Presidential address: How shall we teach? How shall we learn? Educating hand surgeons in the new millennium.

Before I begin I would like to ask two questions. I do this to characterize you, my audience. First, I ask all the students to raise their right hand. Next, I ask all the teachers to raise their right hand. My great hope is that each of you in this room raised your hand in response to both questions. My expectation is that you are, as I am, a life-long learner and teacher. Teaching and learning have a special relationship. Let me illustrate this relationship. A man boasted to his friend that he had taught his dog how to whistle. The friend put his ear up close to the dog’s mouth and listened intently. “I don’t hear anything,” the friend said. The man replied, “I said I taught him to whistle. I didn’t say he learned it.” As health care professionals you and I are obligated by those who give us license to practice our craft to learn about new knowledge that enhances our ability to care for our patients. As for teaching, we do not all lecture medical students or mentor residents and fellows. If we care for patients, however, we continually teach. Indeed, the word “doctor” is derived from the Latin “docer” meaning “teacher.” Since my subject is teaching and learning, let me offer the following definitions: learning is the interest in acquiring information; teaching is helping the acquisition of information and stimulating that interest. Education is learning and teaching. While some of the tools we use in medical education have changed radically, until the early part of this now dying decade the basic methodology has been the result of a simple linear progression from prehistoric time. Teaching and learning were two sides of a simple equation. On one side was the expert, or primary source, and on the other side was the unfilled vessel. The physician’s teaching/learning paradigm has always involved pedagogic methods designed to make each new physician an independent information master. Knowledge was transferred from some primary source to what would become in time the next generation’s expert or primary source. This transference took successive forms as first one epistemologic theory prevailed only to be replaced by another. Socrates had his methods and Plato his. Both were good teachers for they satisfied Milton’s definition: “A good teacher is one whose spirit enters the soul of the pupil.” At this moment we are involved in the very oldest of these transference processes: the lecture. The scope of verbal transmission was on a one-to-one or a one-to-just a few basis. History has failed to record the name of the first boring lecturer. This is, of course, someone who talks in someone else’s sleep. The transmission of information became enhanced when we attained the ability to represent objects and ideas by written symbols. Information and thus From the Department of Functional Restoration, Stanford University, Palo Alto, CA. Presented at the 54th annual meeting of the American Society for Surgery of the Hand, Boston, MA, September 2, 1999. Received for publication February 14, 2000; accepted in revised form February 15, 2000. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Reprint requests: Vincent R. Hentz, MD, 900 Welch Rd, Suite 15, Palo Alto, CA 94304. Copyright © 2000 by the American Society for Surgery of the Hand 0363-5023/00/25A04-0001$3.00/0 doi: 10.1053/jhsu.2000.7384