''Inclusive teaching involves deliberately cultivating a learning environment where all learners are treated equitably, have equal access to learning, and feel valued and supported in their learning.''
- Center for Research on Learning & Teaching (CRLT), University of Michigan
This important statement from the CRLT at University of Michigan says it all. As teachers, I am convinced that it is our responsibility to preserve this idea of optimization of the learning environment. On hospitalization wards and notably on the clinical teaching units (CTU), the burden of the numerous duties often puts pressure on us and harms the quality of our teaching. Nevertheless, it is not a good reason not to nurture such an inclusive teaching environment.
On the CTU, as attendings and clinical teachers, I think we should openly acknowledge that we are imbedded in a demanding environment. We will be more prone to fatigue, stress and probably to more biases, so we should be self-aware about this. Namely, we have to recognize that we will have stereotype biases regarding the way our medical students understand the clinical cases. The burden of the large number of tasks on the CTU should never be an excuse not to actively disengage these stereotypes.
During clinical rounds, ''structured interactions'', as suggested by the CRLT at U-M could imply, could be implemented systematically and deliberately to organize discussions around the cases, so all the students may talk equally about their ideas. The level of participation can differ from one student from another during the rounds, but this could be explained by past embarrassing experiences, introverted personality, stuttering, family responsibilities that distracts the student during discussions, and so on. We should keep these aspects in mind and organize the discussions so no one is feeling pressured to answer, while trying to build meaningful learning with our students.
Favorizing ''Academic belonging'', another strategy proposed by the CRTL, could also be a relevant approach on the clinical teaching units. When they are in their clinical rotations, students know usually where they are heading to, roughly, regarding their future post graduate studies and medical specialty. I think we could cultivate inclusive teaching through academic belonging by approaching the cases through the lens of the student her/himself, to validate her/his interests and show respect to that. For example, while talking about septic arthritis, we will have to explore all the aspects of it at the end of the road, of course. But why not introducing the case with orthopedic notions with the student interested in orthopedics, and with the microbiologic notions with the student interested in infectious diseases? Moreover, cultivate academic belonging could also be done on the CTU by actively promoting a growth mindset in the clinical cases discussions : openly allow errors, find time to talk about failure in medicine, etc.
On the clinical teaching unit, unfortunately, we tend to prioritize efficiency over meaningful learning and inclusive teaching. We have to keep in mind the patient, of course, but we must be able to put inclusive teaching at the forefront, showing our learners they are our top priority.
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