Teaching Portfolio

Jeff Wiese, MD, FACP

SECTION 2: PERSONAL PHILOSOPHY OF TEACHING AND LEARNING

Medicine is about the ability to perform… the ability to take intellectual knowledge and put it in act for the benefit of the patient. What a student knows is immaterial if he or she is unable to put the knowledge into action. Where teaching is about the dissemination of knowledge, coaching is about enabling performance. My philosophy of teaching is not to teach, but to coach. Teaching provides knowledge; coaching enables performance.
In the Teaching Teaching (Coaching) class offered to fourth-year students and residents, I begin with asking the students to recognize the four developmental phases of a teacher:

1. Phase 1: After years of struggling with a clinical topic, the teacher seeks to prove to himself that he has finally gained mastery of the topic. This teacher’s lectures are full of details and proceed at a blistering pace. The goal is not for the students to learn or use the material, but rather to be a witness to the teacher’s self-driven desire to prove mastery of the topic. The focus is on the teacher’s ego, not the students’ ability to perform.
   
   
2. Phase 2: Along the way, the teacher receives approbation from her students. The approbation becomes her primary motivation for teaching. Like an artist who has sold out to the popular media, the teacher begins to think less about what the student needs to perform (her art), and more about what will make the student happy. While student satisfaction is important, the teacher is at risk for abandoning important lessons in lieu of popularity. The focus is on the teacher’s ego, not the students’ ability to perform.
   
   
3. Phase 3: The teacher discovers that awards are given for teaching, and these awards are important for promotion and pay. The teacher’s motivation is for his personal gain, not for the for the student’s performance. The risk of popularity driving the teacher’s agenda seen in phase II is increased. The focus is on the teacher’s personal gain, not the students’ ability to perform.
   
   
4. And then there is Phase 4, where the teacher becomes the coach. Whether recognition or popularity come his way, his focus is undistorted: he is driven by a vision of turning the corner of a hospital ward one day, and seeing a former student doing the right thing for a patient, because of something he had taught him. The focus is on the student’s ability to perform; the coach is content to be anonymous.
   

My father was a prolific coach, and while he has not been a part of my life for twenty years, I do remember this important lesson of coaching: to establish greatness in a player, you must begin early in his career, and you must give of yourself completely to ensure his development along the way. In my teaching career, I have been through all four levels, and still I struggle with keeping myself from being swayed by popularity and concerns for my career (phase II and III). When it is all said and done, it is my wish that my coaching career will be characterized by my father’s first principle: I want to be able to say that I devoted all elements of myself to the development of my students; my success will be measured by students’ ability to perform. I wish too that I can find peace with this goal, such that I am content with no recognition of my efforts, save the satisfaction of knowing that the world is a better and healthier place because of what I enabled my students to do.

Perhaps this narrative will give you an idea of how I have tried to accomplish this goal, for even though the different courses I teach seem disparate, there is a common vision that holds them all together.
I evoke the idea of coaching and teams not only because I think it is a better paradigm for an educational venture with performance as its ultimate goal, but also because at the end of all training, medicine is about being a part of a team. I think this team philosophy that underlies each of my courses and teaching ventures not only makes for better physician “players,” but more importantly, it makes for better physician “team players.”