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 James
Johnston, School of Medicine, shares a
“basic philosophy” of teaching that is somewhat
remarkable for its simplicity, especially coming from a
nationally known clinical nephrologist: “The basic concepts
are most important. If
students remember the basics, then they are ready to learn the
flexibility to apply this knowledge in different areas.”
The imaginative, supportive practices that Johnston uses
to help students learn and apply knowledge have earned him
numerous teaching awards, most recently the Chancellor’s
award. Next
in importance after learning to apply the basics is for students
to learn to “keep on learning, because the information is
always changing,” according to Johnston. Illustrating with one
of the analogies that pepper his conversations and teaching, he
says, “I can
teach them what I know, but it’s like planting a seed.
It has to be nurtured along the way, and it goes on
growing forever.” Johnston says his views are inextricably linked to his
growing up in a family that had farmed for generations.
He often uses analogies from planting, harvesting, and
animal husbandry, saying, “The care of living things—it’s
all the same…”
Concrete
Examples
As clinical director
of the school’s renal electrolyte division and director of the
training program, Johnston comments,
“My two favorite things are patient care and teaching.
I consider them two sides of the same coin.
If one is to be an effective doctor, one has to be a good
teacher, because doctors are constantly teaching their patients
about use of medicines and lifestyle changes they must make in
order to recover. If
you can’t communicate with patients, you can’t be a good
doctor.”
Johnston thinks it is essential to use specific examples
to communicate in his teaching: "If you get to the basic kernel of my teaching, it’s to
use as many real-world analogies and apply them to what I’m
teaching. The
whole key is to think about what I’m teaching, take it out of
the realm of arcane and hard-to-approach, and put it into terms
students have experience with.
The whole basis of my teaching is to find analogies that
can be used to fit certain situations.
When students have that associative learning background,
they can take a principle and go on to apply it.”
Johnston uses his varied experiences—farm hand,
chemical engineer, librarian, lab technician—and his love of
reading to continually think about new ways he can present
information as concretely as possible.
His illustrations also draw upon his extensive reading
and interests, including popular cultural icons.
For example, in explaining how the kidney transporters
operate, he refers to a well-known Lucille Ball Show segment
where Lucy was working in a candy factory assembly line. Like Lucy and her conveyor belt, when the kidney transporters
are hit with too many things trying to pass through, trouble is
bound to occur.
Humor
As a foundation for his imaginative explanations,
Johnston uses structured techniques, whether teaching a small
group of post-graduates or a large class of 150 medical
students. He
provides students with a detailed handout of what’s to be
covered in each session, emphasizing four to six basics.
But his meticulous preparation relies as much upon humor
as it does upon structure for effective teaching.
Acknowledging that “people’s minds tend to wander no
matter how good a speaker is,” Johnston, at intervals of 10 to
15 minutes, does “something unexpected to keep them alert.”
His students learn to watch for, for example, large
overhead projections of colorful Prince Valiant or Uncle Scrooge
cartoons from Johnston’s comic book collections or Star Trek
photos (he’s also a “Trekkie”).
Always geared to the purpose of the lecture, Johnston
says, “The humor, or light touch, helps students tune
back in. When
they’re relaxed, their minds open up.”
Johnston’s belief in the importance of humor is shared
by his wife, Georgia Duker, Cell Biology, who won the
Chancellor’s Distinguished Teaching Award several years ago.
The two frequently practice delivering their lectures to
each other.
In more advanced classes, after students have acquired a
solid background in the basics, Johnston uses problem-based
learning to guide students to make the decisions they will have
to make as physicians in the real world.
He uses traditional Socratic methods—“you ask
questions, they ask questions”—to actively engage students.
“I’m an advocate of problem-based learning because it
gets students to USE their knowledge.
I hope I have given them enough basics and flexibility
that they can navigate from area to area.
Doctors have to be able to take knowledge about one area
and tailor it for another area.
Doctors have to be confident in the face of uncertainty,
confident of their skills…”
Respect
Johnston emphasizes that, in
addition to skills, doctors have to respect their patients, and
he strives to model respectful behavior in his interactions with
his students. “Students
know I will sit down with them, make eye contact and take my
time. Everyone is treated with the kind of respect he or she would
want as a patient. I
show by my own actions and words the compassion we should have
and that should carry over into all interactions at a
hospital.”
Johnston’s availability is noticed by his office
neighbor, Dr. Tom Kleyman, chief of the renal electrolyte
division, who comments,
“It’s incredible to see how many students stop by
this office.”
Johnston’s teaching has been rewarded many times over
the years, but the awards he most values—and displays on his
office walls—are those from students.
He is most proud of the Golden Apple Award for Teaching
in the Basic Sciences.
“For a clinician to be recognized in that manner by
students is very special to me.
But it’s embarrassing to be recognized for doing
something that’s so much fun.”
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