Do Every Time Like the First Time


Academic Medicine:
Teaching and Learning Moments
Author Information

Dr. Kellner is director of the third-year clinical clerkship, Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville.

I thought I had it all figured out. After ten years as a clerkship director, I thought that if I put everything in the syllabus then the students would do everything I wanted them to without any further instruction. Yet, they constantly asked questions that, as I told them, were answered in the syllabus. Going over the same material every eight weeks had certainly worn down my patience with their lack of attention. How could they be so forgetful?

Then my wife and I took a two-week trip to Greece and Turkey. It was our first trip with a full-time guide. The guide's name was David. At the end of the day, David would tell the group what we would see the next day, when and where to meet, what to wear, and other important information. What struck me was that the next morning he would go over the same information as if he had never said it to us. My first thought was this was insulting, “Does he think we're so forgetful that we can't remember a few simple things?” Then I thought of how often I found myself in a room and could not remember why I was there, or struggling to remember the name of a drug mentioned in a lecture just the day before or the name of the student who had presented to me in clinic that morning. I realized that I was assuming the students would remember everything while David was assuming we wouldn't remember anything. By saying things every time as if it were the first time, he not only made sure we knew what we needed to know, but he avoided any overt or covert judgment of our memories. Wouldn't my students benefit from the same approach?

On my return, I had two signs made for the clerkship administrator and me to put on the walls in our offices. They read “Do Every Time Like the First Time” Since then, when asked a question I know we've already answered, we calmly answer it or subtly suggest they look in the syllabus. This has not only resulted in a more positive response from the students but eliminated the mental stress of making a judgment about their memories. Five years later we took another trip with this same company and David was one of the guides! He was very surprised and proud to learn that he had made me not only a better historian of Greece but also a better teacher of obstetrics and gynecology.

© 2003 Association of American Medical Colleges