EXCELLENCE IN CLINICAL TEACHING - THE CORE OF THE MISSION

The core of clinical education is the dialogue between physician teach ers and their students and residents. Several years ago the authors be gan to examine the nature of the ''talk'' in one-on-one ambulatory cli nical teaching encounters. Discourse analysis, a qualitative method fo r examining communication, can identify patterns of interaction and ca n highlight the factors that impede useful teaching conversation and l earning in the contexts of clinical education. Further, it can identif y the microskills that physician-teachers need to teach effectively an d humanistically. Having faculty members coach each other is an effect ive institutional approach to teaching these microskills, and it is es pecially valuable to have teachers examine the language they use in cl inical teaching, so that they can understand the different impacts tha t different kinds of language can have on learners. Physicians are res ponsible for cultivating humanistic attitudes in their students. When a physician is humanistic in helping a student learn, the student can, in turn, use the same attributes with the patient. The humanistic beh aviors that are valuable parts of the physician-patient relationship a re the same ones that must also characterize the relationship between physicians and their students. Excellent one-on-one teaching in clinic al settings requires two major things: first, medical educators must u nderstand the special communication skills that create effective and h umanistic teaching; and second, administrators must re-recognize that teaching is the true heart of our medical schools and teaching hospita ls, and therefore support the faculty professional development needed to foster excellent teaching.