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T. Varagunam

teachers teach knowledge to students. The knowledge being taught in medical schools in Sri Lanka comes mainly from textbooks and journals and, unfortunately, very little from knowledge generated locally through research. Knowledge is the easiest aspect to teach and can be done using lectures, tutorials and guided reading assignments. Second, teachers teach manual and mental skills by demonstrating the relevant procedures to the students and then by getting the student to practice them under supervision. Most of the manual and mental skills required of medical students are related to the diagnosis and management of patients. Third, teachers teach desirable attitudes to students and this is probably the most difficult and the most neglected aspect of medical education today. Teachers teach attitudes or rather student learn attitudes from observing and experiencing teacher behaviour. They do not learn attitudes by reading textbooks nor by listening to what teachers say. In addition to acquiring compassionate attitudes of empathy and caring for the sick, students need to develop a scientific attitude to solving problems and should value scientific research as a tool for generating new knowledge in the field of health. Can medical teachers be taught how to teach desirable attitudes to students? My opinion is (there is only scanty research evidence on this aspect) that the theoretical aspects can be taught in the context of teacher training workshops. But this does necessarily translate into actual behaviour in which desirable attitudes are demonstrated by the teachers in their work as teachers, clinicians and researchers. Students learn attitudes from what teachers actually do (and not from what they say) when they carry out their work in helping students learn. Sociological studies done in medical schools have shown that teachers often become role models to students during the early years of the medical

course. In the later years of the course an element of cynicism creeps into student minds and they acquire a more realistic view of their teachers. In order to teach attitudes, teachers need to display these desirable attitudes with a true sense of conviction in their daily work.


The need to strengthen the profession of medical teachers:
The profession of teaching in medical schools seems to be loosing its status and popularity amongst Sri Lankan doctors and scientists. That is what the statistics show. For example, statistics from the University Grants Commission indicate that in the year 2000 there were only a total of 92 permanent staff occupying a cadre of 136 positions in the six medical schools in the island. With an annual total intake of around 1000 students into the medical schools, this number of fulltime teachers is hardly sufficient to maintain quality teaching programmes. There are no data on the number of applicants for vacant posts in medical schools. It may be that medical schools demand the highest standards for filling their teaching posts. Whatever the reason, we need to remind ourselves that the quality of the teachers in medical schools determine, at least partly, the quality of the doctors of this country and thus the quality of health care provided to the people. An investment in improving the quality of the teaching that occurs in medical schools is an investment for improving the health of the nation.


T. Varagunam
MD, FRCP, M.Ed
Former Professor of Medicine and
Former Director - Medical Education Unit,
Faculty of Medicine, Peradeniya.

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