Wednesday, February 22, 2012

Role Model

As I am relatively new to the attending physician role, I am still getting used to the idea that my students and residents are watching me.  All the time.  Whether I am consciously teaching them something or not.  I put a great deal of thought and preparation into the didactic talks that I give them, the teaching points to bring up on rounds, and the formal feedback that I deliver.  But I am starting to realize that there are many dimensions to the team’s education that are more subtle.

When I am leading a team of residents and medical students, I am supervising their patient care.  They are absorbing knowledge about clinical judgment, the management of the diseases that we encounter, and integrating their scientific foundation with practical applications.  However, they are also learning the art of dealing with uncertainty and with the infinite variety of humanity.  I feel a responsibility for their clinical development and also their moral awareness. 

While I am on the inpatient wards, or in the residents’ clinic, everything that I do or say communicates something about being a doctor.  My tone of voice can convey respect or exasperation.  When I speak about disagreeing with a colleague, I can be collegial or unprofessional.  I am modeling attitudes for my learners, which may be subconscious to them (and to me) but nonetheless influential as they are growing into their doctor identities.

Sometimes it is hard to avoid mixed messages.  When I stay late at the hospital with my call team, I show them dedication to the job.  But do I also undermine the ideal of work-life balance?  When I admit to not knowing something, does it shake their confidence in me?  Or can we use the opportunity to look it up and promote life-long learning?

Even my lifestyle choices are under scrutiny.  My team knows what I get from the cafeteria or what I bring in for meals and snacks.  It actually motivates me toward healthier eating.  If I spend all day counseling others about their diet, I had better practice what I preach.

It is exhausting to be constantly alert, not only to the high demands of patient care but the role of teacher as well.  I need to keep in mind that my team of doctors-in-training is learning a science and an art at the same time.  They are figuring out how to apply clinical knowledge, analyze data, keep up with advances, interact with people, improve systems, behave professionally, balance their work and personal lives, and countless other complex tasks. 

They are learning through observation.  I must keep all of this in mind, as they are observing me.


  1. Have you ever read "McKeachie's Teaching Tips" ( It's more aimed at classroom environments, but it deals directly with university and postgraduate educational methods and techniques. It has a lot of ideas for dealing with issues like not knowing an answer, and the demeanor used when dealing with students.

    Another good one is "What the Best College Teachers Do" (

  2. This is really the mysterious chemistry that happens in professional education -- it's not merely training, it's a kind of inculturation. That's one reason why I don't want to see the decline of full-time residential student programs at theological seminaries like ours. Yes, we can teach content online, and online community is helpful, too. But there is something of value in our students observing the way our faculty lead worship, share meals, interact with each other, and live out their professional values.

  3. @ Eric: Thanks for the suggestion. Someone also recommended to me Patrick Palmer's book "Courage to Teach" but I haven't had a chance to check it out yet.

    @ Library: I agree that role modeling as a teaching method is relevant to any profession that requires sharing not only a body of knowledge but also a code of behavior. Both medical and theological education are about identity formation, in formal and informal ways.

  4. Dr. Tabor,

    Well stated. When I was a teaching attending, I too, felt the need on my part to be as exemplary as possible in my professional conduct, oral and written communication style (not to exclude penmanship even) and how I speak to other members of the staff and team such as nurses, physical therapists, and secretaries. Even remebering the names and saying hello to certain ancillary staff such as nurses' aids, says a lot. Thank you again for your enjoyable entry.