Tomorrow's Health, Today's Research

Dr. Jane Gair

Senior Instructor, Division of Medical Sciences, University of Victoria
Faculty Development Coordinator, Island Medical Program, Faculty of Medicine, University of British Columbia
BC Provincial Representative to the International Association of Professors of Human and Medical Genetics
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Phone: (250) 472-5543

Department Page
Research area: abnormal chromosome numbers in human pregnancy; education methods: problem-based learning and using arts and humanities to teach medicine.

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Research Profile:

Teaching doctors empathy

Most science professors have no formal teaching training and little practice before they first face a theatre lecture. This introduction to teaching has been likened to passing a kidney stone by one CfBR member (which is no reflection on his current teaching skills). Geneticist Dr. Jane Gair remembers being on the other side as a student. “I was amazed to realize that the further up the system you go, the more specialized, the more money you spend, the less qualified they (professors) are to teach.”

Gair reacted so strongly to the gap between the atrocious and terrific teaching that she experienced during her post-secondary education, that by the time she was doing her PhD in Medical Genetics at the University of British Columbia, she knew she wanted to focus on teaching. She started seeking out teaching workshops and courses with Teaching and Academic Growth at UBC.

Now she works as a Teaching Consultant with UVic’s Learning and Teaching Centre and she is the Faculty Development Coordinator for the Island Medical Program (a distributed site of UBC’s Medical Program run in collaboration with UVic). Her role is to help develop curriculum for the medical school and to train faculty how to teach, based on the latest education research, such as problem-based learning. (She also uses problem-based learning when she teaches Foundations of Medicine; Doctor, Patient and Society; and medical genetics with fellow CfBR-member Dr. Laura Arbour.)

One of the ways that Gair trains faculty how to teach is to have them lead a mock problem-based learning tutorial with mock students, who are volunteers from across campus. As the lesson progresses, Dr. Jane Gair watches through one-way glass to give feedback. The professors are learning through doing, which is itself an example of the problem-based learning that Gair promotes.

Problem-based learning began at McMaster University’s department of medicine in the ‘70s, and spread from there to many professional schools, including most medical schools in North America. At its core, it involves breaking students into small groups to solve problems. The method is the antithesis of lectures, rote memorization and regurgitation. Proponents say that problem-based learning produces doctors who are not only knowledgeable, but have the other skills that were never explicitly taught to doctors before, such as communication skills and team work. As an interesting side note, McMaster began with a radical approach that resembles “alternative” high schools in B.C.: no lectures, no exams and self-directed studies.

When evaluated in the field, the consensus was that graduates were indeed better than average in important interpersonal skills, but that they lagged behind in medical knowledge. McMaster has toned it down since then with a more accepted blended model, bringing back lectures and exams, alongside problem-based learning tenets. Recently, Gair has continued this trend of education innovation in medical schools. She wants to know: can you teach med students empathy through art training? She thinks so, based on an exercise she developed for the course, Doctor, Patient and Society.

The course has four weeks devoted to the types of victims of violence doctors are likely to encounter. The course covers domestic violence, child abuse, elder abuse and international conflict. Traditionally, these topics were not covered at all in medical school, and when medical curriculums first started addressing them, it was in the traditional fashion: guest lecturers with slides – graphic slides. “The students were shocked and horrified by the images,” Gair says. Basically, the students were swamped with awful facts and figures with no tools to cope with them. According to Gair, the default coping skill for doctors has been to block themselves off emotionally, but lately, there has been a debate among doctors about whether or not this works.

“There is a lot of talk about ‘burn-out’ and being hardened to horror,” Gair says. “Maybe you need that hardening, or can you have boundaries, but not lose your humanity?” she wonders. Art therapy is a common treatment for victims of violence, so Gair theorized that an art project that progressed throughout the section on violence would be valuable for the students. She also believes that art training can help one be creative, curious and critical, attributes doctors should have. So, she introduced mask making into the class as a way to reflect on violence, which she developped with Dr. John Anderson, former course director of Doctor, Patient Society. The students still receive the information, such as the prevalence and social context of violence, but at the same time, the students also explore their feelings and discuss professional responsibilities and ethics while making their masks. The outside of the mask represents their professional shell, the inside, their personal side, perhaps representing an honest appraisal of the depth of their reaction, for instance.

And how do the medical students react when presented with art materials and told to get in touch with their feelings? “They hate it. They are so resistant. They are really not impressed,” says Gair. It is not hard to imagine why. Not only is the art project a radical departure from their regular school experience, the medical students can be uncomfortable with their art skills. Also, the topics are disturbing, and can touch on personal experiences. Gair makes sure that the students do not have to share either their progress on the mask or their personal feelings if they don’t want to.

Although students hated it at first, when UBC administration evaluated the class by interviewing students at the end, most students said that they grew to think the exercise was valuable and would even like more. Even those that wanted to opt out at first, got on board.
Did it teach empathy? It is a hard thing to measure. Gair believes the students will be more self aware, and therefore more effective in the field.


Improve your course through contact with the IMP
Dr. Jane Gair joined the Centre for Biomedical Research as part of her ongoing goal to join people from different disciplines to learn from each other: in this case, physicians and medical researchers. She believes there is room for Science faculty and Island Medical Program faculty to swap expertise to improve each others' courses. Do you share this interest or have an idea? Contact Dr. Jane Gair at This e-mail address is being protected from spambots. You need JavaScript enabled to view it. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 

 

 

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