Letters to the Editor
Dr. Elnicki1 in his point-counterpoint essay and now Dr. Artino and Dr. Durning in their letter to the editor make several excellent points about what we know, or do not know, about the impact of emotions in education. I agree with the letter's authors completely that not all negative emotions are created equal. However, when I think of those magical moments that intuitive, experienced teachers have with their learners, whether in preschool or in medical school, I typically associate them with positive emotions, even if the positive emotion is the celebration of the resolution of any anxiety that preceded it.
Since the time that I “tricked” an entire class of medical students into thinking they had an extra final exam— to demonstrate both how to effectively deliver bad news and a patient's likely visceral response—I had the opportunity to reflect on the experience in writing.2 So when I taught the same session the following year, I must confess that I was not as brave. Instead of tricking the current medical students, I told them the story about tricking last year's class. I made exactly the same points; however, the current students experienced no preceding anxiety with subsequent positive resolution, only positive emotions. I realized that with my original strategy, I was sharing the emotional risk with my students. Although I have no evidence, I am convinced that my second approach was not quite as effective, but it definitely felt safer for me as a teacher.
More research is needed on the role of emotions in education so that we as medical educators can have objective evidence for what can feel subjectively in the moment like the most effective teaching strategy, however risky.
Julie Scott Taylor, MD, MSc
Associate professor of family medicine and director of clinical curriculum, Alpert Medical School of Brown University, Providence, Rhode Island; Julie_Taylor@brown.edu.