AAMC Reporter: November 2007

Distinguished Professors Keep Students Coming Back

By Scott Harris

Robert M. Klein, Ph.D., Associate Dean for Professional Development and Faculty Affairs and Professor of Anatomy and Cell Biology at the University of Kansas School of Medicine

The medical school classroom, like so many other things in society, is changing—rapidly and constantly. With information more accessible than ever, the traditional lecture hall format no longer seems as crucial to the learning process as it once did. As a result, a new brand of educator is beginning to emerge: personable, passionate, and unafraid to adjust their sails to the shifting winds, these educators say they are succeeding by making sure their classes are can't-miss events. Perhaps that is one reason why these four professors received the 2007 AAMC-Alpha Omega Alpha (AOA) Robert J. Glaser Distinguished Teacher Awards.

This year's recipients are University of Kansas School of Medicine Anatomy and Cell Biology Professor Robert M. Klein, Ph.D.; University of Arizona College of Medicine Cell Biology and Anatomy Professor John Nolte, Ph.D.; Harvard Medical School Associate Professor of Medicine Richard M. Schwartzstein, M.D.; and Medical College of Wisconsin Professor of Medicine James L. Sebastian, M.D., F.A.C.P.

"All four 2007 award recipients have distinguished themselves on the basis of their content expertise; their use of innovative educational methods; their local, regional, and national reputations as teachers; and their ability to make a regional and national impact on medical student education in their areas of expertise," said Robert Sabalis, Ph.D., AAMC associate vice president and head of the Glaser awards selection committee.

The Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Awards were established by the AOA medical honor society in 1988 to provide national recognition to faculty members who have distinguished themselves in medical student education. The award is named for long-time AOA executive secretary Robert J. Glaser, M.D.

According to Klein, shrinking attention spans (as low as just a few minutes by some estimates) and expanding resources outside the classroom (and diversions inside the classroom) mean that keeping students engaged is a crucial priority.

"If you're just a talking head at the front of the room, they're going to tune out," Klein said. "With podcasts, they can listen to a lecture anytime. They don't have to go to class anymore. Students should feel like they need to be there."

Perhaps in a case of fighting fire with fire, many medical schools are bringing cutting-edge technologies into educational settings. For example, Klein cited a tool students can use to vote on a question and see results in real time during lectures.

"The school of medicine has allowed us to use the classroom as an area for experimentation," Klein said. "You've got to get your point across immediately, and technology allows you to do that."

Sebastian, who considers himself a "throwback," nevertheless incorporates handheld electronic devices into his courses, and acknowledges technology's role in education and in the practice of medicine.He adds, however, that it should never subsume the human component of either.

"I see it as a complement rather than a substitute for what physicians have always done," he said. Of course, technology is not a cure-all for keeping students engaged. Many of the fundamental ways of establishing a connection with students, and ensuring that they learn, are the same simple, low-tech methods they have always been.

Humor is one of these tools. Matthew Wheatley, a third year Medical College ofWisconsin student who recently completed a clinical rotation under Sebastian, recalled one rather memorable day at the bedside. Trying to ease student trepidation over performing their first rectal examination, Wheatley said, Sebastian "told us that if we didn't do it, the student would become the patient."

"He really had a special way," Wheatley said, "of motivating us.

"He understands how to put things into words that students can understand, and he does it with humor," he continued. "Other professors are almost impossible to relate to. But Dr. Sebastian is extremely personable. You really feel like you can talk to him about almost anything. You felt like he was your friend. And he was your friend."

Simply taking the time to help a student can resonate deeply. Christopher Liverman, a student in the University of Kansas School of Medicine's anatomy and cell biology department's M.D./Ph.D. program, recalled Klein putting a busy schedule on hold to provide a little extra instruction and encouragement.

"One time, he stayed late on a Sunday night to help me with a seminar I was going to be giving," Liverman said. "Here's a guy who probably works 100 hours a week, and he's always taking that extra step to help.He's been a good mentor.He makes sure you know what you need to know so nothing ever sneaks up on you."

Good educators inspire students to think independently, by teaching outside traditional boundaries. According to Harvard Medical School Professor David Roberts, M.D., this is what Schwartzstein tries to do. Roberts, who was a fellow under Schwartzstein, now teaches second-year medical students. As a result, he said he sees "the products" of Schwartzstein's efforts to stimulate students to think critically and without limits.

"Not only does Dr. Schwartzstein have the knowledge, he has the capacity to dream," Roberts said. "He asks, 'What if we took this convention, scrapped it, and did it in the best way we can imagine?' His philosophy is, what's the harm in trying?"

Exercises that thoroughly explore a topic and do not make conventional assumptions can hold rewards for the educator as well.

"It's a big difference between knowing and understanding," Schwartzstein said. "The more I teach, the better I understand things. Students don't have preconceptions. They ask about things you take for granted but don't truly understand yourself. So teaching makes me a better physician and researcher."

Presenting an open question to the class and giving students free reign to lead the discourse and explore all sides of the topic is the main tenet behind problembased learning. Arizona's Nolte said the now-fairly common approach was fairly radical when he helped pioneer it in the late 1980s.

"Back then, to have a problem-based learning course, where there were no lectures and students would lead the discussion groups, was pretty exciting," Nolte said. Although these kinds of human connections will probably always be a good approach to teaching. In today's culture, there are times when speaking the language of students does mean talking about technology. Nolte, a former photo receptor physiologist who has been trying different instructional technologies since introducing videotape and laserdiscs to his classrooms more than two decades ago, produced a humorous instructional anatomy video called "Stalking the Wild Asparagyrus" that former students wove into a satirical rap video posted on their MySpace profiles.

"It's just a matter of making the information accessible to students," he said. "One way to do that is to bring technology in."

Still, at the end of the day, it's all about learning. And with new information coming out everyday, staying on top of a subject can be a challenge in and of itself. "We really don't know what information they will need three decades from now, when they are really in the primes of their careers," Klein said. "But what we can do is teach them how to learn, and how to find information in the best way in a technological environment."

Of course, a great educator's commitment to learning cannot end in the classroom, no matter how engaging or innovative his or her techniques might be. Schwartzstein, for example, served on his local public school board, taking away myriad lessons to apply at Harvard. All four teachers blazed trails in advocating for more tools and resources.

"[Sebastian] was the first to try standardized patients all those years ago, and new strategies in education and mentoring," said Deborah E. Simpson, Ph.D., professor of academic affairs and associate dean for educational support and evaluation. "He's a risk taker among our educators."

"No one else has his grasp on the principles of learning, and what it means to be a student," Roberts said of Schwartzstein. "He's a real advocate for students, residents, and faculty."

Overall, Klein said, it boils down to loving what you do. After all, if educators view their classes as can't-miss events, chances are students will follow suit.

"Maybe the biggest part is the passion the educator has for the field as much as the content," he said. "People talk about spring being the season of rejuvenation. For me, that time is the fall. Because with every new student class, I am rejuvenated."

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