480 480 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 480 Bedside learning and teaching How do I teach a student who ‘knows it all’? Sanchita Pal, Rosie Neonatal Unit, Addenbrookes Hospital, Cambridge, UK T oday, a new group of students joined our team. During a few minutes of lull on the ward round I offered to teach on a small topic, and suggested jaundice, related to the last case seen. To this, one student – we can call her Jill, confidently replied ‘we know all about the pathophysiology of jaundice’, I shuffled, and politely offered to discuss something else. I felt Jill’s eyes glance towards my ID badge. A few thoughts crossed my mind. Firstly, I was a tad embar- rassed. Secondly, how young or inexperienced do I look? And thirdly, ‘in my day, I would never have dreamt of saying that’. This raised an interesting problem for clinical teachers: is it possible to teach students who seem to know it all? With the old proverb ‘you can lead a horse to water…’ in mind, can we as educa- tors entice our learners to drink? In this situation, I perse- vered. I encouraged Jill to share her knowledge with the group, and then tried to add clinical aspects, and finally to situate it to our patient. This session ended up being surprisingly useful, and I could see that Jill realised that perhaps she had been overly confident initially. She approach- ed me later, and acknowledged my teaching experience and background, and was much more open to my further sessions. As a teacher, I was able to use Jill’s knowledge to help to teach the other students. In this case, Jill did know a lot about the science behind this condition, and as a clinician I was able to situate that and link it to our patient. On reflection, this was a potentially explosive situation for both learner and teacher. For the learner, it could undermine their confidence, making them less willing to join group activities, or worse still have a negative effect on motivation and self-directed learning, and Jill was obviously doing lots of reading at home. When teaching, I try to offer support to my juniors, ensuring that they know when to ask for help, and also know where to start looking for answers. Without insight into gaps in knowledge, how will the student know when to ask for help? How can I teach this skill? One possible solution is to lead by example, and to demonstrate that I ask for help when needed, and enjoy discuss- ing cases and learning from my community of colleagues with individual skill sets and interests. This event has allowed me to adapt to a difficult situation using the skills and varied knowledge of the learner group. My aims were to highlight areas in which Jill could learn from others as well as share her knowledge with the learner group (including myself). Corresponding author’s contact details: Sanchita Pal, Rosie Neonatal Unit, Addenbrookes Hospital, Cambridge, Cambridgeshire, UK. E-mail: [email protected] Funding: None. Conflict of interest: None. Ethical approval: Not required. doi: 10.1111/tct.12173 When teaching, I try to offer support to my juniors, ensuring that they know when to ask for help

How do I teach a student who ‘knows it all’?

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Page 1: How do I teach a student who ‘knows it all’?

Bedside learning and teaching

How do I teach a student who ‘knows it all’? Sanchita Pal , Rosie Neonatal Unit , Addenbrookes Hospital , Cambridge , UK

Today, a new group of students joined our team. During a few minutes of lull

on the ward round I offered to teach on a small topic, and suggested jaundice, related to the last case seen. To this, one student – we can call her Jill, confi dently replied ‘we know all about the pathophysiology of jaundice’, I shuffl ed, and politely offered to discuss something else. I felt Jill ’ s eyes glance towards my ID badge.

A few thoughts crossed my mind. Firstly, I was a tad embar-rassed. Secondly, how young or inexperienced do I look? And thirdly, ‘in my day, I would never have dreamt of saying that’.

This raised an interesting problem for clinical teachers: is it possible to teach students who seem to know it all? With the old proverb ‘you can lead a horse to water…’ in mind, can we as educa-tors entice our learners to drink?

In this situation, I perse-vered. I encouraged Jill to share her knowledge with the group, and then tried to add clinical aspects, and fi nally to situate it to our patient. This session ended up being surprisingly useful, and I could see that Jill realised that perhaps she had been overly confi dent initially. She approach-ed me later, and acknowledged my teaching experience and background, and was much more open to my further sessions.

As a teacher, I was able to use Jill ’ s knowledge to help to teach the other students. In this case, Jill did know a lot about the science behind this condition, and as a clinician I was able to situate that and link it to our patient.

On refl ection, this was a potentially explosive situation for both learner and teacher. For the learner, it could undermine their confi dence, making them less willing to join group activities, or

worse still have a negative effect on motivation and self-directed learning, and Jill was obviously doing lots of reading at home. When teaching, I try to offer support to my juniors, ensuring that they know when to ask for help, and also know where to start looking for answers. Without insight into gaps in knowledge, how will the student know when to ask for help? How can I teach this skill? One possible solution is to lead by example, and to demonstrate that I ask for help when needed, and enjoy discuss-ing cases and learning from my community of colleagues with individual skill sets and interests.

This event has allowed me to adapt to a diffi cult situation using the skills and varied knowledge of the learner group. My aims were to highlight areas in which Jill could learn from others as well as share her knowledge with the learner group (including myself).

Corresponding author ’ s contact details: Sanchita Pal, Rosie Neonatal Unit, Addenbrookes Hospital, Cambridge, Cambridgeshire, UK. E-mail: [email protected]

Funding: None.

Confl ict of interest: None.

Ethical approval: Not required.

doi: 10.1111/tct.12173

When teaching, I try to offer

support to my juniors,

ensuring that they know when

to ask for help

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