outcomes are mostly negligible and sometimes negative

    • Argument: Research-intensive universities provide the best undergraduate education. Fact: Wrong. In reality, significant negative correlations have been found between a university’s research orientation and numerous student learning and satisfaction outcomes

    • Argument: Only active researchers are sufficiently current in science and engineering to be viable teachers. Fact: Never demonstrated, and almost certainly wrong

    • Argument: Faculty with active research programs bring their research into the classroom and use it to inform and enliven their teaching. Fact: Usually wrong, especially in undergraduate classes, and when research is integrated into teaching it’s not always a good thing. Most current research is well beyond the scope of all but advanced graduate courses, and rigid curricula make it challenging to bring in new material

    • Argument: Research experiences enhance undergraduate education. Fact: True for some students. No supporting evidence exists for this presumption; in fact, much undergraduate research directed by research faculty has students functioning more as unpaid lab technicians than as true researchers

    • In short, the unwritten rule that all university faculty should be active researchers places unreasonable and unhealthy demands on faculty members; weakens departmental teaching programs; keeps potentially outstanding teachers from devoting enough time and energy to teaching to realize their potential; deprives students of some inspirational and possibly life-changing instructors, mentors, and role models; and is unsupportable by either logic or research
    • Flexible Thinking: In a world in which future workers are likely to have as many as eight careers or more in their lifetimes, lifelong learning will be essential but flexibility of thought will be equally critical, enabling individuals to move seamlessly from one transition to another
    • Multiple Interpretations: The New Civic Discourse driver from the 2020 Forecast depicts a world in which continuous, bottom-up communication will be the norm, bringing an ever-widening circle of individuals with divergent views into contact with one another. If this dialogue is to be fruitful, not fractious, we will need to develop a new capacity for dialogue which includes the capacity to see multiple perspectives
    • Willingness to Experiment and Learning from Mistakes: Dynamism and acceleration are hallmarks of our current age. To innovate in this world, rapid beta-building and the habits of mind such as a willingness to experiment and reframing of “mistakes” as failures, to “mistake” as learning opportunities will be required
    • Visual and Spatial Abilities: If we are to make sense of the vast amounts of knowledge we are creating, the knowledge era must become the visual era. We need to develop the capacity to bring multiple streams of information together in new ways to provide sophisticated and elegant pictures of complex situations