Educational Perspective
The Golden Rule of Education Richard B. Gunderman, MD, PhD, Zachary Ballenger, MD Key Words: Education; teaching; role models; excellence. ªAUR, 2014
EDUCATION’S GOLDEN RULE
W
here do great educators come from? Are they born or made? If nurture, as opposed to nature, plays at least some role in their development, what kind of experiences seem to be the most formative? As we seek to enhance radiology education, it is vital that we ask such questions, and it is not enough simply to ask what degrees someone has earned or how well they scored on standardized tests. Instead we need to dig deeper. With this article, we begin a series of occasional articles seeking to provide a deeper, biographical perspective on outstanding educators, in hopes that their stories will prove both edifying and inspirational for other educators seeking to enrich their teaching. Isaac Wu, MD, is an assistant professor of radiology in the Indiana University Department of Radiology and Imaging Sciences, where he has been on faculty for 4 years. He is widely recognized as one of the best educators in this large department that focuses on education. At Indiana University, even residents who are not known for their dedication and affection for daily radiology conferences express regret when they discover they have missed one of his. He has won multiple departmental awards for teaching. He is simply a superb educator. What makes him so good? At first glance, Isaac’s excellence as an educator is difficult to account for. He immigrated to the United States from Taiwan as a teenager, speaking not a word of English. Living with his uncle’s family in California, he learned English by watching television, movies, and part-time work. Specifically, in high school he held jobs simultaneously in two different fast food restaurants, McDonalds and Burger King, where a good command of English was not required. Because he spent so many hours there, his friends often referred to him as ‘‘The Burgermeister.’’ As an international student, the language barrier made his studies difficult, but he worked hard and earned admission to college. He attended college in Oregon, where he majored in economics and minored in Japanese, expecting to pursue a career in business. During his undergraduate studies, he spent 2 years
Acad Radiol 2014; 21:1078–1079 From the Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202 (R.B.G., Z.B.). Received January 11, 2014; accepted January 14, 2014. Address correspondence to: R.B.G. e-mail: [email protected] ªAUR, 2014 http://dx.doi.org/10.1016/j.acra.2014.01.026
1078
abroad in Japan, studying Japanese and international business. While there, he met another study-abroad student who came from a Brazilian family of plastic surgeons. The Brazilian student told him about his family’s charitable work back home helping homeless children who had suffered disfiguring injuries. This convinced Isaac that he should pursue a career in medicine. He now says that had he known how long and arduous the path to medicine would be, he would not have chosen it. But with little understanding of what he was getting himself into, and perhaps with an overly romanticized view of medicine, he went back to Oregon and started over on a premedical track. His efforts paid off when he was admitted to the Oregon Health Sciences University, where he intended to pursue training for a career in primary care. He knew about organizations such as Doctors without Borders, and he envisioned himself doing international relief work. In medical school, however, he began to feel burned out by his experiences in clinical medicine. Fortunately, the school offered a pathology internship program for medical students, and he leapt at the opportunity. He quickly got to assume intern-level responsibility, performing dozens of autopsies on his own, and found that he loved using his eyes to make diagnoses. This experience revealed a completely different, ‘‘behind-the-scenes’’ aspect of medicine. But as he progressed, he began to worry that he might never see a living patient again. He explained the situation to one of his teachers, who suggested that he consider a career in radiology. He could not decide, so he ended up applying to programs in both pathology and radiology, ‘‘letting fate decide’’ as he puts it. He was delighted when he received the news that he had received a diagnostic radiology position at the Geisinger Medical Center in central Pennsylvania. Isaac then completed a 2-year neuroradiology fellowship at Brigham and Women’s Hospital, where one of his most formative experiences was working with Hugh Curtin, MD, at the Massachusetts Eye and Ear Infirmary. It was during this fellowship that he first developed an interest in resident education. Isaac marveled at Curtin’s ability to take a complex and difficult subject and make it less intimidating for the trainees. Although a renowned authority in his field, he maintained an extremely easygoing and approachable demeanor. He was simply a superb teacher. According to Isaac, if you ever needed to find Curtin, all you needed to do was to look for a group of medical students, residents, or fellows, who would always be clustered around his workstation.
Academic Radiology, Vol 21, No 8, August 2014
Inspired by Curtin and other great mentors, Isaac now makes it a priority to make his teaching as interesting and engaging as possible. No question is too stupid, no honest mistake unpardonable. To create an environment conducive for learning, he frequently tells stories about his own past errors. He believes that past mistakes can often serve as an effective learning tool, whereas intimidation and humiliation should play no role in a learning environment. In one case, he showed a group of residents a missed finding, then surprised them by telling them that ‘‘he’’ was the one who missed the finding. He took the point even further by sharing with them a similar miss years ago, when he promised himself he would do all that he could to never make such a mistake again. Such stories create a shared experience with someone learners admire, allowing them to feel more comfortable about learning from their own mistakes. As one resident puts it, ‘‘When people find out that Isaac is on service, they are actually excited and relieved. They are excited because he is so much fun to work with. And they are relieved because they know he is there to help them be their best. There is nothing they can’t ask, and he will never make them feel stupid. Instead he is very approachable, and when he does not know something, he will simply admit it and set about working with them to find the answer.’’ One way he lightens the mood and breaks down hierarchical barriers in education is humor. In fact, he is known for his corny jokes. He remembers that one of his supervisors at Burger King used to tell him jokes to teach him the nuances of the English language. Now he has a joke ready for every staffing session, basing the teacher–learner relationship on common ground. Initially, the idea that Isaac would become a good lecturer would have seemed preposterous. He hated lecturing and harbored a deep dread of it. He would have done almost anything to avoid giving a lecture. But as a resident at Geisinger, he was required to give two formal lectures every year. The first ones were terrible, but he learned as much as he could from each one, and eventually he began to develop a degree of comfort and new approaches that worked better. Isaac believes that he is unconsciously emulating the teachers he worked with, such as Curtin. And even bad teachers taught him a lot. He can recall sitting in bad lectures and case conferences and thinking, ‘‘If someday I ever find myself in that position, I have some ideas about how to do this better.’’ As he says now, ‘‘This is someday.’’ Are great educators born or made? Isaac strongly disclaims any notion that he is a gifted teacher. He points over and over again to disappointments in his initial forays into teaching. Moreover, he regards himself as an average learner. But in his view, this helps him to be a better teacher. He needs to hear things many times, and this makes him open to repetition as a way to drive home complex topics. As a fellow, his colleagues would show exotic cases, but Isaac always gravitated toward the more basic, bread-and-butter topics. He was initially surprised when learners reacted so favorably to his focus-on-the-basics approach.
THE GOLDEN RULE OF EDUCATION
As a resident and fellow, Isaac always loved it when teachers went beyond just providing the right answer and talked about how they approached cases. This is precisely what he tries to do. ‘‘I avoid trying to appear as though I understand everything well.’’ He encourages residents to do the same, continuously focusing on the fundamentals of the field. He takes time to get to know what learners already know, and focuses his teaching accordingly. Every day, Isaac says, he feels he needs to live up to the educators and institutions who educated him. He hopes that someday someone will say, ‘‘I worked with Isaac, and I just wanted to tell you that you guys did a good job with him. He is doing well.’’ It is this sense of responsibility that he hopes most residents will carry with them throughout their careers, which in turn may help enhance radiology as a field. One of his cardinal rules is a variation on the golden rule: teach others as you would want to be taught. ‘‘There is no need to intimidate or embarrass other people,’’ he says. ‘‘What is the point of making someone feel that they have asked a dumb question? If they knew the answer, they wouldn’t be asking it. And if they are asking it, it means that they would really like to know the answer.’’ His goal is to seize that intrinsic motivation and turn it to full educational advantage. He also worries about the future of education in medicine. He fears a day when productivity and money will rule everything, and people will discourage teaching because it does not generate the same amount of revenue as clinical work. He believes that medicine needs people who care about education and who are willing to make sacrifices if necessary to ensure that future physicians can be as well educated as he was. Another key to his success is hard work. He invests a lot of time and energy in his presentations, treating them like art projects. At many conferences, 50 or more physicians are going to be focusing their attention on what he has to say, and he feels strongly that everything needs to be as good as he can make it. At one level, it would pain him to project a slide on which a word was misspelled or the images were misaligned. But more broadly speaking, he wants to convey the ideas as well as he possibly can. To give less than his best in a public forum would represent an embarrassing failure. He is acutely aware that any error, any distraction, could threaten the connection with his learners, and he goes to great lengths to make his lectures as good as he can. A poorly prepared presentation sends a message to the listeners that the topic and the audience are simply not important enough to warrant the presenter’s best efforts. What makes a great educator? In Isaac’s case, the answer appears to be this: He aspires to teach well for all the right reasons. He likes to learn, and he enjoys helping others to learn. He seeks to emulate his very best teachers, attempting to carry on the best of what they have to offer for subsequent generations. He works hard at it. In short, he is seeking to embody the very educational approaches he admires most. This, surely, is the golden rule of education—to teach others as we ourselves would want to be taught. 1079
The Golden Rule of Education Richard B. Gunderman, MD, PhD, Zachary Ballenger, MD Key Words: Education; teaching; role models; excellence. ªAUR, 2014
EDUCATION’S GOLDEN RULE
W
here do great educators come from? Are they born or made? If nurture, as opposed to nature, plays at least some role in their development, what kind of experiences seem to be the most formative? As we seek to enhance radiology education, it is vital that we ask such questions, and it is not enough simply to ask what degrees someone has earned or how well they scored on standardized tests. Instead we need to dig deeper. With this article, we begin a series of occasional articles seeking to provide a deeper, biographical perspective on outstanding educators, in hopes that their stories will prove both edifying and inspirational for other educators seeking to enrich their teaching. Isaac Wu, MD, is an assistant professor of radiology in the Indiana University Department of Radiology and Imaging Sciences, where he has been on faculty for 4 years. He is widely recognized as one of the best educators in this large department that focuses on education. At Indiana University, even residents who are not known for their dedication and affection for daily radiology conferences express regret when they discover they have missed one of his. He has won multiple departmental awards for teaching. He is simply a superb educator. What makes him so good? At first glance, Isaac’s excellence as an educator is difficult to account for. He immigrated to the United States from Taiwan as a teenager, speaking not a word of English. Living with his uncle’s family in California, he learned English by watching television, movies, and part-time work. Specifically, in high school he held jobs simultaneously in two different fast food restaurants, McDonalds and Burger King, where a good command of English was not required. Because he spent so many hours there, his friends often referred to him as ‘‘The Burgermeister.’’ As an international student, the language barrier made his studies difficult, but he worked hard and earned admission to college. He attended college in Oregon, where he majored in economics and minored in Japanese, expecting to pursue a career in business. During his undergraduate studies, he spent 2 years
Acad Radiol 2014; 21:1078–1079 From the Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202 (R.B.G., Z.B.). Received January 11, 2014; accepted January 14, 2014. Address correspondence to: R.B.G. e-mail: [email protected] ªAUR, 2014 http://dx.doi.org/10.1016/j.acra.2014.01.026
1078
abroad in Japan, studying Japanese and international business. While there, he met another study-abroad student who came from a Brazilian family of plastic surgeons. The Brazilian student told him about his family’s charitable work back home helping homeless children who had suffered disfiguring injuries. This convinced Isaac that he should pursue a career in medicine. He now says that had he known how long and arduous the path to medicine would be, he would not have chosen it. But with little understanding of what he was getting himself into, and perhaps with an overly romanticized view of medicine, he went back to Oregon and started over on a premedical track. His efforts paid off when he was admitted to the Oregon Health Sciences University, where he intended to pursue training for a career in primary care. He knew about organizations such as Doctors without Borders, and he envisioned himself doing international relief work. In medical school, however, he began to feel burned out by his experiences in clinical medicine. Fortunately, the school offered a pathology internship program for medical students, and he leapt at the opportunity. He quickly got to assume intern-level responsibility, performing dozens of autopsies on his own, and found that he loved using his eyes to make diagnoses. This experience revealed a completely different, ‘‘behind-the-scenes’’ aspect of medicine. But as he progressed, he began to worry that he might never see a living patient again. He explained the situation to one of his teachers, who suggested that he consider a career in radiology. He could not decide, so he ended up applying to programs in both pathology and radiology, ‘‘letting fate decide’’ as he puts it. He was delighted when he received the news that he had received a diagnostic radiology position at the Geisinger Medical Center in central Pennsylvania. Isaac then completed a 2-year neuroradiology fellowship at Brigham and Women’s Hospital, where one of his most formative experiences was working with Hugh Curtin, MD, at the Massachusetts Eye and Ear Infirmary. It was during this fellowship that he first developed an interest in resident education. Isaac marveled at Curtin’s ability to take a complex and difficult subject and make it less intimidating for the trainees. Although a renowned authority in his field, he maintained an extremely easygoing and approachable demeanor. He was simply a superb teacher. According to Isaac, if you ever needed to find Curtin, all you needed to do was to look for a group of medical students, residents, or fellows, who would always be clustered around his workstation.
Academic Radiology, Vol 21, No 8, August 2014
Inspired by Curtin and other great mentors, Isaac now makes it a priority to make his teaching as interesting and engaging as possible. No question is too stupid, no honest mistake unpardonable. To create an environment conducive for learning, he frequently tells stories about his own past errors. He believes that past mistakes can often serve as an effective learning tool, whereas intimidation and humiliation should play no role in a learning environment. In one case, he showed a group of residents a missed finding, then surprised them by telling them that ‘‘he’’ was the one who missed the finding. He took the point even further by sharing with them a similar miss years ago, when he promised himself he would do all that he could to never make such a mistake again. Such stories create a shared experience with someone learners admire, allowing them to feel more comfortable about learning from their own mistakes. As one resident puts it, ‘‘When people find out that Isaac is on service, they are actually excited and relieved. They are excited because he is so much fun to work with. And they are relieved because they know he is there to help them be their best. There is nothing they can’t ask, and he will never make them feel stupid. Instead he is very approachable, and when he does not know something, he will simply admit it and set about working with them to find the answer.’’ One way he lightens the mood and breaks down hierarchical barriers in education is humor. In fact, he is known for his corny jokes. He remembers that one of his supervisors at Burger King used to tell him jokes to teach him the nuances of the English language. Now he has a joke ready for every staffing session, basing the teacher–learner relationship on common ground. Initially, the idea that Isaac would become a good lecturer would have seemed preposterous. He hated lecturing and harbored a deep dread of it. He would have done almost anything to avoid giving a lecture. But as a resident at Geisinger, he was required to give two formal lectures every year. The first ones were terrible, but he learned as much as he could from each one, and eventually he began to develop a degree of comfort and new approaches that worked better. Isaac believes that he is unconsciously emulating the teachers he worked with, such as Curtin. And even bad teachers taught him a lot. He can recall sitting in bad lectures and case conferences and thinking, ‘‘If someday I ever find myself in that position, I have some ideas about how to do this better.’’ As he says now, ‘‘This is someday.’’ Are great educators born or made? Isaac strongly disclaims any notion that he is a gifted teacher. He points over and over again to disappointments in his initial forays into teaching. Moreover, he regards himself as an average learner. But in his view, this helps him to be a better teacher. He needs to hear things many times, and this makes him open to repetition as a way to drive home complex topics. As a fellow, his colleagues would show exotic cases, but Isaac always gravitated toward the more basic, bread-and-butter topics. He was initially surprised when learners reacted so favorably to his focus-on-the-basics approach.
THE GOLDEN RULE OF EDUCATION
As a resident and fellow, Isaac always loved it when teachers went beyond just providing the right answer and talked about how they approached cases. This is precisely what he tries to do. ‘‘I avoid trying to appear as though I understand everything well.’’ He encourages residents to do the same, continuously focusing on the fundamentals of the field. He takes time to get to know what learners already know, and focuses his teaching accordingly. Every day, Isaac says, he feels he needs to live up to the educators and institutions who educated him. He hopes that someday someone will say, ‘‘I worked with Isaac, and I just wanted to tell you that you guys did a good job with him. He is doing well.’’ It is this sense of responsibility that he hopes most residents will carry with them throughout their careers, which in turn may help enhance radiology as a field. One of his cardinal rules is a variation on the golden rule: teach others as you would want to be taught. ‘‘There is no need to intimidate or embarrass other people,’’ he says. ‘‘What is the point of making someone feel that they have asked a dumb question? If they knew the answer, they wouldn’t be asking it. And if they are asking it, it means that they would really like to know the answer.’’ His goal is to seize that intrinsic motivation and turn it to full educational advantage. He also worries about the future of education in medicine. He fears a day when productivity and money will rule everything, and people will discourage teaching because it does not generate the same amount of revenue as clinical work. He believes that medicine needs people who care about education and who are willing to make sacrifices if necessary to ensure that future physicians can be as well educated as he was. Another key to his success is hard work. He invests a lot of time and energy in his presentations, treating them like art projects. At many conferences, 50 or more physicians are going to be focusing their attention on what he has to say, and he feels strongly that everything needs to be as good as he can make it. At one level, it would pain him to project a slide on which a word was misspelled or the images were misaligned. But more broadly speaking, he wants to convey the ideas as well as he possibly can. To give less than his best in a public forum would represent an embarrassing failure. He is acutely aware that any error, any distraction, could threaten the connection with his learners, and he goes to great lengths to make his lectures as good as he can. A poorly prepared presentation sends a message to the listeners that the topic and the audience are simply not important enough to warrant the presenter’s best efforts. What makes a great educator? In Isaac’s case, the answer appears to be this: He aspires to teach well for all the right reasons. He likes to learn, and he enjoys helping others to learn. He seeks to emulate his very best teachers, attempting to carry on the best of what they have to offer for subsequent generations. He works hard at it. In short, he is seeking to embody the very educational approaches he admires most. This, surely, is the golden rule of education—to teach others as we ourselves would want to be taught. 1079
