Are you a good EM educator?

IMG_3422Should I even ask the question? Of course you are, you’re awesome just like the rest of us, but are you really?

Education is a cornerstone of our role as emergency physicians, be it patients, colleagues, juniors or specialities a day never goes by without some form of educational experience. Every day, every hour involves transmission of knowledge and or skills to those around us and I would argue that nearly everything we do involves teaching and learning. For anyone working in an academic institution with undergraduate or postgraduate students then it’s even more important.

So are you any good at it?

What if I were to ask about your abilities as a driver? Data suggests that the vast majority of you will rate yourself as above average (and presumably then rate the rest of us as below average). This illusory delusion suggests that most people will overestimate their positive qualities and underestimate their negative qualities across many aspects of their lives. I wonder if teaching in the ED suffers a similar effect? Presumably we all exist on a spectrum of abilities and some amongst us will be great educators others not so much, but how would you know?

Knowing where you are is not the same as simply defining the characteristics of good educators. That’s rather easy, looking back at yourself and seeing the positives and the flaws is much harder.

In preparation for a talk I gave recently I asked twitter and got some great replies. There were several themes about how you would know if you were good.

Intuition – you know it when you see it, a gestalt approach to knowing if something is good. I can understand this when observing others, but how would this work for oneself?

Sparks – many people were under the impression that our students possess intrinsic electrical activity as words such as energy, spark flash were used as a marker of something you may see in students as the learned and understood. Again, this is interesting, but hardly objective and there are reasons why staring into the eyes of students for feedback may turn nasty.

Outcome – one could argue that the best education results in positive patient outcomes and some tweets alluded to this suggesting that when we see patient care change and improve as a result of teaching that’s evidence of good teaching…, but is it? It’s evidence of learning, but that’s not a marker of whether you are a good educator.

Feedback – well feedback pervades medical education these days. End of lecture forms, or ‘happy sheets’ as I call them are a must have for portfolio and ego massaging as they inevitably score everyone as above average, or at least that’s my experience in reviewing them anyway. Routine feedback after individual sessions rarely delivers the depth required to improve nor allows teachers to benchmark themselves against others. Similarly departmental feedback as occurs in the UK through surveys such as the GMC trainee’s survey almost never delivers the fidelity to inform your personal practice. Obviously the positive comments will apply to you, but the negative comments must surely be to someone else in the department as you are…, of course…, above average at this sort of thing…., or are you?

The question remains and one might ask about the purpose of the question itself. Is ‘good’ an absolute? A measure that you reach a standard, or is it a relative measure that you are indeed above average? The former is easier to answer through standard feedback mechanisms, but the latter? I’m not so sure. For many of us the question is really rather difficult to answer and I ask you to consider it for yourself now.

and then?

It would be rude of me to ask the question with no hope of answer. I might suggest that in order to find out whether you are indeed a ‘good educator’ you need to expend some effort. By all means carry on and collect the happy sheets and national feedback scores, they are quick, easy and available, but also consider how you might learn more about yourself through one or all of the following.

  • Keep a reflective teaching diary
  • Ask an experienced educator to observe and peer review your teaching sessions.
  • Offer to peer review someone else’s session (this is often more helpful than being observed in my opinion)
  • Take part in a personal educational 360/MSF

Think about it and let me know how you’re getting on. I’d really like to know and to be honest I might join you, although to be honest I might not bother as I know I’m above average, just like you 😉


Perhaps I should leave the final words to Martin Duffy, a UK anasesthetist.

I did think this was a tad ambitious…….

…but you can’t derail an optimist like Martin….



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