DEVELOPING CLINICAL TEACHERS

Clinical education is the most important formative period during undergraduate and postgraduate medical education. The clinical learning environment has been described as chaotic, unplanned and at times, intimidating. The most important determinant of the quality of the clinical learning environment is the clinical teacher, yet most clinical educators have not been trained to teach. It has always been assumed that expert clinical knowledge is the only requirement for teaching clinical medicine. However, it has become increasingly clear that the haphazard nature of the clinical learning environment and the variable quality of clinical education is no longer acceptable and needs to be addressed. The most obvious development is help clinical educators to become better and more consistent teachers, mentors and supervisors. This is the essential focus of this chapter. However, if clinical teacher development is to work there also needs to be concomitant adjustments to the organisational structures of clinical settings that facilitate better education without jeopardising clinical care.Despite the fact that most clinical educators have not been trained to teach, they often process considerable tacit knowledge of pedagogy. This knowledge is likely to have been derived from their experiences as learners and teachers during a so called apprenticeship of observation. It is vital that teacher developers take cognisance of clinical teachers prior pedagogical knowledge and beliefs because they exert huge influence on what they are capable of learning from teacher training workshops and courses. When planning teacher training it is also important to consider the nature of the clinical contexts where teachers work. The quality of the clinical environment is a key determinant of the ability of teachers to transfer new knowledge and skills to their workplaces. The first part of this chapter will review how teachers are developed from different theoretical perspectives. The second part of the chapter will describe and critique current teacher development approaches. Readers should emerge with a clearer understanding of what developing teachers is all about and be able to select appropriate teaching methodologies to suit their educational goals and purposes