A good practitioner-patient relationship is vital to effective healthcare. The quality of the relationship affects the quality and quantity of information that patients are willing to provide about themselves and their condition.
It also determines the extent to which they are free to ask questions and be candid about their concerns, the value and credibility they attach to information and advice provided by their physicians.
Likewise, the effectiveness of a teacher is linked to the quality of the relationships developed with students and residents. Your success in developing positive relationships can affect what your students are willing to share with you and with each other and how seriously they take the information and advice you offer them. It also affects how much they can learn from each other.
The way clinical faculty and interns regard each other also affects the faculty's ability to influence and enhance the intern's education. If the clinical faculty member is regarded as accessible and credible they are likely to be sought out for help and be positively influenced by what the faculty advises. If the faculty member is regarded as trustworthy and fair, interns are more likely to be open and honest. Taking the time to get to know the intern better allows the faculty member to provide guidance in ways that are sensitive to the intern's uniqueness and takes into account any special needs. In addition, faculty have the benefit of recognizing the context in which the intern is functioning and a fuller understanding of the intern's performance.
Research has found evidence that student and interns perceive teachers who are actively involved with them as more effective than their counterparts who are only slightly or moderately involved.
The way you treat students can affect how they treat other students and colleagues. There are many reasons to conclude that the ways we relate to students and residents can have a powerful effect on them beyond what we say to them. When teachers treat students in hurtful ways, those students will be likely to treat others in hurtful ways when they serve as superiors.
It is also likely that the way teachers treat students can influence the way students treat patients. If we treat them in authoritarian ways, they are more likely to be authoritarian with patients (Jason & Westberg, 1982).
Students experiencing the negative effects of stress can benefit from talking with an understanding teacher. Over the years, researchers have identified numerous stressors in medical students' lives (e.g., Adset, 1968; Coburn & Jovaisas, 1975; Coombs, 1978; Sacks et al., 1980; Marchand et al., 1985):
A perceived need to "learn it all"
A fear of being unable to absorb and retain sufficient knowledge
Preoccupation with success and the consequent fear of failure
Little or no opportunity to "process" the disturbing events inherent to medical education
Limited recreational and social outlets
Fear of contagion and loss of personal health
In addition, students are vulnerable to all the other normal stressors of their specific age group:
Family & Relationships
Expense of education
Balancing personal and work obligation
Through developing a trust-based relationship with students, teachers can provide a safe outlet for expression of student frustration and feelings. Teachers can also assist interns in developing the coping skills that will support them as developing professionals throughout life.
A good relationship can be a source of satisfaction for both students and teachers.
Characteristics of Positive Teacher-Student relationships
Relationships between students and teachers are as varied as the people involved. Yet several elements typically characterize most successful student-teacher relationship.
Open & Honest
In positive relationships, teachers and students learn to be straightforward with each other. Students are able to reveal their self-doubts and deficiencies and are open about what they need or do not need from their teacher. Teachers can be candid about themselves and share relevant personal experiences, their concerns and their difficulties. They can even share their candid perception of the student, in a constructive way.
The condition most needed for teachers and students to be open and honest with each other is trust. Mutual trust implies that both partners in a relationship can feel confident that whatever each reveals or is revealed to them will not be used in a way that can hurt the other person. Support is provided when needed. If students are to take the kinds of risks needed for significant learning (e.g. being open about their strengths and weaknesses and being will to go through the awkward, clumsy periods that inevitably accompany significant new learning) they must feel they can trust us.
Trust also implies being able to believe what the other person says about himself or herself. We need to trust that the student is being honest about themselves and their experience. The students need to trust that we are what we say we are, and that our suggestions and advice are worthy.
In positive relationships, teachers and students respect each others' differences. If needed, teachers make reasonable adaptations to the students' characteristics. The student must respect the teacher as a credible, competent person who has something worthy to offer. In a mutually respectful relationship, the teacher also sees the student as someone from whom he or she can learn.
Teachers and students in positive relationships foster and promote each others' best interests and actually serve, if necessary, as advocates of one another. Teachers are usually expected to nurture the growth of students and to be available, when needed in response to their needs
Collaborative, Fostering Students Independence
In collaborative teacher - student relationships, students are seen as valuable contributors to the teaching- learning partnership and are encouraged to be as actively involved as possible in their learning: generating learning goals, devising strategies for meeting their goals, critiquing and monitoring their progress. Collaborative teachers do no immediately force students to function as self directed if they are not ready for the role. They start where the student is and help them become increasingly more independent.
Effective teacher-student relationships are flexible. The teacher responds to the changing needs of the learner and to varying circumstances. Generally, effective teachers serve as facilitators, trying to help learners do their own thinking and arrive at their own discoveries. There are circumstances, though, when the teacher may take charge. If the student is unprepared to take change on a case.
Fostering Helpful Relationships with Students
Set aside time for getting acquainted.
Help students understand that you can be most helpful to them if you have a chance to get to know them, including their aspirations, strengths and learning needs. Also, help students get to know you.
Take steps to assess the students' readiness for developing a collaborative relationship with you.
Ask each student about their prior learning experiences, particularly the extent to which they have been active in designing and monitoring their prior educational experiences.
Find out what role they would like you to play. Observe the extent to which they look to you for advice.
Dr. Teri Powers is president of the Acupuncture and Integrated Medicine College (AIMC) in Berkeley, Calif.
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