On Leadership and Education

The old walls of Jerusalem

During another recent, nonmedicine-related trip to the Middle East and Jerusalem, I had the privilege of experiencing first hand many examples of leadership on an international scale. This trip reminded me of the importance of the educator-leader, and inspires me to make several small but important revisions to the WABIP/Bronchoscopy International Train-the-Trainer core curriculum.

Leadership is a very sought after and precious commodity. Like teaching, however, leadership is rarely taught as part of faculty training in our medical schools and universities. How many of us have taken courses in negotiation and conflict resolution, psychology, or communication? Yet knowledge in these areas is essential, in my opinion, to becoming an effective teacher. These are also areas in which improvement is always possible. We can learn to interact more effectively with our colleagues and our trainees, and we can learn to communicate more clearly, more enthusiastically, and with greater confidence our vision, goals, and expectations.

As many of us already know, leadership is a complex process that has multiple dimensions. My plan is to introduce participants in our Train-the-Trainer programs to at least a few aspects of leadership theory, and to focus on the “psychodynamic approach” to leadership through a new role-playing exercise that highlights the complex and often paradoxical behaviors of human interaction.

This new component of our program is the result of questions raised by many Train-the-Trainer course participants. How does one deal with the problem student? How do I share my expectations without appearing put-offish, condescending, or overly demanding? The answers to these questions reside in having greater knowledge of human behaviors and a better understanding of the needs, desires, and mental lives of our students. It requires educators to manifest curiosity in regards to the motivations and reasoning that underlie student behaviors. It also prompts us to engage in learner-centric activities that form the basis of our Train-the-Trainer core curriculum.

Moving from the “see one, do one, teach one” educational paradigm to one in which a multidimensional approach is used as part of a measurable and objectifiable quest for competency presents many challenges. One must overcome the natural resistance to change; one must convince rather than coerce those who doubt the effectiveness or utility of a new educational approach, and one must motivate adult learners whose greatest strengths come from within.

As more national medical societies and university training programs recognize the value of checklists, assessment tools, case-based studies, simulation, and active engagement using step-by-step instructional techniques advanced by Bronchoscopy International, educators need to be equipped to address new challenges, including how to determine levels of minimally-accepted competency, how to interact with technically or cognitively diverse groups, and how to best manage the individual during critical one-on-one teaching moments. We are no longer living in a time when twenty students follow the all-knowing professor about on the wards, palpating and probing the anonymous patient. We have, instead, entered a time where learning is constantly at our fingertips and simulation permits both experimentation and gradually acquired perfection.

I think that a greater understanding of at least some facets of the psychodynamic approach to leadership will help educators overcome obstacles and face new challenges. It will also help open our minds to new educational techniques and methodologies, regardless of our pasts and prior biases. In fact, the psychodynamic approach to leadership is, in part, based on a framework many experts call the clinical paradigm. This paradigm presumes there is a rationale to each and every action, that many of our motives and behaviors are linked to events outside of our conscious awareness, that people feel and express their emotions differently, and that everyone carries with them the baggage of past experiences that influence current behaviors.

A greater understanding of ourselves can only help us to better understand others, and often times, understanding is what educational leadership is all about.