Dr. Mirvis
is the Editor-in-Chief of this journal and a Professor of
Radiology, Diagnostic Imaging Department, University of Maryland
Medical Center, Baltimore, MD.
In the past 2 decades I have had lots of opportunities to
experiment with different styles of teaching radiology. Obviously,
some things work a lot better than others. I've made a few
observations of my own that were new to me about teaching and have
confirmed some others that my mentors and associates have mentioned
along the way. Also, I believe I have discovered just about
everything that can go wrong during the process of teaching both
formally and informally. I would like to share some of these
observations for your consideration. First, and I believe most
importantly, most audiences do not want too much information. Most
of what you preach as crucial information has a half-life of about
1 to 2 minutes, assuming it is attended to at all. Most attempts to
make teaching points, rather than forming a permanent neural
pathway, simply add heat to the room, increasing the chaos of the
universe. Learning is an antientropic energy-consuming process, so
do not overtax the system. At most, you should hope to convey a few
points that you consider absolutely key. Those among us who teach,
which at some time in our careers includes most of us, believe we
must cover the entire waterfront on a given topic with everything
we know, or think we know. After all, we are the assumed experts.
But that is what textbooks are for, not lectures or instructing
small groups or individuals. Too much material buries what is vital
and perhaps reveals a lack of self-confidence as the speaker
attempts to impress upon the audience his/her vast fund of
knowledge, which will be on better display while handling
questions.
I have found that tying teaching points to a little joke or
story is the best way to cement the recall of any concept. For
instance, an anecdote about how you missed the finding in a key
case or an unusual clinical presentation that illustrated the point
is useful. Years later, most people remember the radiologic
observation as well, but, if not, they usually at least are still
entertained by the story.
On the technical side, I believe that text slides should be
simple, uncluttered, and pleasing to the eye. The background should
not distract from the text; flying text, wild colors and patterns,
and cartoons on the slide often distract from the teaching point.
On the other hand, lots of slides illustrating the point and
summary slides are very worthwhile. Also, try to use the laser
pointer minimally and in short bursts. You can nauseate the
audience by swirling it around the slides constantly.
Give the audience mini-breaks within a formal lecture. This
allows the audience to wake up, refocus, and remember where they
are and why they are there. Little cartoons, a brief joke
(politically correct, if possible), or a short true anecdote are
useful to fill these pauses. During a really long lecture, 60
minutes or more, allow a standing 3- to 5-minute break, perhaps
with a question or two permitted.
During formal lectures, assume that everything will go wrong.
The more formal and important the lecture, the more likely disaster
will strike. Some lecture calamities I can report include: No CD
drive on the supplied laptop to run my CD, bringing the wrong
lecture, forgetting to change the name of the meeting on the title
slide from the last time you used the lecture, bringing the 2-year
old version of the lecture instead of the latest one with the cool
volumetric images, and projecting the laptop desktop on the screen
for the entire audience to see (revealing some things you would
prefer to remain private concerning your various interests).
Finally, perhaps the biggest calamity of all, the power can go out
and stay out, as happened to me several years ago during an RSNA
review course.
Some suggestions to deal with these pitfalls include: Bring your
laptop along to run the lecture, if needed. Do not assume that the
correct equipment provisions will always be available unless it's a
large course that has an established track record. Bring the
lecture on a "thumb" USB drive with a CD back-up, and load the talk
onto the hard drive of the host computer. Run the spell-checker on
the lecture the night before, as simple spelling mistakes are
usually seen by the viewers and reflect poorly on your preparation.
Make sure that movies run on the host laptop readily. Have a couple
of logical end points inserted into the later half of the lecture
so you can smoothly end the talk early, if necessary, to stay on
time. No one knows what they missed, but everyone appreciates
staying on schedule. Bring an extra favorite lecture to offer if
another speaker is indisposed. Finally, make yourself very
available after the lecture. Lots of folks with good questions, or
other worthwhile points to relate to you, may not be comfortable
speaking up in the formal question period.
In a small group or one-on-one teaching session, always set a
relaxed tone. Nervous people do not participate readily and may
learn poorly. Ask some easy questions about the material to first
build confidence. Ask other people within the group some follow-up
questions to keep them tuned-in. Praise accurate responses and
insights. In your closing, offer one or two other pieces of
information on the topic. If you are not sure about a point, do not
attempt to convey it. I often ask a resident or a student to look
up the topic and let the whole group know the gospel the next day.
When teaching residents in another department, try to let them know
you are friendly and nonthreatening, even if you are neither (save
inherent hostility for your own residents-just kidding). Also,
remember you are never as big a treat or as famous to your own
residents and staff as you are when you are on the road. The folks
you instruct at home already know your schtick, jokes, cases, etc.,
and they are allowed to yawn or fall asleep during your
lectures.
Finally, have fun. Teaching should be enjoyable from either side
of the podium.