Editorial Comment:  Does Instructional Function follow Form?

The ASAM Webinair listed below (The ASAM National Practice Guideline 2020 Focused Update Webinar: Fundamentals), as well as this year’s ASAM Virtual Conference, oblige attention to the evolution in how we teach. 

In medical pedagogy, we are asked to accommodate new styles of learning with new styles of teaching. There is still not much variance from the presentation norm, traditionally one of standup didactics or panels. But inevitably the use of new platforms, some of which are already familiar if not actually dated (e.g., Zoom, Cisco Webex), shapes the knowledge itself.  It’s a peculiarly psychiatric concept, that the form in is in its way as important as the content. That’s certainly true in education, where the delivery system is a huge component of the any success in conveying the desired knowledge.  But it is also a psychological diagnostic premise that we must listen for what is not said, what is not overtly communicated; and it would seem reasonable to extend that premise to teaching. What is lost in the move from actual presence in the classroom, to a panel of 5, 10, or 100 avatars, each at risk for leaving off the “mute” button or failing to appease the hunger of house pet/child?  Is there an element of trust that evaporates when the teacher becomes, at best, the Master of Ceremonies in Hollywood Squares?  And if that is so, can it be restored by some pre-emptive technique – such as meeting beforehand in individual or smaller-group sessions - to cohere the expectation of the participants?  While ACCME, ACGME, AAMC and others rightly concern themselves with these very questions, no one appears to have a monopoly on answers.  Suggestions for experimental approaches will be welcomed here, education being at the core of the ASAM mission.

- W. Haning, MD