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Center for the Future of Health Professions Nov. 2023 digest

The Center for the Future of the Health Professions is publishing another monthly op-ed column. These columns provide strong, well-informed opinions on matters that impact the future of the health professions. As mentioned previously, the center was established to offer accurate, reliable, and comprehensive data and research on the healthcare workforce to support effective planning for a sustainable future and optimal use of available resources for state, local, and national policymakers, as well as health system stakeholders.

This month’s column will serve as a follow-up to last year’s article, “Further Confessions of a Recovering Sage-on-the-Stage Performer,” by Norman Gevitz, PhD, professor of history and sociology of health professions and senior vice president-academic affairs at A.T. Still University. This addition, “Sage on the Stage – Part 3 – A Return to the Classroom,” further explores Dr. Gevitz’s humorous presentation on his return to teaching as he shares his experiences in an entertaining manner. We eagerly await your response.

Randy Danielsen, PhD, PA-C Emeritus, DFAAPA

Professor and Director

The Center for the Future of the Health Professions

A.T. Still University

Sage on the Stage – Part 3 – A Return to the Classroom

When I was hired to be the new senior vice president-academic affairs at A.T. Still University in 2013, I believed my time in the classroom was done. The new position was, and is, labor intensive; you’re directly responsible for, and have oversight of, all the schools/colleges and degree and certificate programs at our University, including its programmatic and institutional accreditation. As I hope I have conveyed in my previous two contributions* to this series, I loved teaching, whether as a “sage on the stage” and, subsequently, as someone who created an interactive dynamic where students essentially taught themselves by discussing cases in the classroom, using basic concepts presented to them. So, when I accepted the position as senior vice president-academic affairs, it was with great anticipation of looking forward to the challenge, yet with regret that a significant ongoing joy of mine – teaching – would not be a part of my new responsibilities.

Nevertheless, nine years into my position at ATSU, I was asked by one of our colleges – the School of Osteopathic Medicine in Arizona (SOMA) if I would consider getting “back in the saddle.” The professor who taught medical ethics had just retired, and they could not find someone within their faculty to teach the subject. I consulted with the President, who raised appropriate concerns, which I addressed, and told SOMA I would agree. I would teach four two hour blocks – to two sections of students – 16 classroom hours. Not a heavy load, I thought. I have been teaching medical ethics for more than 25 years. I could do this.

The biggest surprise for me was the amount of literature I had to review. Ten years is a long time to be away from the printed materials that constitute the corpus of learning in a field – including medical ethics. While the basic concepts of medical ethics were still operative, new applications of these concepts have changed as medicine has been transformed, as well as the related field of medical jurisprudence. This was most apparent in women’s reproductive rights, given the recent Supreme Court decision in Dobbs. Much of what medical ethicists taught and what students were tested on in national board examinations related to reproductive ethics has now been made uncertain and questionable.

Also, though I only wrote a few exam questions, the time I needed to develop board-quality test items was considerable. In my early years of teaching medical ethics, I asked short essay questions, which is a reasonable assessment, but they do not prepare students for the multiple choice vignette-based questions that COMLEX or USMLE ask. In reviewing sample test questions in the written literature and viewing online tutorials, I was struck by how nuanced many of these test questions were, whereby more than one of the choices had merit. It was more a matter of choosing the “most” correct answer based on the precise language in the stem. As a result, I worked on mirroring this approach in many of the questions I constructed.

However, as to the teaching itself, it was a joy. I had truly missed my time in the classroom with health science students ­– in this case, osteopathic medical students. I followed the classroom interactive style outlined in my first two contributions to this periodical. I wrote the clinical vignettes – approximately eight of them – for each session, had the students discuss the vignettes in small groups five or six at a table, and then asked for volunteers to address the ethical questions posed within the vignette. The discussions that ensued in the larger group were lively, and at the end of these sessions, students appeared to grasp how to work through complex ethical issues in medicine.

The student feedback at the end of these sessions was positive. They enjoyed the interactive nature of these encounters, and frankly, after every session, I felt pumped up. It is truly exhausting to spend four hours in a classroom. However, as any professor who enjoys teaching will likely admit, it feels exhilarating when you believe a teaching experience has gone well. Furthermore, as for me, since SOMA has yet to find a permanent replacement to teach medical ethics, I am happily doing this once again.

*Read Dr. Gevitz’s previous column’s here:

  1. Confessions of a recovering sage-on-the-stage performer
  2. Further confessions of a recovering sage-on-the-stage performer


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