Learning to teach

“See one, do one, teach one” is a phrase commonly used to describe the way in which doctors learn their craft. Although clearly a caricature, like many, there is an element of truth in it. In the traditional apprenticeship style of learning, students and junior doctors picked up knowledge, skills, and attitudes opportunistically on whatever patients presented. This was a largely informal process of observation and gradual assumption of tasks, often described as “learning by osmosis”. As junior doctors became more experienced and climbed the hierarchy, they started to teach students or doctors more junior than themselves. Despite the fact that educating patients and colleagues is a routine and fundamental part of doctors' work, little if any education or training was provided to develop this skill. A similar situation was prevalent across higher education in the UK, where expertise in one's subject was considered the only prerequisite for teaching it. Ironically, this was not the case in earlier stages of education, where a degree or postgraduate certificate in education was required to teach in state schools. Prospective school teachers were expected to develop an understanding of how children learn and of psychological and sociological factors affecting learning, as well as developing the practical “craft” skills of teaching. A few universities (mostly former polytechnics) and nursing colleges also recognised the need to develop teaching, and required lecturers to gain teaching certificates. In medicine, general practice was unusual in requiring postgraduate trainers to undertake a programme of education before teaching/supervising trainees, and in recognising the importance of the trainer as a role model.1 Does the general lack of training and education for teaching matter? A range of studies have shown that teachers themselves are often critical of the quality …