My usual Friday morning O&G outpatient clinic activities would comprise of consultation of seven or eight patients, with a group of three or four medical students observing me handling the session. This is a part of an ambulatory clinical teaching for students undergoing the O&G rotation. McGee et al (1997) emphasized the importance of teaching medical students in the outpatient clinic setting to offer unique educational opportunities.
What started off as an ordinary morning clinic turned out to be a very exciting teaching session for my students. Four out of the eight patients I saw that day brought surprise gifts for me! It was not unusual for patients to bring some tokens to my clinic, but to receive four presents during the same clinic session was indeed overwhelmingly exciting! At the end of the clinic, I was looking at these gifts on my table - a pretty pink pouch-bag from Beijing, a hand-woven shawl from Indonesia, a home-baked carrot cake and a small box of `serunding daging’ or spicy meat floss, a local delicacy from Kelantan. It must have been one of those best days at work!
I could not forget the facial expressions on my students’ faces that day. They were obviously surprised and shocked to discover how `fruitful’ and productive a routine and mundane clinic session have turned out. I decided to share the carrot cake with the students and took the opportunity to carry out a brief reflection exercise on doctor-patient relationship while we were eating in the pantry. One student’s observation was particularly meaningful and made an imprint in my lifelong memory when he said: `Doctor, I observe that many patients walked into your clinic as strangers, but they walked out minutes later as your friends! That would surely motivate a pleasant encounter for both the attending doctor as well as the sick patient. How did you do that? I would like to have such a positive relationship with my patients when I become a doctor one day ’. I listed out some tips for an effective and positive relationship between doctor and patient, emphasizing that the gifts and token of appreciation should not jeopardize one’s professional judgement and clinical decisions. It was an important learning opportunity to drive the message across. Schon (1987) described this communication as reflection in action (reasons we are doing it), on action (impact on patient, students and oneself) as well as for action (guide for future interaction).
I was particularly moved by the question because it contained a deep-seated desire of a young learner who wished to role-model his teacher’s conduct. He might have been motivated by the pleasant tokens of appreciation I received from my patients. I am sure the experience was powerful enough to convince him that he should also try to emulate the positive doctor-patient interaction. It dawned on me how important it is for clinical teachers to be very aware of their professional conducts since the medical students are consistently watching and observing. They could see the good and exemplary behaviours, as well as the bad and ugly. Cruess et al (2008) cautioned the clinical teachers, to be aware of the conscious and unconscious components of learning from role modelling, with a major aim to produce a positive net effect of the process for the medical students.
Dedicated to MEDICAL STUDENTS all over the world - may you survive the challenges ahead.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 1 - Thank God for this golden opportunity. Allow yourself to be trained with the basic medical knowledge, skills, attitudes and behaviours that are essential for the profession. If you're a caring, responsible, unselfish and emphatic person, half the battle is won. If you're not, it's a long way ahead!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 2 - Do not be afraid to make mistakes now. As students, you learn through your mistakes and corrections by your teachers. If you're scolded or criticized for your mistakes, be strong. Do not take it personally. You could only be hurt or affected as much as you have allowed yourself to be!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 3 - Look forward for your exams, instead of being depressed over them. Two reasons for that; first - exams are TRADEMARK of medical schools (they are here to stay!), secondly - they serve as signboards, telling you how close (or how far) you're to the destiny. Enjoy & cherish them!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 4 - Enhance your passion & hunger for knowledge. You might have your own learning style, but you can always switch your approach from superficial to deep. Learn because you really wanna know, not for simply passing exams (superficial approach)!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 5 - Appreciate the cooperative patients who have agreed to allow you to examine them. Give them their due respect. Despite their pain and misery, they let you `disturb' their rest/sleep. Promise yourself that you will be a competent doctor one day, so all the patients' sacrifice for you would not go wasteful!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 6 - Apply active participation in your learning process. Force yourself to come forward the next time your clinical teacher looks for a volunteer to clerk a patient, perform a physical exam, assist in a procedure or operation. You will be rewarded with a great sense of achievement, much more than your passive friends - even if you gonna get some criticism/ negative feedback at the end.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 7 - Do not procrastinate, submit assignments before deadline. Do not postpone till the very last minute, no matter how tempting it is to delay. Put in your best effort in everything you do. Be exceptional, not just a mediocre!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 8 - Ask questions, clarify any area of doubt. Make it a must to ask your teacher before a teaching session ends. Keep asking - there are no such things as stupid questions - only stupid answers! A lot of active, critical thinking must come before asking...it might be too much for some. No wonder you all are no longer asking questions these days!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 9 - Never leave God behind in your pursuit to be the men/women of medicine. As healers, we are the INSTRUMENT of God's mercy. Continue your strive to be close to Him, for you will definitely need Him endlessly. It is through your hands, words, eyes and smiles that God is going to cure and care for the sick and fallen. May you deserve such honour!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 10 - Keep in touch with your parents & family. They're your best support. Update them with your progress. Include them into your busy, busy stressed-up life. Share with them your sorrow, but convince them that you'll be fine with their prayers tagged along.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 11 - Try your best to make your teachers feel respected and appreciated. Take what is good from them, whilst forgive them for their shortcomings. Assist your teachers by getting actively involved in teaching learning activities. Make them interactive, lively, fun and enjoyable. Help your teachers, they need you to be on board!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 12 - Strengthen your friendship with peers, seniors & juniors. Don't be a loner. Help one another always. Study in a group, studying alone limits your understanding & perspective. The best way to learn is to teach! So, teach one another - you'll be amazed by the result of such teamwork.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 13 - Spend your holiday/semester break with your family. Visit your grandparents, uncles, aunts & cousins. Let them see the `new, better, matured' future family doctor whom they're so proud of. Impress them with your improved communication & interpersonal skills. Listen attentively to their complaints, groans & moans. Gently remind them, you're not yet licensed to treat...
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 14 - Manage your time wisely. Sleep early and wake up fresh. Do not compromise your sleeping time by spending too much time online. Chronic sleep deprivation will only result in higher level of stress! Stop the vicious cycle, NOW!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 15 - Pluck your courage to greet ALL your teachers when you meet them at the corridors/cafetaria/lifts etc. Don't expect them to remember your name, unless you're really exceptional. They might not be smiling back to you, but your consistent greetings will somewhat make your face familiar to them. At least they realize that you EXIST....and that really matters.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 16 - Train yourself to serve others always. After all, medical profession is about public servitude. Your calling is to go all out to help, assist and facilitate others. Altruism (placing other's interest before one self) is the keystone of medicine. Without it, the whole arch of medicine collapses!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 17 - Overcome your fear, sadness and uncertainties with constant reminder that what you're aiming for is not something ordinary. Training to be a medical doctor pushes you to your limits! Be warned, the sailing is not going to be smooth, it's an uphill climb, a lifelong commitment.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 18 - Learn to be genuinely interested in your patient's life - not simply his/her diseases. Remember this equation : Patient = Person + Disease. While learning how to doctor the disease, never forget to doctor the PERSON, who is made up of body, mind, heart & soul.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 19 - Jump out of the bed with enthusiasm and excitement each morning. Promise yourself that you're going to make full use of the many golden opportunities in front of you. Say your morning prayers consistently, without fail. Look into the mirror and say it out loud : I believe I can be a better person today, better than yesterday, InsyaAllah!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 20 - Be emotionally intelligent. Manage your emotions wisely. Remember, emotion is the window to your thoughts. When you're feeling happy and motivated, you're thinking positive thoughts. When you're feeling down and demoralized, your head is full with negative thoughts. Ask yourself, how much do you want to ALLOW the trigger/stimulus to affect you emotionally...it's your own choice!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 21 - Stop being a perfectionist, for one good reason - no human being can be perfect! Be kind to your self, please. Set an achievable target, strive to overcome challenges and acknowledge your own achievement, no matter how small. Wanting to excel will motivate you, aiming for perfection will only drain you out DRY!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 22 - Focus on your study. Do not allow distractions to interfere with your concentration. Apply deep learning strategy - focus on YOUR own pumping heart when you're studying CVS, on YOUR own thinking brain when you're reading about neurons & synapses! Studying is not supposed to be burdening, it should be liberating, enjoyable and empowering.
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 23 - Fight your laziness with this reminder - nobody likes to consult a LAZY doctor, not even yourself! Being lazy is a waste of resources, a thief of your precious time and a betrayal to your potentials. Come on, grab the books, spend a lot of time in the wards/clinics and finish off your calls. Say goodbye to laziness TODAY!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 24 - Seek professional help ASAP once you detect symptoms of depression & anxiety within yourself. Lack of energy, loss of interest, insomnia, isolation and crying spells...to name a few. Help your friends with such symptoms - esp. if they're still in denial. Life as medical students can be very challenging & frightening, so monitor your progress closely!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 25 - Be exceptionally strong in your spiritual development. A doctor's soul needs constant enhancement and purification. It's your pure and sincere intention that serves as a shining beacon in the dark, showing you the way. Do not ever neglect your soul, or else you'll get easily de-motivated, demoralized, derailed and defeated!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 26 - Optimize your studying time to obtain as much medical knowledge
as possible. Take up all opportunities to sharpen your generic and medical skills. Equip yourself with appropriate manners and attitudes. Do not just aim for a borderline pass. How would you like consulting a doctor who only knows 5 out of 10 causes of acute abdominal pain?
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 27 - Take care of your love life, if you have decided you’re ready to commit for one. If it’s taking away too much of your time and energy, simply trying to make the other person happy – I guess you know where you’re heading to. Be wise in managing your priorities, first thing first! If things between you and him/her turn sour, do not mourn too long. Pick up the pieces and move on.
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 28 - Return to your old schools if you have the opportunities to do so. Meet up your old teachers and motivate the juniors to follow your footsteps. Walk down those familiar corridors and bring back good memories, of how confident and enthusiastic you were feeling, once upon a time! Wonder where have all those feelings gone to? When did you exactly lose them? Work hard to regain those feelings.
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 29 - Pray that you are going to do everything better today, InsyaAllah. Promise yourself that today is going to better than yesterday and tomorrow should be better than today. That's the only way to improve and move forward. If you're doing otherwise, whereby today is worse than yesterday - you're really regressing, not progressing here!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 30 - Pay attention to the needs of your body, mind, heart & soul. When your body is tired & your mind is exhausted, find rest by uplifting your emotion & spirit. Do not drown your soul with fake entertainment - providing temporary relief. Handle your fragile emotion with care.
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 31 - Never forget to ask your parents to continue praying for you. Never hurt their feelings, never ever neglect them. Call home once every two or three days, no matter how busy you are. Spend time with them during semester breaks. You might be lucky enough to overheard their prayers during the tahajud (early morning prayers)....
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 32 - Practice makes perfect. Volunteer to present your clinical cases to your teachers. Perform physical examination of body systems regularly in front of your consultants or specialists. Polish up your skills. Build up your confidence and competence. There is no shortcuts to success & excellence!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 33 - Go to bed before 12MN and wake up early. Do you know that the quality of one hour of sleep before midnight is comparable to two hours of sleep after 12MN? Let your body rest, achieve deep REM sleep, allow your circadian rhythm to flow. Wake up fresh the next morning -ready to face the world!
SURVIVAL TIPS FOR MEDICAL STUDENTS: Tip no. 34 - Always be a considerate roommate & a helpful friend. Never hurt another individual with your words & actions. Be well-known as a kind person, rather than as someone rude and disrespectful. Good virtues strengthen your inner core, negativeness will only weaken and erode your existing potentials.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 35 - Be your own best friend, and love thyself. Do not harm the precious soul that is now within you. Once you regret being you, and wonder why you're not someone else, push the pause button! There shall be no regret, for who you are now is more important than who you were before, because your future is dependent on what you decide now, for your very own self!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 36 - Find practical solutions to your problems. Do not simply ignore or sweep them under the carpet. Seek help & assistance from those around you. Have faith - there is no problem too big to be solved. Problem solving is a 'a must-have' generic skill for medical students!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 37 - Overcome your weaknesses with effective & practical steps. If you're not proficient in English, find a private tutor among your friends/teachers & start conversing in English. Don't be shy! Learn to laugh at your own mistakes, but don't forget to improve the next time.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 38 - Give your self a break today. Do something different than the usual routine. How about a quiet stroll down the park? Watch the leaves fall, smell the freshly-cut grass, listen to the birds chirping and look up the blue clear sky. Be grateful to Allah, for the opportunity to witness His magnificent glory & be a part of His Greatness!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 39 - Plan your study schedule accordingly. Allocate time to plan strategically, rather than simply studying haphazardly. It does not stop there - the biggest challenge is to discipline yourself to follow the schedule/plan. You can do it! Correction - you HAVE to do it! If you really want to survive med school...
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 40 - Be well-known as a kind, pleasant and caring person. If you're not known as that, it's never too late to change. Wondering whether you really have to? Well, that's my suggestion. Kindness is the buffer of human's sufferings. As doctors, we should have plenty of that.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 41- Be gently reminded, as much as you're frustrated with your teachers sometimes, so do the teachers. Help them to help you out. Be active and responsive during teaching sessions, speak out your doubts. Ask questions, ask questions, ask questions! Don't just stand there like a dead log! Don't give your teachers that glassy, empty, perplexed look each time they demand answers from you! Arrrggh...
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 42 - Do not be discouraged by what your seniors told you - this posting is hectic, the lecturers are fierce and malignant, the patients are terrible & not cooperative, etc. The information might be useful to prepare you, but do not allow it to shape your perception until you go through the posting rotation yourself!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no 43 - Look at the brighter side if you happen to fail a test/exam/evaluation today. Reflect why you failed, get feedback from your examiner(s). If you're still considered `incompetent' in the area evaluated, be grateful that you still have the chances to improve. Now is the right time for you to make mistakes (not blunders) - because you have teachers around to correct you!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 44 - For goodness sake, stop studying medicine just becoz' you wanna pass exams! How many times do I need to emphasize : exams are merely signposts by the roadside, in your journey to reach the destiny? Learn becoz' you NEED to know! And you know why that is so very important. Very soon, you are going to be doctors. Are you prepared to shoulder such great responsibility?
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 45 - Never forget to pray for other medical students all over the world, who are currently struggling to survive medic schools, just like you! You all share the same concerns, worries & uncertainties. Each of you can already start writing your autobiography by now. Yeah, why not do that? It's a great de-stressing mechanism, guys!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 46 - Listen carefully to what your patients tell you. You will learn more than just about the disease signs & symptoms. Most often than not, you will end up reflecting on your own life journey, wondering if you will end up like the patient you have just clerked. Learn from others and you'll be a wiser person each day.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 47 - Find your own de-stressing mechanism. Anything, just make sure it is not too risky & daring. Look out for your own space & solace. Friends can help. But at times, they may become too loud, noisy and distractive. If that is so, gently excuse yourself for a while. Don't worry, your friends will surely understand that you need time for yourself.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 48 - Improve your communication and interpersonal skills, even if you feel you're already good at that. Mind you, it requires a special skill to communicate with those who are sick, ill and diseased. Learn how to listen, talk and touch them. Listen carefully to all their complaints, sorrow and regrets. Soothe them with your kind words, caring facial expression and gentle touch. When it is your turn to be a patient soon, you would want a doctor who has mastered all those skills to look after you!
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 49 - Do not walk around with a miserable frown on your face, as if the sky is gonna fall on your head! Look up, walk straight, pull up your shoulders and wear a friendly smile. Greet and acknowledge people with cheerful salam. Bring the colourful rainbow with you, brighten up the day for others. You'll be surprised to experience the vibrant, positive energy returning back to you.
SURVIVAL TIPS FOR MEDICAL STUDENTS : Tip no. 50 - Keep reminding yourself that you are currently training to be a future medical doctor. Whatever/Whoever had motivated you to take up medicine is not as important as what drives your desire to learn and discover the profession now. We're living in realtime, not in the past. Look forward and focus, once in a while you can glance into your `rear mirror' to remind you of the past and see who is catching up with you. Be inspired to become one of the best doctors around.
By Dr Harlina Halizah Siraj
Ex UKM medic student 1985 – 91
A student’s reflection illustrating the Kolb’s experiential learning cycle
Tears of joy rolled down my cheeks when I read what Fairuz wrote in her `Thank you Teacher’ card. I guess, nothing brings more colours to my heart than an acknowledgement from a student on how much she discovered her own potentials through the window of opportunities I have opened up for her!
What is more meaningful to me, this reflection was written by Fairuz nearly three months after the event (consultant ward round) had occurred. The fact that she could still recall so explicitly after quite some time, indicated the powerful positive emotion she would have experienced during the session. Emotion plays an important role in education. According to Sylwester (1994), emotion drives attention, which in turn drives learning and memory.
Fairuz’s short reflection on her learning experience during the ward round, might explain the Kolb’s experiential learning style theory (Table 1).
It started off as she experienced a new teaching approach – when she was asked by the clinical teacher to determine her own learning goal for the one hour session, in the beginning of the round. She admitted that she was never being asked to do that before. She went through a concrete new experience then – Stage 1. She went on to experience the subsequent events to the new approach, whereby she stated her learning goal for the session, presented her uterine fibroid case as a way to achieve her own objective, discovered her inadequacies (incompetence) through feedbacks given and was later guided to include the relevant negative findings as well. This is Stage 2 – when she reflected on the inconsistencies and gaps between her knowledge and experience.
Later on, Fairuz proceeded to relate the new discovery to her daily life as a student. She realized that `…having goal or aim everyday really made me motivated in everything I do. I was able to see clearly and achieved it in a more satisfying way.’ This is Stage 3 – where she was able to conceptualize the meaning of the new experience to her everyday life. This is also the part of Fairuz’s writing that touched me to the core as a teacher. In fact, that might be the most defining moment for a teacher – to be able to provide a fishing rod to a student, so she could fish on her own for the rest of her life.
Fairuz then internalized the lessons learnt, made changes to her subsequent case presentation in the next ward round and managed to obtain a complementary reassurance by another clinical teacher. Her active experimentation (Stage 4) had concluded the experiential learning cycle. She is now ready to face the next level of education which is going to be triggered by another new experience.
I must thank Fairuz for her deep, insightful reflection on our learning session together three months ago. She might not have realized how much she has taught me on the Kolb’s experiential learning theory. Surely I am more convinced now than ever– to treat learners’ emotions with more respect. Just as how Priscilla L. Vail (1994) had indicated : The emotional brain, the limbic system, has the power to open or close access to learning, memory, and the ability to make novel connections.
Reflection on the evolutionary journey of a novice to become a competent, experienced clinician educator.
As far as I could remember, I was never being formally taught on how to plan a proper lesson for a teaching session. Never in my whole life as a clinical teacher! Come to think about it, I never actually received a proper instructional guidance to become a teacher. I was thrown into the battlefield almost immediately after I qualified as a clinical O&G specialist in 1997. I might have imposed more damage and harm on my students’ learning experience during my teaching sessions all these years!
Married for 20 over years to my husband who is a trained teacher, a graduate of Islamic Studies and holding a Diploma in Education, is somewhat a blessing for me. I witnessed how he planned for his classes carefully, constructing his teaching objectives and outlining the minute-to-minute steps on the teaching and learning methods. I had always wondered on how to plan for my clinical teaching sessions – but somewhat was able to convince myself that it might not be possible to come up with a lesson plan for such an opportunistic clinical teaching session. I had minimal exposure to basic learning or educational theories, micro-teaching or peer assessment on my teaching ability. The only teaching supervision I received was once, when a senior consultant sat quietly at the back of the lecture theatre for 10 short minutes during a lecture I delivered to a small group of medical students. The feedback I got from him later was a very general comment of : `You are ok!’. I ended up emulating the teaching styles of my predecessors : harsh, regimented, teacher-centred full with humiliation and degradation for my learners. I hardly know much about pedagogy, learning and educational theories or specific communication skills for teaching.
Brew and Ginn (2008) indicated that students experienced a higher quality course input when the teachers were engaged with the scholarship of teaching. Certainly, a well-designed teacher education programme would improve the competencies of teachers and enhance the students’ learning experience. Such an awareness dawned to me quite some time ago, which drawn my interest further into the educational track of my career. I attended a few faculty development programmes organized by the university which highlighted the importance of Bloom’s taxonomy, constructing of learning outcomes and assessment tools. However I found the input was too general and difficult to apply to teaching in clinical setting.
As a novice clinical teacher, I remember how anxious I was preparing for the rounds. I would carefully select my own patients whom I admitted for bedside teaching sessions with the medical students. I would get easily angered, disappointed and furious by my students’ inabilities to present a detailed history, perform a proper physical examination and formulate the provisional diagnosis. The teaching environment was always hostile and I found my students to be withdrawn and passive, much to my dismay! The vicious cycle continued. I never stopped to think and reflect, that it might have been my incompetency as a teacher that contributed to the ineffectiveness of the teaching and learning activities. Nope, it was not me – the students were weak and poor in all aspects! This was my stage of `unconscious incompetence’ as described by Robinson WL (1974).
Now, after 17 years of being a clinical teacher, I am more aware of my roles and functions as an educator in a student-centred learning environment. I am able to pitch my teachings to whatever level of maturity my students might be at (undergraduates, postgraduates or peers), in the wards, clinics or even at the corridors. I could now turn an empty patient bed into a productive and valuable clinical teaching material for my students’ learning. My attempt to obtain a postgraduate certificate in clinical teaching this year is most probably a manifestation of my journey towards the fifth stage of the conscious competence learning model as proposed by David Baume (2004). It is indeed refreshing and rejuvenating to travel a committed journey of a lifelong learner!
I uploaded these tips some 5 years ago on my old blog : drhar.blogspot
I sincerely hope they are still relevant now & today.....
SURVIVAL TIPS FOR TEACHERS : Tip no. 1 - Reflect on the main reason why you become a teacher in the first place. Was it your childhood dream or mainly because you did not have much choices then? Why on earth are you still a teacher now? Find the answers in your heart. What you are today is a result of how you first took off in this noble profession...
SURVIVAL TIPS FOR TEACHERS : Tip no. 2 - Assign a special task to your students today : ` Write ONE word that best describes my teacher, Puan/Mrs/Dr/Prof/Mdm ....(fill in the blank with your own name)' Provide each student with a post-it note. Input should be anonymous. Pass around a small box to collect the notes. Paste them on a wall surface (in your bedroom) - the words describe what the students see in you!
SURVIVAL TIPS FOR TEACHERS : Tip no. 3 - Prioritize the weakest student in your class, instead of the cleverest. Those who are gifted with superb IQ could sail thru' without much of your help. It's the weakest who needs you the most. Don't ignore him/her. Look at her/him with a different perspective today - full with hopes & dreams!
SURVIVAL TIPS FOR TEACHERS : Tip no. 4 - Be a great teacher who inspires. From William Hart - a mediocre teacher tells, a good teacher explains, a superior teacher demonstrates & a great teacher inspires! Convince your students that you're a different breed of teacher - the one who really cares & prays for them, every time, every day!
SURVIVAL TIPS FOR TEACHERS : Tip no. 5 - Honour the students' trust in you. Keep their secrets. Do not spread out the private info they confided in you to other teachers in the school, unless it's related to safety and legal matters. Even then, just tell the principle/headmaster. Confidentiality is a part of teaching ethics.
SURVIVAL TIPS FOR TEACHERS : Tip no. 6 - Teach with all your heart, imagine the students are your own flesh and blood. Thank Allah (again & again) for the honour of being a teacher. Focus your energy before stepping into class. Remind yourself of the responsibilities put on your shoulders. Finish this statement : ` At the end of this session, my students would be able to.....'
SURVIVAL TIPS FOR TEACHERS - Tip no.7 - Look back into history - all great individuals were teachers. Rasulullah SAW was a great mu'allim/murrabi. Imam Al-Ghazali, Ibnu Sina, Gandhi, Maimonides, Hippocrates, Buddha, Lao Tzu, Mother Teresa, the list is non-exhaustive. These great people shared a common teaching style - they touched the hearts of each student they encountered (student-centred teaching). How about you?
SURVIVAL TIPS FOR TEACHERS - Tip no.8 - Read, read and read more! Teachers are readers and readers are leaders. Lead your students to explore the marvelous world of knowledge & virtue. Look up for new books & re-read the old ones. Reading builds up the creativity of teachers. So, what book are you reading now?
SURVIVAL TIPS FOR TEACHERS - Tip no.9 - Shine as your students' best role model, especially for those who do not have one at home. Practise what you preach, and walk the talk. For students who only have bad role modelling all these while, YOU are their shining beacon, salvation and last hope. Don't let them down, please...
SURVIVAL TIPS FOR TEACHERS - Tip no.10 - Serve as your students' mentor. Do you still receive phone messages, emails, wedding cards, festive greetings and well wishes years after your students have left school/college? Did the old students look for you whenever they came visiting? If so, rejoice...for you're indeed your students' life mentor! If not and you do not really mind, you might have never meant to be one.
SURVIVAL TIPS FOR TEACHERS : Tip no.11 - Remind yourself that teaching profession will not propel you to stardom and wealth. It is indeed a very humble and modest profession. If you're able to turn your teaching career into money-churning business, maybe it helps to pause awhile and rethink. Are you taking advantages of the public's (esp. parents') feeling of insecurity, inadequacy and ignorance? I really hope not....
SURVIVAL TIPS FOR TEACHERS : Tip no.12 - Pat yourself at the back sometimes, especially after a long day at school. Convince yourself that you've done what you could, as best as you would. The end product is not yours to determine. It is indeed sad to see why students keep choosing wrong decisions all the time.At the end of the day, you just have to move on...
SURVIVAL TIPS FOR TEACHERS : Tip no.13 - Smile whenever you're facing your students in class. Experience the `lightness & feel-good feeling' that comes with it. See the counter response from your students, they'll be more cheerful, relaxed and attentive. Enjoy the session together...and before you know it, there goes the bell!
SURVIVAL TIPS FOR TEACHERS: Tip no. 14 - Avoid burnout & fatigue by ensuring that you're sincere in your teachings. At times when you feel like giving up, check your intentions - there might be secondary (inferior) motives. Pause, reflect & contemplate. You have to recharge your batteries & dynamo to keep shining!
SURVIVAL TIPS FOR TEACHERS: Tip no. 15 - Be a `student-friendly' and `stress-free' teacher. Provide a safe environment for your students to make mistakes and learn, yet be clear of what you expect from them. Only the best and nothing less! You can strike the balance between being fair, realistic and strict all at the same time.
SURVIVAL TIPS FOR TEACHERS: Tip no. 16 - Pray for your students, every single one of them. Visualize their faces as you say your prayers. Beg Allah to bestow you with wisdom, patience and dedication. You definitely will have to depend on divine intervention to complete this noble teaching mission. Ask nothing in return, except for Allah's blessings.
SURVIVAL TIPS FOR TEACHERS: Tip no. 17 - Share a part of you with your students. Do not be aloof and detached from them. Tell them about your life experiences - esp. those that have changed you to be a better person. Yet, do not ever try to be boastful - they can easily tell when you're inflating yourself!
SURVIVAL TIPS FOR TEACHERS: Tip no. 18 - Be creative in class . Surprise your students with new style of teaching & learning materials. Bring them out of the class, guide them to discover the biggest book, spread open in-front of them : the world & universe. Learning is supposed to be fun, thrilling & enjoyable!
SURVIVAL TIPS FOR TEACHERS: Tip no. 19 - Contain your anger the next time you almost blow your top in front of the class! Push the `pause' button. Give yourself and the students time-out...I suggest you tell them why you're angry, assign a short redemption task , step out of the class, return after 10 min - InsyaAllah, you'll find a more cooperative class - how grateful they are that you do not shout this time!
SURVIVAL TIPS FOR TEACHERS: Tip no. 20 - Be humble, lower down your wings. Humility will never make you inferior. Avoid being a snob, or feeling more superior. Stop looking down at others. It takes a lot of courage and sense of security to be humble, especially if you have achieved so much in life. You will gain more respect from students and colleagues if you're humble, Just mark my words.
SURVIVAL TIPS FOR TEACHERS: Tip no. 21 - Aim to greet your students first, before they greet you. Surprise them with your warm salam/hello, calling out their names (if you have good memory) at the end of the greeting.Enjoy their initial `stunned' facial expression. Dale Carnegie reminded us : The most important word a person would like to hear is his/her own name!
SURVIVAL TIPS FOR TEACHERS: Tip no. 22 - Be a good team member among the teaching staff. Demonstrate outstanding tolerance, cooperation and teamwork. Do not back-bite, gossip or talk bad about other teachers in front of your class. Settle all misunderstandings with colleagues. Never turn the teaching staff room into a war zone!
SURVIVAL TIPS FOR TEACHERS: Tip no. 23 - Use encouraging words when you're giving feedback to students. Replace all those harsh, bitter, humiliating critics with better alternatives words in your comments. Be aware of your body languages. Constant degradation and humiliation is the WORST form of teaching! If that's your usual feedback strategy, it is indeed high time to change!
SURVIVAL TIPS FOR TEACHERS: Tip no. 24 - Extend your friendly hands to your partners in this noble mission of teaching; the parents & guardians of your students! They might not seem to be interested or just too busy to supervise their children, yet their role is indeed pivotal. Engage them as much as you can, don't give up! How about sending them an informal personal friendship card through their children? You might see an increase turn-ups in the next PTA meeting!
SURVIVAL TIPS FOR TEACHERS: Tip no. 25 - Be exceptionally strong in your spiritual development. A teacher's soul needs constant enhancement and purification. It's your pure and sincere intention that serves as a shining beacon in the dark, showing you the way. Do not ever neglect your soul, or else you'll get easily demotivated, demoralized, derailed and defeated!
SURVIVAL TIPS FOR TEACHERS : Tip no. 26 - Recall your own teacher whom you liked most. What was the main quality in that particular teacher that made him/her exceptionally special, at least to you, if not for anyone else? How about you now? Are you inspiring enough to your students? Does anyone in your class wish to be like YOU one day?
SURVIVAL TIPS FOR TEACHERS: Tip no. 27 – Stop nagging your students. Instead, start listening to their heart messages. When your student complains that no matter what he/she does, it is never enough to please you – his/her heart message is saying ; `I hope you appreciate me and notice what I’m trying to do here.’ There’s no way you can hear those heart messages with your loud nagging noise at the background!
SURVIVAL TIPS FOR TEACHERS: Tip no. 28 - Involve yourself in voluntary social work within your neighbourhood to enrich your life experience and perspectives. Do not isolate yourself from your community. Display genuine and caring attitudes to others. A teacher is highly regarded in a society, for the wisdom and good deeds that he/she is expected to contribute. Just give yourself away, you'll get more in return, InsyaAllah!
SURVIVAL TIPS FOR TEACHERS: Tip no. 29 - Assist your students to discover Allah their Creator, their purpose of life, their destiny. Do not push TRUTH down their throats, they might regurgitate & vomit it all out. Allow them to come to their own conclusions. Be prepared to face their challenges & debates. After all, you want them to be critical thinkers, eh? Just lead their thoughts to Allah, and they will soon discover Him themselves.
SURVIVAL TIPS FOR TEACHERS: Tip no. 30 - Allocate the last five minutes of your teaching session for a short, special dedication to one of your students. One student for each session. It can be a line of poem, a Malay pantun, a remark or a statement that indicates your hope - with his/her name specifically mentioned in it. Start with the last student in the name list, going upward. Feel the anticipation & excitement buzzing in the class as each session comes to an end....Enjoy it!
SURVIVAL TIPS FOR TEACHERS: Tip no. 31 - Always bear in mind, there might be a few `late bloomers' in your class now. They are relatively slower in catching up with what you're teaching. Hold your tongue, do not degrade/compare them with the smart, brilliant students. Google `late bloomers' - you'll be surprised to see the famous names listed in this category!
SURVIVAL TIPS FOR TEACHERS: Tip no. 32 - Overcome your prejudice and bias. Do not discriminate. Different does not mean less good or much better. Manage diversity wisely by celebrating or embracing it. Or at least be tolerant and inclusive. There would not have been beautiful rainbows around without the seven different colours!
SURVIVAL TIPS FOR TEACHERS: Tip no. 33 - Avoid measuring your teaching success simply by the number of students scoring A for your subject. That might be the easiest way, but certainly not the most accurate. If only you could keep track of those students who were inspired by you, and shifted their paradigms for better lives & future - now, that is what I consider real success!
SURVIVAL TIPS FOR TEACHERS: Tip no. 34 - First, reflect and contemplate. Then regulate and align your actions. After that, correct all your mistakes and wrongdoings. Those are three steps towards building up your professionalism. Without ability to reflect, you will never realize your strengths & weaknesses, resistant towards feedback and will not be able to improve!
SURVIVAL TIPS FOR TEACHERS: Tip no. 35 - Adhere to principles. Let the students experience what principle-centredness really means. We have to disagree and dispute our close friends when they're doing wrongs, and compliment/praise our enemies if they're doing the right thing! How else would students learn about what's right or wrong - if it's not from the teachers! (parents included)
SURVIVAL TIPS FOR TEACHERS : Tip no. 36 - Assist your students to adapt deep learning approach. Guide them to relate everything they learn to their daily lives, it is not merely to pass exams! Impress them with your massive knowledge & experience.
SURVIVAL TIPS FOR TEACHERS : Tip no. 37 - Do not expect much gratitude from your students, especially after they have succeeded. Be grateful if they pray for you, even sometimes if not always. Allah knows exactly how much you have contributed for those young people's life and future. Stop worrying & sulking, just go on teaching.
SURVIVAL TIPS FOR TEACHERS : Tip no. 38 - Thank your students today before you step out of your class. Appreciate their determination to attend school everyday. Tell them how much you treasure their trust in you. After their usual sing-song thank, `Terima kasih Cikgu! (Thank you Teacher!), stand there for another 10 seconds & say `Terima kasih murid-muridku!' ( Thank to YOU, my dear students!) Say it out loud, clear and sincerely.
SURVIVAL TIPS FOR TEACHERS : Tip no. 39 - Be constantly reminded, as teachers, we cannot not role-model. Students are observing and watching. Choose between the two - as a good, exemplary role model or a bad one. The choice is totally yours!
SURVIVAL TIPS FOR TEACHERS : Tip no. 40 - Never be discouraged by your students' misconducts & lack of good manners. Those undesirable behaviours are indicators of existing gaps / loopholes in the education process of the individuals. Simply speaking, they haven't learned enough from their parents, teachers & other adults around them. Wonder if it is us (adults) who have not taught them enough?
SURVIVAL TIPS FOR TEACHERS : Tip no. 41 - Pick a student today and walk down the corridor with him/her. Observe his/her body language. Does he/she look relax, comfortable and chatty? Or does he/she look tense, anxious and scared? You can try this tip if you are curious about how the students perceive you. If you couldn't bother to find out, simply ignore this tip....
SURVIVAL TIPS FOR TEACHERS : Tip no. 42 - Practise student-centred teaching learning process. Focus on your learners. Identify their learning needs. Enough with teacher-centred learning, where you decide everything for the learners - what , why, who, where, when & how to learn. Stop pushing the learners to score good marks for your subject because it will make you look real good in front of your other colleagues! Guide them from where they are.
SURVIVAL TIPS FOR TEACHERS : Tip no. 43 - Never worry that one day, your students would exceed you in so many ways. Do not feel insecure. Teach them all the knowledge & skills that you have. If they inform you that they are inspired to be like you, gently squeeze their hands, look straight into their eyes and say this with full sincerity: `I pray that you are going to be better than me.'
SURVIVAL TIPS FOR TEACHERS : Tip no. 44 - Pray that today, you are going to help your students in your class realize that learning is supposed to be liberating, enjoyable and fun. At least, ONE student...if you can't do much for the rest. For that one student, she/he will soon venture to be an independent learner throughout his/her life. Then, you can sit back and say : Mission accomplished!
SURVIVAL TIPS FOR TEACHERS : Tip no. 45 - Treasure those proud moments when you witness your students graduating/ moving on to another phase of their lives. Pat yourself at the back, dear teacher - for you have done your little part and contributed your little share into the lives of those students. Pray that even if those were considered small deeds in the eyes of men, they would be regarded as significant enough in the eyes of Allah SWT!
SURVIVAL TIPS FOR TEACHERS : Tip no. 46 - Remind your students on the 4S of life - Survival, Stability, Success & Significance. Advise them to focus on their studies, get a degree and find a well-paid job - so they can accelerate past thru' Survival & Stability. Success depends on how they define it. This is the most treacherous phase where many had failed to handle. Only a few`successful' people can become Significant by sharing their success with others
SURVIVAL TIPS FOR TEACHERS : Tip no. 47 - Bake a cake, order a pizza or buy `nasi lemak' for the class today. Surprise your students with unexpected treats from time to time. When they ask you why, give this answer : ` I'm thankful to God for giving me another day to teach you all. I might not be around tomorrow. But I want you all to know that I really care for each and every one of you!
SURVIVAL TIPS FOR TEACHERS : Tip no. 48 - Tell a short story about your favourite teacher to your class. Explain what you like most about his/her characters that made him/her your favourite. Share what was taught to you by this particular teacher that still stays with you until today. If the teacher has passed away, recite Al-Fatihah & prayers for him/her. You've just demonstrated to your students how to show continuous respect to teachers.
SURVIVAL TIPS FOR TEACHERS : Tip no. 49 - Inform your students about Gary Chapman's five love languages (how love is expressed) - affirmative words, gifts, quality time, acts of service & physical touch. Instruct them to choose one that made them feel most loved & write down the choice on a piece of paper. Collect the notes & make a list. Now you basically have the database on how to express your genuine care & love for your learners. This tip is especially dedicated to those who are always willing to go that EXTRA mile!
SURVIVAL TIPS FOR TEACHERS : Tip no. 50 - Walk your talk. Practise what you preach. If you're not capable to do so, talk less and stop preaching. Indeed, as teachers we have to role model the appropriate behaviours for our students to emulate. We are not perfect, therefore we have to keep improving ourselves. We have to go on carrying the torch....
Reflection on what clinical supervision means to me.
Clinical supervision can be defined as a conversation between professionals at all levels of experience, aimed at promoting learning, reflective practice and improving patient safety and the quality of patient care (NHS London Faculty of Deanery). The word `supervision’ indicates an act of over-seeing, looking over somebody’s shoulder to check on what he is doing. It includes both aspects of development and performance.
On the first day of our intensive mode session on clinical supervision, Prof Steve Trumble elaborated on the model of skills acquisition by Dreyfus and Dreyfus (1986). When he later instructed us to draw our own masterpiece, depicting our basic understanding of clinical supervision, I was thinking of the Russian babushka dolls. The prettiest and most decorated doll would be the biggest, which contained the other five dolls – hence the `master’ in performing the skill. The novice is the smallest doll, which are supervised by the other five bigger dolls – most immediately by the advanced beginner. (refer Diagram 1)
The power gaps between the novice and the master is too far and wide. I wonder whether the novice could bypass the other four bigger dolls and have direct access to the master, without stepping on other people’s toes. Could the master simply bring himself down to supervise the novice or the advanced beginner? From my own experience so far, the relationship between the `dolls of clinical supervisors’ has always been somewhat hierarchal, domineering and paternalistic.
We were later instructed to explain our masterpiece in details to a partner. I paired up with Kate Davey and listened to her brief explanation on her abstract masterpiece. Kate was obviously excited to see my babushka dolls. She challenged my view and proposed a different perspective. Kate indicated that the position of the dolls should be reversed – the master being the smallest while the novice should be represented by the biggest, prettiest doll. She was looking from the level of support to individuals in the different ranks of competencies. The master and expert would be the loneliest with minimal support around them, while the novice’s learning needs and requirements would be fully supported by his supervisors. According to Kate, the babushka dolls should be arranged like this (refer Diagram 2) :
Dreyfus model of skill acquisition could be seen from many angles and perspectives. The model was challenged by Pena A. (2010). He proposed that the acquisition of clinical skills is much more complex and could not be explained directly by Dreyfus model which depends on implicit knowledge and intuition. Clinical skills which embedded explicit as well as implicit knowledge, depend upon sound analytical and empirical data. Pena insisted that unlike the highly competent expert described in Dreyfus model who were mainly intuitive, the clinical expert attained high level of performance through working intuitively, reflectively and analytically.
As for me, I could see why and how clinical supervision plays a pivotal role in the field of clinical teaching. Inevitably, the degree of competencies of any medical doctor would depend heavily on the quality as well as quantity of the clinical supervision he had, is having and will have in the future.
When I first came across this insightful quote by Ralph Waldo Emerson (1803 -1882) a few years ago, I found the quote to be an eye-opener - revealing as well as inspiring. Apparently, Mr Emerson was already advocating a student-centred learning approach when he emphasized on `respecting the pupil’ as the secret of education, some 150 years ago. Gibbs (1992) described student-centred learning as ` an approach that gives students greater autonomy and control over choice of subject matter, learning methods and pace of study.’ This definition describes the basic level of respect that a teacher should give to the learners if he is to adopt the student centred learning in his teaching.
Growing up in a pure teacher-centred teaching and learning environment all my life, it had been quite a struggle for me to adopt the student-centred approach when it was first introduced to me some five years ago. I admit I initially had my doubts on the effectiveness of such an education that is tailored and designed to meet the learner’s needs and prior learning experience. How could the learners be allowed to decide on what they should be taught, when they themselves are still green, immature and inexperienced? How on earth would they know what they should learn and focus on as part of their journey to be knowledgeable and scholarly?
Those questions pushed me further to seek the answers. From my readings, discussions and interactions with other senior educators, I become more aware of how natural learning actually happens. Individuals learn better when the motivation is intrinsically-driven, determined by the learners’ needs and values given to the subject matter (Armstrong 2012). Learning is more meaningful if the learner takes full responsibility of the learning process and contents, rather than being repeatedly directed to read this, do that and analyse those elements that the teacher regards as important for the learners! Student centred learning is strongly based on the constructivist theory, which assumes that human beings are active learners and must construct knowledge for themselves (Geary 1995).
It is empowering to redefine my roles as a teacher in a student centred learning. I no longer have to shoulder full responsibility of my students’ learning process. I changed the approach in my clinical teaching to accommodate and firstly show my respect to the students. I asked for everyone’s name before teaching sessions with genuine intention to recall the names, at least during that particular class. I would invite the students to share their learning objectives for the designated teaching session. It was difficult in the beginning, but later on I became more motivated to help the students who were also getting more attentive and involved in their own learning progress. I finally learn to relinquish my so-called `power’ as a teacher and hand it over to the students so that they could take charge of their own learning. However, I do not `abandon’ my students and let them go astray wandering lost. I choose to become a `guide by the side’, rather than a `sage on the stage’.
Reading what my final year medical student, Imran Faisal wrote as a feedback for my last bedside teaching session with his group in the middle of last March, I could not help feeling somewhat relieved and fulfilled. Imran wrote :
The approach used was student centred, making myself and friends able to decide for ourselves what we want to learn at that point of time and where we are going in the session. The interaction was two-sided, making me feel acknowledged and appreciated both as a student and a future colleague in medicine. The clinical teacher is able to highlight not only the medical aspect of the patient's disease but relationship and bedside manners as well. The teacher was also able to make us synthesize and develop the learning issues and what should be improved on was pointed out."
I promise that I will continue my struggle in becoming a more effective clinical teacher for my learners and provide them the experience that Imran had. May God provide me strength to strive for the best!