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Is “School” Becoming Unrecognizable?

As long as there has been this “thing” called “education,” or teaching, this question has constantly arisen: “What is the function of school?” An overall pat answer could probably be to prepare, mold, and expand young or old minds! However when we consider a medical school, the particular functions may not be so clear cut or simple.

In early history, a school may have been a cave and the teaching revolved around how to throw a spear in order to get some food….or how to select the right plant to put on the wound in case one received a spear wound or a bite. A more contemporary school may involve a teacher teaching a student how to repair a torn ACL.

Primitively thinking, two things the two schools (the old cave and today’s classroom) have in common is one, that they both involve a form of teaching that involves face to face interaction (only one student had to handle the spear properly and the other student has to handle an instrument properly), and two, each teacher looks (looked) at the pupil in the face to measure attention and understanding to some degree.

Through the ages, across cultural, ethnic, gender, geographic, etc. boundaries, imagine how much we have come to depend (in varying degrees) upon reading expressions when communicating. In addition, have we not experienced that despite differences in the spoken language, facial expressions are similar when specific messages are being sent? No matter what the language is, the expression of satisfaction, for example, is just about the same.

Will we reach the state of technical advancement when it will be possible for a student, assuming he/she has both the discipline and motivation, can learn whatever need be for almost any course, such as English literature or grammar, psychology, microbiology, physics, a language, sociology; and so forth at the undergraduate level without attending a class? Then assuming the eventual same developing technology, able to take graduate level courses such as most medical courses including anatomy, the same way as in undergraduate “school”?

Although objectives involving the teaching and preparing of people may remain the same, the methods may be changing. As such, will the goals be adequately met? In other words, if “face to face” teaching dwindles or disappears, how effective will we be in reading and understanding someone else’s emotions? How far can we go without personal contact with the teacher? How do we teach online that responding to someone coming into the office and saying calmly, “I have an ache in my knee,” might send one message while another person uttering the same words, only with more emotion in tone of voice and more intensity in facial expression (like agony), conveys a different message.

One of the biggest complaints that patients voice about their relationship with their clinician is the “bedside manner” of the clinician …. as opposed to technical skills. Successful interactions between two people generally rely on three elements: cognition (thoughts), behavior (physical interaction), and affect (feelings). Will we be jeopardizing the development of the art of “personal interactions” as schools change and stray further and further away from incorporating personal or “face to face” teaching?

In addition, as we move further away from “face to face” teaching, and more and more towards on-line teaching, will we be changing the profile of the teacher? Might we be needing more teachers with technical skills and fewer teachers who are good “talkers” and good “presenters? Will the teachers of the future be teachers less involved in the behavior of pupils? Would teaching of teachers have to change? How do we, as teachers, effectively teach would-be clinicians the need to be sensitive to the patient’s affect without our personal contact with the would-be clinicians?

The bottom line is, if we have less and less “face to face” educating, are we fostering or conditioning less importance of personal contact in our personality development and less importance of the role of personal contact in our relationship with a patient? Is the term “personal” slipping away from our behavior as well as our language, and thus less and less in need of the development of the art of personal contact? If so, with such a trend, will schools (the curriculums, the teachers, the missions) have to be changed so that with such changes, “the school” would have to be redefined and thus possibly become unrecognizable, at least to today’s generations?


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