Abstract
Background
One aim of medical education is to cultivate student thinking, and specific methods have been developed, implemented, and evaluated for doing this. However, doing so is not as straightforward as simply employing these methods.
Methods
In a wider year-long participatory action research study about developing student thinking, we interviewed, observed, and video-recorded six medical teacher-participants. Participants also filled out reflective journals and regularly discussed practices as a group.
Results
We found that teaching methods customarily used to develop student thinking (e.g. reflective thinking, clinical reasoning) sometimes failed. This failure was because students experienced fear as a result of such methods, such as fear of looking stupid in a discussion. Our teacher-participants went on to develop very specific methods for identifying and mitigating fears and better cultivating students’ thinking. They (1) got to know students and understand what they were afraid of, (2) mitigated student fear by talking regularly and ‘normalising’ fear in learning for them, (3) modified teaching methods to make students feel less scared and (4) demonstrated ‘care’ for their students, a value which could increase students’ confidence and help them mitigate fears for themselves.
Recommendations and Summary
We suggest teachers to (1) create opportunities to learn about their students, (2) regularly discuss with their students how fear can be normal in learning, (3) adjust teaching methods to mitigate fear and (4) care and show their care for their students. We also suggest that medical teachers could benefit from staff development about the phenomenon of potential student fear and recommend the pursuit of a better understanding of how ‘caring’ might be identified, nurtured in teachers and usefully expressed in practice.