February 1998

For the Office-based Teacher of Family Medicine

Paul M. Paulman, MD
Feature Editor

Editor's Note: This is the second column provided by Dan Benzie, MD, of the University of Minnesota- Duluth. Dr Benzie examines teaching styles as they impact the learning process. Send your submissions to Paul Paulman, MD, University of Nebraska, Department of Family Medicine, 600 South 42nd Street, Box 983075, Omaha, NE 68198-3075. 402-559-6818. Fax: 402-559-6501. E-mail: ppaulman@mail.unmc.edu.



Teaching Styles

Dan Benzie, MD
 
   As Heraclitus once said, “Much knowledge does not teach wisdom.” Our individual teaching styles help determine how much information is retained and understood by the student. Just as each of us uses our own personal style of physician-patient interaction, we also use many unique teaching styles with the students and residents in our offices. However, some general categories of teaching styles can help us look at our own strengths and weaknesses and allow us to expand the variety of teaching styles we use. With a given student or even with a given patient-student-teacher encounter, we may use several different styles. Table 1, adapted from Quirk,1 describes four basic teaching styles. The characteristics of each style range from a teacher-centered approach on the left to a student-centered approach on the right. The further to the right we go, the more the students are required to think and problem solve and the more information they will retain. Students learn best when a variety of methods are used and respond best to more-facilitative and less-assertive teaching. We want to move the student along the spectrum from where the preceptor provides all of the information to promoting self-understanding by the student. The particular objectives you are trying to teach, the time available, and the student’s level of training will influence the methods used.

Examples of Each Style
Assertive
The objectives may be content specific, such as giving a drug dosage or showing the student how to hold the otoscope properly.

Suggestive
This style is often used in describing your previous experiences (war stories) with a particular patient problem, along with your preferred solution. You might describe your treatment choices for hypertension in the elderly, and then assign the student to read more about this topic.

Collaborative
This style involves asking the student for the differential diagnosis of a patient’s headache or having the student assess the impact of lifestyle on the patient’s current health problem. This style is helpful in teaching problem-solving skills.

Facilitative
This style allows for more student self-understanding. This style is important in teaching about emotions and attitudes and might include facilitating a student to feel more comfortable about delivering bad news to a patient or determining the student’s feelings toward a noncompliant patient. While you are asking the questions, try to display your enjoyment of practice and encourage the positive aspects of family practice, which will leave a lasting impression on the student. Present your values and beliefs to the students, and encourage them to ask questions about ethical issues. The teacher who is able to incorporate a variety of levels and types of questions in his/her teaching, use alternative teaching styles (being more facilitative and less assertive), and reflect a positive attitude toward patients, colleagues, and students can greatly improve teaching effectiveness and have a lasting impact on the learner.

 

Assertive Suggestive Collaborative Facilitative
Gives direction Suggests alternatives Elicits student ideas Elicits student feelings
Asks direct questions Offers opinions Explores student ideas Offers feelings
Gives information Relates personal experiences Invites personal experiences Encourages/ Uses silence
       
TEACHER CENTERED     LEARNER CENTERED

 

References
1. Quirk ME. How to learn and teach in medical school: a learner-centered approach. New York: Charles C. Thomas Publishers, 1994.

Correspondence: Address correspondence to Dr Benzie, University of Minnesota-Duluth, Department of Family Medicine, 139 Med, 10 University Drive, Duluth, MN 55812. 218-726-7574. Fax: 218-726-6235. E-mail: dbenzie@d.umn.edu.