PRSonally Speaking

Tuesday, August 7, 2012

The Physician as an Educator
by Devra Becker, MD
 
The Educator’s Series has a special place in the journal. As a special topic, the articles are more thorough in their treatment of their subject than space-restricted Letters to the Editor or Editorials. Topics range from teaching styles to optimizing student experience—though the topics all relate to education, they remind me a little of The Talk of the Town series of the New Yorker: research-based short articles on topics of interest to the authors. The Educator’s Series features physicians grappling with the best way to identify the educational needs of residents, to become better teachers, and to use to data to improve education of our students.
 
It is high school teachers of literature, rather than physicians, who have captured Hollywood’s imagination as the great educators of our time. English teachers of film are creative, they are unorthodox, and they educate by integrating the intellectual and sensorial aspects of literature to allow their students to learn and grow. Physicians may be brilliant, they may connect with their patients, and they may be healers, but as great educators—well, that’s just not really how society sees us. Are you not surprised? You should be.
 
 
In 1896, the first woman to earn a doctorate of medicine in Italy graduated from the University of Rome. It could not have been easy. And although the study of medicine is never easy, her path must have felt particularly isolated. Though she had excelled as a child in mathematics and sciences, her decision to pursue medicine was met with derision and discouragement. Her father made it clear he did not support her decision, and the leadership of the University of Rome tried to dissuade her when she approached them with her interest. When she did enroll in 1890, there was no “go-make-me-proud” send-off from her family, or stately announcement of diversity from the University.
 
So she went, and studied. After two years, she earned the qualifications to go on to study medicine formally. Still, she encountered bigotry and resistance. She was barred from performing cadaver dissections with the other students—out of concerns that it was immodest—and dissected after the other students had finished, alone and late at night. There was no Ridley Scott to cast a McCool to give her an encouraging speech when she was down.
 
And yet, she excelled. Despite the harassment and segregation, she attained academic distinctions, and went on to study pediatrics and psychiatry after receiving her medical degree. She worked with disabled children, and began to publish—even then, one had to publish—her observations and findings. The children she worked with were not considered educable, but she approached it as an empirical question, rather than a fact. She approached it as a scientist—she observed, she hypothesized, and she tested. Her conclusions and approaches were evidence based.
 
Of course, the fairy tale did not end there. The Italian Ministry of Education rejected her approach to education, and she was made to work in shocking conditions with the most underprivileged children in the slums of Rome.
 
She persisted. Based on her evidence, she integrated sensory experience in her education. She created sandpaper letters so that her students could use touch to learn reading. She used pink cubes of varying sizes to use visual and tactile cues to teach the concepts of large and small, and rank order of size. And—my personal favorite—she used the binomial cube representing (a+b)3 to use visual and tactile cues to teach math concepts.
 

The binomial cube is a cube that has the following pieces: one red cube, three black and red prisms, three black and blue prisms, and one blue cube. The pieces are stored in a box with two hinged opening sides. The color pattern of the cube is painted all around the outside of the box (except the bottom).

 
In her lifetime, she saw the spread of her educational method throughout Europe and overseas. She was nominated for the Nobel Peace Prize three times before her death in 1952. Today, Maria Montessori’s educational methods can be seen schools throughout the world. Independent Montessori schools are thriving. Her name is a household word.
 
In surgery, we have not drifted far from those educational roots. We assess, we observe, and while our orthophrenic students face different challenges than Maria Montessori’s, her approach—using the scientific method, and integrating sensory experience in education—is mirrored in our approach to education.
 
It is our medical legacy.