영향력있는 선생님들: 우리의 찬양받지 못한 영웅들을 인정해주기 (Med Educ, 2015)

영향력있는 선생님들: 우리의 찬양받지 못한 영웅들을 인정해주기 (Med Educ, 2015)

The highly influential teacher: recognising our unsung heroes

Lars Osterberg,1 Rachel Swigris,2 Amy Weil3 & William T Branch Jr4

"나는 '이 사람은 병동에서 학생을 가르쳤다'라는 문구 외에 다른 묘지명은 필요 없다. 나에게 요청된 일 중 가장 유용하고 중요한 일이기 때문이다."

I desire no other epitaph... than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do. (Sir William Osler, from The Fixed Period,in Aequanimitas)

도입

INTRODUCTION

의학을 배우는 자가 사회화되는 과정을 이해하기 위해서는 교육자들은 정체성 형성의 단계에 영향을 미치는 긍정적인 선생님/가이드/롤모델을 이해해야 한다.

To understand the process of socialisation by which a medical trainee becomes a physician, educators must understand the positive teachers, guides and role models who influence the stages of identity formation.11,12

우리의 서사적 방법론은 관계적 의미에 대한 생생하고, 심도 있는 묘사를 보여주며, 영향력 있는 선생님에 대해서 앞선 연구에서 알려준 것을 더 심화시켜줄 것이다.

Our narra- tive methodology provides vivid, in-depth descrip- tions of relational meanings and impacts that deepen what has been learned about influential teachers in previous studies using surveys and brief interviews.15,16

방법

METHODS

Our qualitative study was approved by the institu- tional review boards at the respective institutions of the authors (WTB, LO, RS and AW) as part of a larger study examining the effects of a longitudinal (1-year) small group-based faculty development programme designed to enhance humanistic beha- viours at 10 schools. The programme, described elsewhere, has been evaluated and found to be effective.13,14

 

Participants were selected at all schools, including the three that volunteered to take part in the present study, because they were recognised as promising and respected teachers who were willing to participate in a year-long faculty development programme. They generally func- tioned as clinical teachers on the faculties of their schools. Participants at the three schools involved in the present study were chosen as a convenience sample for this qualitative study.

 

The four authors of this study comprise the principal investigator on the project and site leaders or facilitators from each of the three schools. Within the faculty develop- ment programme, participating faculty members at Stanford University (SU), University of Colorado, Denver (UCD) and University of North Carolina, Chapel Hill (UNC) were asked to perform an appreciative inquiry narrative reflective exercise. Appreciative inquiry narratives describe an incident or circumstance in the subject’s life as a clinician, teacher or learner that stands out as particularly rewarding and meaningful. Participants were asked to write short narrative accounts describing their most influential teacher in response to the follow- ing prompt: ‘Write about your most influential tea- cher.’

 

We collected a total of 20 narratives from a possible 22 participating faculty members. Faculty staff at SU contributed eight narratives, faculty members at UCD contributed six narratives and fac- ulty staff at UNC contributed six narratives. Partici- pant rates were 89% (eight of nine) at SU, 100% (six of six) at UCD, and 86% (six of seven) at UNC (total collection rate: 91%).

We employed grounded theory by using the con- stant comparison method to analyse our narratives.

• The constant comparison method identifies persis- tent concepts, themes and illustrative phrases from a dataset, such as narratives.
• An initial analysis of some items in the dataset is compared with the analysis of new items, thereby generating new themes.
• When the investigators find that further comparisons no longer generate new themes and insights, they may conclude that they have identi- fied the most meaningful themes and plausible interpretations corresponding to the data.17–19

 

The four authors of this study met in conference calls on five occasions to iteratively compare themes and insights garnered from the reading of four to six narratives randomly selected from the dataset. Themes were recorded after each call and were revised with the objective of seeking new or deeper meanings after reading an additional four to six randomly selected narratives before the next call. Authors were not assigned narratives from their own schools, but all authors participated in the dis- cussions. The authors identified quotations from the narratives that best illustrated each of the major themes. At the last of the five conference calls, all 20 of the narratives were reconsidered and searched for deeper meanings, themes and insights. At this time, we reached a point of saturation at which we discovered no additional insights.

결과

RESULTS

These themes were divided into two domains: personal or teaching qualities of the teachers and relational qualities noted in the learner/teacher dyad.

개인적 특성, 교육적 특성

Personal and teaching qualities

• Mindful, present, calm 
• Passionate and dedicated to teaching 
• Respected role model 
• Comfortable being vulnerable 
• Prioritised teaching even when it was busy 
• Knowledgeable 
• Charismatic 
• Master communicator 
• Set high expectations

관계적 특성

Relational qualities

영향력있는 선생님들은 학습자들에게 personal and professional 관심을 보였다.

The influential teachers showed both personal and professional interest in their learners.

이 선생님들은 학습자들의 특정 요구를 맞춰주었다. 이들은 학습자의 특정 능력을 처음으로 인정해주고 격려해준 사람으로 묘사되었으며, 또는 학습자를 억제하고 있었거나 취약했던 부분을 극복하게 도와주었다.

Influential teachers met particular needs of the learners. They were often described as the person who had first recognised and encouraged a learner’s particular talent, or helped the learner overcome an inhibition or vulnerability.

• Generous and giving, selfless in the relationship 
• Caring, longitudinal relationship focused on the learner’s personal development 
• Removed hierarchy and valued learner as a colleague 
• Encouraged learner to seek his or her own direction and achieve his or her own goals 

DISCUSSION

이 선생님들은 교육적 pathway의 여러 부분에서 학습자에게 영향을 주고 있었으나, 가장 많은 경우는 임상 선생님들이었다. 가장 영향력있는 선생님들은 학생을 그들 가까이로 끌어모으고, 관례적인 교육적 강점을 병합하여 강력하고 긍정적인 영향력을 미쳤다.

These teachers influenced their learners along vari- ous parts of the educational pathway, but most were clinical teachers. Most influential teachers drew students to them and exerted their powerfully positive influences through combinations of con- ventional teaching strengths.20–24

영향력있는 교사들은..

Influential teachers were

• generous,
• showed per- sonal interest in the learner’s (rather than their own) chosen path of development, and
• showed car- ing toward the learner in both a professional and personal manner.

 

이러한 방식으로, 이들은 의료계에서 흔한 위계를 없애고, 학습자와 의미있는 관계를 형성하고, 통상적인 임상 로테이션기간보다 더 오랜 기간 관계를 유지했다.

In these ways, influential teachers often diminished the hierarchy that is pervasive in the medical field and formed meaningful relation- ships with their learners that lasted longer than the usual clinical rotation.

Paukert and Richards 는 영향력있는 교사의 특징으로 다음을 발견함.

Paukert and Richards identified

• 교육에 대한 관심 being interested in teach- ing,
• 영감/자극을 주는 being inspirational,
• 롤모델이 되는 being a role model,
• 학습자를 돌와주고 지지해주는 being caring and supportive of the learner, and
• 학습의 기회를 주는 providing opportunities for learning

 

as characteristics of influ- ential teachers.15 These

 

이야기를 읽어나갈수록, 우리는 교육자들이 학습자에게 불어넣어주고 싶어하는 특성과 동일한 특성을 이들 선생님들로부터 찾았다. 이러한 특성들은 전문직으로서의 정체성 형성에 핵심이다.

As we read the stories, we encountered the same attributes in these teachers that educators aspire to instil in their learners:

• 전문직 가치를 고수함 a strong adherence to profes-sional values;
• 수월성의 문화를 형성하는데 헌신함 commitment to the creation of a cul- ture of excellence, and
• 평생학습자로서의 자세 the status of a lifelong learner.11

 

These traits are vital to professional iden- tity formation.4

 

영향력있는 선생이란 누군가? 그들은 외부적 인정과 승진이 아니라 너그러움과 내적 보상에 의해 동기부여된다. 그들의 커리어 결정career decision은 '더 나은 세상을 만들고자 하는 기저의 가치'로부터 나오는 듯 보였다.

Who were the highly influential teachers? They seemed moti- vated by generosity and internal rewards, and not by external recognition or promotion. Their career decisions seemed to have ‘emanated from an underlying set of values associated with making the world better’.16

 

 

 

 

Jarvis-Selinger S, Pratt DD, Regehr G. Competency is not enough: integrating identity formation into the medical education discourse. Acad Med 2012;87:1185–90. 

9 Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med 2010;85:220–7.

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Med Educ. 2015 Nov;49(11):1117-23. doi: 10.1111/medu.12808.

The highly influential teacher: recognising our unsung heroes.

Osterberg L1, Swigris R2, Weil A3, Branch WT Jr4.

Author information

• 1Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
• 2Department of Medicine, University of Colorado Denver, Denver, Colorado, USA.
• 3Division of General Medicine and Epidemiology, Chapel Hill School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
• 4Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

Abstract

OBJECTIVES:

This study was designed to investigate the roles, characteristics and contributions to the educational process of highly influentialteachers described retrospectively by faculty members who were former medical students and trainees.

METHODS:

The authors collected 20 appreciative inquiry narratives from a convenience sample of 22 faculty members (91% collection rate) at three medical schools that had volunteered to participate in a year-long programme of faculty development in humanism in medicine. The faculty members wrote narratives in response to the prompt: 'Write about your most influential teacher.' The four authors performed qualitative analysis of the 20 narratives using the constant comparison method to identify the characteristics of influential teachers.

RESULTS:

Particular relational features with their learners explain the profound influences of these teachers on the professional development of their learners. All influential teachers shared qualities of excellence in teaching and nearly all were described as caring, generous and selfless in their relationships with learners.

CONCLUSIONS:

Highly influential teachers have no official roles, yet appear to profoundly influence the professional development of many learners at various stages of the educational process.

© 2015 John Wiley & Sons Ltd.

Comment in

• Are influential teachers born or can they be taught? [Med Educ. 2015]

PMID:

 

26494064

 

[PubMed - in process]