Do medical students really lose their empathy?

In my opinion, this was the most interesting read for me this week. My father is a doctor, I have a couple of best friends who are doctors now, and I guess I’ve been to a doctor…or…whatever.

My friend, Sanjay, grew up with me from pre-school. We endured our middle school years together and attended a prom or two as dates. I say this without an ounce of reservation: Sanjay is a truly empathetic and selfless person. He’s also freaking brilliant. In fact, it was pretty much assumed that he would graduate from Duke and move on to medical school, but he wanted to work for a non-profit to help people sign up for healthcare in limited access Appalachian regions for a couple years before reluctantly accepting a spot in Harvard Medical School’s class of 2020(?). Anyways, I forced him to talk to me on the phone. He’s doing rotations right now.

Sanjay read the article entitled “When do medical students lose their empathy” before we spoke, giving him enough time to formulate his thoughts on the topic. “I don’t want it to be true, but I think it is.” Sanjay went on to detail his exhaustion, the competitive environment, the torturous hours, the weight loss, the pressure. Oh, the pressure.

Sonia Henry said: “Fear of exams, of angry surgeons, of night shifts, and of looking stupid is one thing. But fear to engage with a patient, to feel their pain and offer them your comfort — that is something else entirely. For all the medical procedures and lab tests and suture ties I cannot perform as a student, comfort is something that takes no study at all and can be given freely, with almost guaranteed good results.”

Not necessarily so different from the academic environment we subject undergraduates to, in a way, just at a higher caliber. I asked him what he thought he’d do to try and counteract the loss of empathy. “Honestly, it’s not exactly something I can be concerned about right now. I’ve got to get my stuff done. This what they want, this is why they accepted me.” A far cry from the voice calling me lost on an Appalachian back road trying to find the clinic to help patients get the care they needed. “I won’t always be like this, Sarah. I just need some time to breathe.” Maybe we all could use some breathing time.

Farewell Contemporary Pedagogy peeps! Twas a most excellent experience with my fellow GEDI’s by my side. Though I still have a long way to go, some of the important things I have taken away from this experience are:

  1. Start with a plan
  2. Be willing to desert the plan you started with
  3. Be open to digital learning-embrace the changes
  4. Have a philosophy, but make sure that it is fluid
  5. Never be too set in your ways to change the way you teach young people
  6. Reflect, reflect, reflect

 

 

 


There is a need for “Scientists” in the Humanities

 

Dan Edelstein’s article “How Is Innovation Taught? On the Humanities and the Knowledge Economy” does raise an important reality that “In the face of limited resources, administrators and policy makers are urged to invest more in science, engineering, and technology programs (Goldin and Katz 2008); meanwhile, liberal arts colleges are on their way to becoming an endangered species (goodbye, Antioch!).” While there is much funding in the STEM fields, from personal experiences, I know having a sole STEM mindset is not innovative. There is a need for “Scientists” in the Humanities. As an environmental engineer, all of my work translate to affecting society. For example, I worked on a research project that evaluated consumer confidence reports. For those who don’t know what these reports are, they are  reports that contain information on the quality and safety of tap drinking water. They are mandated by the USEPA to be delivered to water customers every year. Unfortunately, my research found that most of these reports were not well written and the clarity of message communication was poor throughout. As a result, a team of environmental engineers and “scientists” from humanities field collaborated to offer improvements to the readability and clarity of these reports. Without the training I had in my Science, Technology & Society course, it would have been difficult for me to communicate my work in a way that will benefit water customers. What is the point of the work I do in water quality and safety if I can’t effectively bridge that gap between me and society? I totally agree that,” the humanities provide students with the best opportunities for learning how to innovate.”

 

How will I be a New Professional?

Throughout this semester, we covered numerous topics in this course relating to pedagogy. For those of you that may not remember, below are the main topics we discussed:

  • Networked learning
  • Mindful learning
  • Assessment
  • Inclusive pedagogy
  • Critical pedagogy
  • Multi-tasking
  • Problem-based learning

I know, that’s a pretty daunting list of topics, but don’t worry it isn’t as bad as it might look. Now, each of these topics can be used individually when teaching an have powerful implications. But instead, if they are used together better results can be achieved to ultimately become the ‘New Professional’ as Parker Palmer likes to put it. For me, I feel that this idea of a ‘New Professional’ can be broken into four components:

  1. Adapting the curriculum
  2. Being mindful
  3. Proper pedagogical praxis
  4. Proper assessments

For each of these four components parts of the list above can be incorporated and mixed together to provide what I feel is a curriculum for a ‘New Professional’. The four components and the interactions of the topics covered in this course are discussed in more detail below.

Adapting the curriculum
The first component of becoming a ‘New Professional’ is adapting the curriculum to individuals in the course. One method of adaption is the used of networked learning. Firstly, networked learning can allow for individuals to participate in the class when they are not able to physically in the classroom. Networked learning can allow for deeper conversations to occur  through the use of blogging or similar online outlets. Adaption does not just stop at the use of blogging and online platforms. Adaption to new technologies in general is as a huge deal. Nobody wants to be taught by a professor that uses transparencies and a slide rule.

Being mindful
A ‘New Professional’ needs to be mindful of the students and be sure to take what Ken Robinson had to say in mind. In order for the students to flourish  a ‘New Professional’ needs to be mindful for three principles: diversity, curiosity, and creativity. Stifling any of these principles can have an adverse effect on the learning process. Being mindful covers more than ensuring your students have the three principles needed to flourish. A ‘New Professional’ must be mindful of the grading policy he/she puts in place. In certain instances an A-F grad may not be the right answer for providing feedback to students. A ‘New Professional’ must be mindful of competition amongst students. I feel that competition can have a positive impact on the students when used in moderation (The Bright Side of Competition Projects). However, if competition is used improperly it can lead to students playing it safe and not learning as much because they are scared to get a “low grade”.

Proper pedagogical praxis
The third component is using a proper pedagogical praxis when teaching a course. When in the classroom, it is important to use teaching methods that work for the students in the class being taught. This means that one method that works one semester may not work as well the next. There are numerous pedagogical praxis out there each with their own spin on what is important and what isn’t in the classroom. In this course we talked about inclusive and critical pedagogies specifically. I think both of these pedagogical praxis are a good start to forming a proper pedagogical praxis. The use of an inclusive pedagogy was illustrated in the first two components above so I will not repeat it here. Looking at what Freire had to say, it is important to not view students as empty banks where information is to be dumped. Instead, a ‘New Professional’ would use dialogic engagement.

Proper assessments
Being a ‘New Professional’ does not stop at teaching information, which is why the fourth component exists, assessments and course work. Deciding what assessment is best is a difficult choice, but it is one that every educator must make. One assessment that I feel will be used at least once in every course I teach is problem-based learning. I want students to develop the critical thinking skills that are necessary for engineering. While knowing the theory and calculations to back up claims is absolutely necessary, in industry there is no book with answers in the back to problems they will face. Therefore, students will need to be able think critically and use logical arguments to back up their claim, both concepts that are taught through problem-based learning assignments.

Final Comments
I feel it is impossible to say that there is one way formula to being a ‘New Professional’. Being a ‘New Professional’ is going to be different from educator to educator, but what will be the same same is the use of personal strengths to develop a curriculum that works for the educator and the instructor. As of now, I haven’t had enough teaching experience to know what topics I learned in this class will be of the best use to me. But, I now have a tool belt partly full of topics and principles that I can test and see how it works for me. Now, notice the “partly” in the prior sentence, I say this because I strongly feel that this course was just the tip of the iceberg and provided me with some tools but there many other tools other there that I still have yet to find. It is now up to me to continue investigating and keeping up with new developments so that I can be a ‘New Professional’.

A Game of Pedagogies

“The best pedagogical practices in the humanities draw attention to the fact that the knowledge being conveyed is questionable. This is not an invitation to rampant revisionism or postmodernism, but a simple recognition that historical, literary, political, and anthropological knowledge is not made up of equations or organic structures, but of perceptions, arguments, aesthetic effects, philosophical concepts, and other representations whose signification is subject to change. The words of Hamlet or of the Declaration of Independence may not vary, but their meaning can.”

Dan Edelstein, “How Is Innovation Taught? On the Humanities and the Knowledge Economy”

Perhaps especially because I realize now that the meaning of so many things can change, it  great comfort to know that, as educators, we’re never re-inventing the wheel. It’s more like we’re improving the wheel, from the material used to make it (e.g. pedagogy)  to the laborers needed to produce it (e.g. teachers). (Wait… does this mean knowledge is like a car in this metaphor? Okay, well that makes students drivers. And maybe I’m the driver’s ed instructor. This is both exciting and terrifying.)

Going home and realizing you’re never done re-doing your assignments

When I think of what it means to be professional, though, I do agree with Parker Palmer’s overview of the “new professional” which is as follows:

(1) We must help our students uncover, examine, and debunk the myth that institutions are external to and constrain us, as if they possessed powers that render us helpless – an assumption that is largely unconscious and wholly untrue.
(2) We must take our students’ emotions as seriously as we take their intellects.
(3) We must start taking seriously the “intelligence” in emotional intelligence. We must do more than affirm and harness the power of emotions to animate learning
(4) We must offer our students the knowledge, skills, and sensibilities required to cultivate communities of discernment and support.
(5) We must help our students understand what it means to live and work with the question of an undivided life always before them.

It’s hard to question the state of things, and harder still to question a discipline. I think Palmer’s emphasis on emotional intelligence is essential… seriously. When I think of this course as a whole, I know that emotion is essential to teaching. A syllabus? Your personality as a teacher (which has emotion). A teaching philosophy? Your view of teaching as a person (which has emotion). A problem-based learning assignment? Your ability to let go and let students guide you as they demonstrate what they learned (which has emotion, y’all).

Thus, I think it might be best to end my final blog post for a course in contemporary pedagogy with this observation by Dan Edelstein: “To innovate is thus less to abandon the past than it is to tinker, transform, and revise what came before.”

Flexibility in a fast changing world

The importance of the humanities, addressed by Dan Edelstein in this publication, reminded me of a couple of articles I had come across before on “Why Top Tech CEOs Want Employees with Liberal Arts Degrees” and “How Studying Philosophy Led Me to the Executive Suite“. A couple of quotes that stood out for me from the first one of these two was: “It’s a horrible irony that at the very moment the world has become more complex, we’re encouraging our young people to be highly specialized in one task. We are doing a disservice to young people by telling them that life is a straight path. The liberal arts are still relevant because they prepare students to be flexible and adaptable to changing circumstances.” and “…the liberal arts train students to thrive in subjectivity and ambiguity, a necessary skill in the tech world where few things are black and white.”

It can also be expanded to the irony that the main fields that are changing at a faster pace than any other, those related to science and technology, are following the same outdated educational system where students are being forced to comply to a predetermined set of rules and provide a predetermined set of answers. This instills the notion that they should be looking for the “right” answer instead of considering a broad range of options, and their implications, which seems to be closer to what they will be faced with out in “the real world”. People with a background in humanities are considered to be better suited to adapt to fast and drastic changes without being thrown off or paralyzed by them. Proof of this should be shared with teachers at all levels of the academy, especially those in STEM fields which seem to be some of the biggest opponents to humanities as part of their curricula. In their quest for all things technical (since everything else is perceived as a waste of time), STEM educational programs can be generating less critical-thinkers/problem-solvers and more oompa loompas.

On the piece by Parker Palmer on the “New Professional“, the author refers to educators avoiding recognizing their students as human beings with their own set of emotions. I kept thinking about how this behavior would translate for underrepresented minorities in any field and their relationships with their mentors and educators. If educators don’t want to engage with their students on a deeper or even personal level, it can make them less equipped to understand and effectively communicate with students from different backgrounds to their own. When colleges and universities start pushing for an increase in admissions for underrepresented minorities without proper training to the faculty and administrators who will be key players in their education, it can be a disservice to these students where the people and resources at their disposal do not meet their particular needs. It seems that programs receive both pressure and incentives to increasing diversity without proper training on how to best manage this new landscape in higher education.

“He chose to do what is right, not what is easy”

In his 2007 essay, “A New Professional: The Aims of Education Revisited,” Parker J. Palmer takes issue with “knowledge” devoid of social context as the product of education, such that graduates—professionals—are subservient to institutions rather than the interests of humanity. ‘The institutions in which we work too often threaten our professional values.’ —Parker J. Palmer …

The musings of a feminist

“The fact that good pedagogy requires emotional intelligence has been demonstrated time and again by educational researchers. The effective exercise of our profession requires us to tap into our own and our students’ feelings”. This piece from Palmer resonated so much with me because I was reminded yet again why I want to be a lecturer. I was in a science faculty in Ghana and the only female lecturer I had in my four years as an undergrad was a lady from the arts department who taught us communication skills, a mandatory course for all freshmen in the university. After my first year, I did not encounter any female lecturers. The common explanation for this, coined by students and even lecturers alike, was that science was a field mainly for men and that the few women who got into science lacked the tenacity for higher education in science, hence the low number of female science lecturers in the universities in Ghana. According to a study by the University of Pennsylvania, girls who had been randomly assigned to an all-girls classroom were more engaged in physics and less likely to agree with statements such as “physics is for boys.” On the other hand, girls who had been randomly assigned to coed physics class were more likely to agree that “physics is for boys.” I ask myself why this is so and I am tempted to believe that some emotional intelligence, like Palmer puts it, is acquired by the girls in the all-girls classroom through their interaction with each other. What tipped the scales in favor of this perception, is an ongoing phenomenon in Ghana. For a while now, the issue of alleged sex for good grades has been rampant in university campuses in the west of Africa. Usually referred to as an “A for a lay”, students are propositioned frequently by their instructors to exchange sexual favors for good grades. For my friends who were not lucky enough to do so well in examinations, this was a very common situation that they always found themselves in. While for most of my friends, such situations mortified them, I had my career defining moment when one of my friends who had slept with two of the men on her defense committee, expressed her feelings about her proposition with me. In words that I will never forget, she told me that she felt empowered when lecturers propositioned her because although she could never get to their level educationally and they seemed so brilliantly superior, she was satisfied with the fact that during those short moments when she was in bed with them, she could feel her own power. I remember as a 21 year old, full of pride and ego about my intellectual prowess, I asked her, but most importantly, I asked myself, why she was obliged to think that she could never get to their level educationally and she only felt her power in bed with them. I decided there and then to strive to be a lecturer in the university so that no other girl after I am a lecturer, will think this way ever again. I feel that it is the job of women to encourage women, like no man can. I want to be that lecturer that taps into both mine and the feelings of my students, especially female students, to propel them forward. At the risk of sounding too much of a feminist, I know that women can transfer emotional intelligence to other women more easily, than men can. And I am reminded that I can be that professor that my students can connect to emotionally, has that emotional intelligence, and therefore, give them a more total education than the current school system offers.

I Need More Ice Cream for This

It was not in Raj Lyubov’s nature to think. Character and training disposed him not to interfere in other mens’s business. His job was to find out what they did, and his inclination was to let them go on doing it. He preferred to be enlightened, rather than to enlighten; to seek facts rather than the Truth. But even the most unmissionary soul, unless he pretend he has no emotions, is sometimes faced with a choice between commission and omission. “What are they doing?” abruptly becomes, “What are we doing?” and then, “What must I do?”
The Word for World is Forest by Ursula Le Guin (2010, p. 124)

When I started reading the selections for this week the above quote from one of Ursula Le Guin’s books came to mind and a pint of Ben and Jerry’s went into my hand. In higher education, in our graduate school careers, in the courses we teach, and with the students we work with the question remains: what are we doing?

MeIRL

What are we doing when students from historically marginalized populations continuously take the third shift of educating their peers, and us, about what it is like to be at an institution that was never meant for them?

What are we doing when we make students jump through hoops of paperwork for “accommodations” that may not actually fit their needs out of fear that someone, somewhere would abuse our generosity if we simply took students at their word?

What are we doing when our peers and colleagues say they suffer in ways we could never understand, that they’re tired, that they have to be on their “best behavior” to avoid validating stereotypes and that they feel tokenized when the only time their voices matter is if they are needed for a photo-op for the upcoming recruitment brochure or for a video highlighting the diversity at a given institution?

What are we doing in these situations? Sometimes this

When I read this weeks readings I felt/feel: angry+sad+irritated+ tired…

All these birds at once…

I feel like I need to go grab another three pints of Ben and Jerry’s even though I know I’m probably at least partially lactose intolerant and that I should be a vegan.

Me.Every.Night.

I feel all these things and this is what is missing from most of the classes I’m in and from a number of the conversations I have with folks outside of my friend circle: emotion and affect.

Palmer’s essay was about this notion and long before Palmer people such Audre Lorde pointed to the uses of emotion and affect, in Lorde’s case The Uses of Anger. In fact, most of his essay read like the work of numerous liberation scholars including liberation theologians and those historically invested in black liberation. While what I say next is in keeping with what Palmer says, it’s from the space of the liberation scholars who did the labor before us all and are no longer around to see their labor bloom into a new movement and conversation.

Contrary to the commonly espoused belief, emotions can serve in a clarificatory capacity for some people at least some of the time. Which  people? Well, probably the folks who historically have had robust reasons to be irritated with the current state of affairs and higher education.

How does this semi-diatribe relate to being a “new professional” and connecting the dots? It’s an invitation to reflect on the final question: What must we do?

How do we make space for emotion and affect to be in our classrooms where our students can be their full, authentic selves even in the midst of deep and sometimes uncomfortable conversations?
How do we relate to those who question the system when historically and systematically we are given disincentives and incentives to the contrary to censure, ostracize, and disassociate from the “revolutionaries”?
How can we be our authentic selves while we are here?

How can we do these things? By being revolutionaries which is what Palmer is gesturing at even if they never use the word and say they aren’t calling for an uprising.

What would that look like? I don’t know, but I suspect that the answer relies on building capacity and a network of colleagues who can share the labor, work together, and change a system to be in the service of those it is charged to serve-to place the system into the obediential service of students and faculty/staff alike.

What might it require? Being for and with one another even in battles that are not our own.

Being for and with our students in the project and labor of inviting them to be critical of themselves, the programs they are in, the lessons they learn, and of the institutions they attend.

 

It requires solidarity (tapputu in Akkadian), emotion, labor, and hope–but what these look like are things we will have to figure out in the process of relating to one another and figuring out our revolution.

“You cannot buy the Revolution. You cannot make the Revolution. You can only be the Revolution. It is in your spirit or, it is nowhere.”
The Dispossessed by Ursula Le Guin (1974, p.301)

 

I’ve forgotten everything…

During undergrad, I often wondered why I had to take certain class and memorize certain things. Some of my classes were completely unrelated to my major as well as uninteresting to me.  Even the experience and knowledge I received from some of my relevant classes was forgotten in a semester or two. Why teach me to format a business proposal or create something in Photoshop and then never have me practice these skills again? I often have to Google information that I know I was taught in undergrad, but without repetition or practice I have lost the knowledge or ability.

I know if I had practiced these skills on my own I would have retained them, but I had several internships in undergrad and had no time to practice skills that I didn’t specifically need for classes or for my internships. Unfortunately, my internships never were exactly inline with the work I wanted to do once I graduated. I often look at my “skills” on my resume think to myself, “Do I even remember how to do that anymore?”

What was the purpose of paying all that tuition if I retained none of the knowledge and gained only minimal experience in my chosen career?

Tangent…

It seems that there are several different reasons people go to formal school: to learn remedial information you need to function in society (elementary and middle school), to experiment and figure out your likes and dislikes (high school), to learn how to think and gain knowledge for knowledge’s sake (college), or to gain experience in your chosen field and profession (trade school or an internship/apprenticeship).

I know you are supposed to do the latter for college as well, but, when your relevant experience and knowledge is being interrupted by irrelevant and forgettable information, are you really ready to enter your chosen career as soon as you graduate?

While I think people should continuously learn and gain skills outside of their chosen careers, I don’t know if lumping all of it together at the same time or in the same format is ideal. Instead of focusing on learning all we can about everything in four years (sometimes indirectly in a class setting), we should focus on internships and apprenticeships with some relevant classes. We can have students focused on gaining experiences in their chosen field instead of getting an “A” in Medieval Literature. Once people are employed and maintaining their skills and knowledge in their position, they can be encouraged to take more classes and gain knowledge for knowledge’s sake.


The Ethical Dilemma of Ethical Dilemmas

“The fact that we have schools does not mean we have education. The fact that we have hospitals does not mean we have health care. The fact that we have courts does not mean we have justice. We need professionals who are “in but not of their institutions, whose allegiance to the core values of their fields”

This quote in Parker Palmer’s article really stuck with me. I think that in every field we have issues where what we learn in school isn’t necessarily what is done in the world of work, whether this be because of lack of time, money, or effort. Obviously this disconnect is an issue, but the bigger issue is the gap in education that we receive in terms of ethics. We’ve discussed numerous times the cursory attention that ethics are given in education, and the more I think about it the more I see this gap everyday.

While writing this I’m sitting across the room from my boyfriend who has a degree in engineering, and he confirmed that he doesn’t recall any of his classes addressing ethics. This man could go out and build buildings, create weapons, design computer programs, and a million other things I’m unaware of, and not once did anyone ever prompt him to consider the ethicality of doing so. Luckily he has a good head on his shoulders, and is a very culturally and environmentally aware person, but what about those who aren’t. What about those engineers or doctors or biologists or teachers who didn’t grow up being taught to think about how their actions impact others? If these people aren’t learning this in their personal lives, and aren’t learning it through their educations who knows what could happen.

There is so much deception, damage, and corruption in the world already. If we don’t, as Palmer says, “humanize” ourselves, and begin to educate in a way that emphasizes the effect rather than the result things will only continue to get worse.

Despite my examples being primarily engineering related, this isn’t an issue that only impacts the hard sciences. We all need to humanize our students. What good does it do for me to teach my students how to give an effective persuasive speech if I don’t address the ethical implications of this type of speech, and when this type of speech might be inappropriate.

We often shrug ethics off as something that everyone already knows, but judging by the current political state in our county I believe we have to accept that everyone doesn’t always know the difference between right and wrong, especially when the lines begin to blur, money becomes involved, and your personal security is on the line. I am throughly convinced that ethics need to be a more prominent subject in my course, and I hope you do too.


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