Grand rounds for teachers

29 August 2010 § Leave a Comment

Teachers at all levels might benefit from adopting a practice used by physicians: grand rounds. Grand rounds are regular meetings of physician staff members at which another physician or researcher gives a talk on his or her research, or presents a case study. For instance, the Department of Neurology and Neurosurgery at Johns Hopkins holds grand rounds regularly on Thursdays at 9 am. The neurology presentations scheduled for September 2010 include “Stroke is Treatable:  Advances in Endovascular Therapy” (16 September) and “Epilepsy Care and Research in Sub-Saharan Africa: The Road Less Traveled” (30 September). These talks will be presented by speakers from other institutions. The neurosurgery grand rounds for August 2010 were all presented by Hopkins neurosurgery faculty.

In contrast with the Neurology and Neurosurgery Department’s grand rounds, which address general issues concerning a particular topic, or present research, the Psychiatry and Behavioral Sciences Department grand rounds follow a more traditional pattern: a case presentation.

Grand Rounds in the Johns Hopkins Department of Psychiatry and Behavioral Sciences began in 1913. Their original format included the presentation of a patient’s case history and an examination of the patient. That format is continued today. A resident begins the Rounds by presenting the case. The patient who has volunteered to participate in the Rounds is typically from one of the inpatient services, outpatient clinics, or is a private patient of a faculty member. The patient is then interviewed by Dr. DePaulo. Then a faculty member gives a lecture related to the case under consideration. Dr. DePaulo leads the discussion afterwards, which is open to all members of the audience. [link]

This format is particularly intriguing because it is structured to give a multi-faceted perspective on the case: a resident, a patient, the department chair (Dr. DePaulo) and a faculty member all address the audience. As well as sharing information, each presenter gains understanding of his or her own role and relationships to others. What is particularly intriguing is that the patient plays an active role.

I interrupt this blog posting to shamelessly promote my own work. I believe that examples are especially important teaching tools. I elaborate on this in the context of teaching evolution in “Evolution by Example,” available free online at Evolution: Education and Outreach, and linked to on the web site; scroll down to mid page. (Directing traffic to elsewhere on my own web site is a particularly aggressive act of self-promotion. For a direct download, visit Now returning to the rest of the blog posting…

Teaching faculty at all levels would benefit from a similar practice. Regularly, perhaps every week or every other week, a member of the teaching or administrative staff makes a brief presentation, perhaps 20 to 30 minutes long. This is followed by a presentation, say 10 minutes long, by a student on the same topic. The remainder of the hour is given over to a discussion directed by the principal, a vice-principal, or a department chair. The student remains to answer and ask questions. Topics might include the results of research, a controversial or especially important news item, a new policy or law, and of course, a case study.

Teaching grand rounds ought to take heed of the Psychiatry and Behavioral Sciences Department’s model: the case study ought to be of special importance. Teachers might share one particular aspect of their practice that they would like to discuss with others. For instance, a teacher might share particularly successful exam questions or essay topics; how he or she integrates the Internet or other technologies in classroom practice; promotes interaction among students; applies a rubric in grading; addresses skills and subjects required under a testing regime in a way that, so much as is possible, the integrity of the broader goals of teaching are not too badly impugned. The student might comment on how his or her classmates view the element of teaching practice under discussion—whether they feel it benefits them; whether it was enjoyable or interesting; or whether it gave them a chance to get to know their classmates better, for instance. In this way, each audience member will gain a broader perspective on some essential element of teaching practice, perhaps integrating some of the methods or adopting some of the attitudes expressed in the meeting by others.

Because the broad group is so broad, the atmosphere should be collegial and professional. The purpose of the meeting is not to criticize or position one’s self politically; it is to exchange ideas, promote discussion, and build unity and familiarity among colleagues and students. Ideally, hierarchy and authority would take a back seat to open discussion and free exchange of ideas. Friendliness and respect should guarantee that each person be able to take away some new idea, or change his or her thinking or practice. There can be no room for self-congratulatory affirmation at the expense of reflection.

The notion that Teaching Grand Rounds be integrated into the teaching profession as a widespread practice probably will be met with resistance on the grounds that teachers are already strained to the maximum with the amount of grading and preparation they must do, particularly in the present climate of quantitative, exam-based evaluation of schools. Teaching Grand Rounds might be seen as a part of a broader shift in the teaching profession. Just as physicians are expected to meet a high standard for skill and knowledge, and so are regarded as professionals of great importance, reaching a similarly high standard might be expected of teachers. Rather than be seen as  “merely” civil servants working at the local level, each teaching professional might be seen, in his or her own right, as a valued source of knowledge and a master of the subtle and demanding art of teaching.

Another model here is the librarian at a public library branch. A librarian must meet demanding requirements established by a profession whose roots stretch back to invention of writing itself. Knowledge and creativity are especially highly valued. To test this claim, engage an otherwise apparently unassuming librarian in the children’s department. He or she brings to bear, on the task of recommending a book, deep experience, command of digital research tools, and knowledge of the community . Genres, characters, authors, and many other distinctions invisible to the reader begin to take shape in the way a bolt of lightning divides the night sky. These skills are practiced against the backdrop of serious ethical commitments concerning the freedom of information, privacy of community members, and demands, which might conflict with the former two, of the community.

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