How Can Educators Cultivate Creativity?

by Lizhi Liang, Ph.D., Doctor of Pharmacy Candidate, University of Maryland School of Pharmacy

If you were to ask “Do you think you are a creative person?”, how often would you expect people to answer “Yes, I am.”  Not many.  What differentiates a creative person from a non-creative person?  Were we born with creativity but somehow lost it as we grew older? If so, whom should we blame? Can we save or restore our creativity? We will be educating future generations, thus it is important for us to answer these questions and try to find solutions.

Creative individuals usually have unique characteristics such as independence, innovation, curiosity, confidence, and risk-taking behaviors.¹  These are similar characteristics we often find among children. Try to imagine how many times you are amazed by the imagination of a child asking you questions that makes you think.  Picasso once said: “all kids are born to be artists”.²  We were all born with curiosity, creativity, and originality.  What happened during our maturation process that made many of us lose these traits?  Sir Kenneth Robinson once told a story about a little girl who seldom concentrated on anything, but one day she sat for a long period time drawing a picture of God.  The teacher asked her “what are you drawing”? She responded “I am drawing God.”  “But nobody knows what God looks like” replied the teacher.  And the girl answered confidently “they will in a minute.”² What a smart and creative girl! This is not rare among kids. If you observe carefully, you will be surprised to see how creative these small creatures are. Why does this kind of creativity disappears as they grow up.  Is our educational system limiting or inhibiting creativity? Do teachers encourage or discourage creativity? Do teachers stifle curiosity of students by telling them to follow orders and adhere to norms? Do teachers teach subject matter based on what’s known rather exploring what’s unknown? Do teachers coercively influence students’ decision making? If you answered yes to any of these questions, then improvement is needed to preserve creativity among learners.

Here are a few things educators can do to foster creativity:

1.  Allow time for creative thinking³ 
Teachers should try to avoid bombarding students with extraneous material. This will only encourage memorization and regurgitation. Good educators teach students the tools they need to solve problems. Like an old saying in China states: “It is much better to teach a hungry person how to fish than give him fish to eat.”   An individual needs to be innovative in order to thrive on his/her own.  Being able to think independently is an indispensable part of being creative and teachers can help students to cultivate their creative, independent thinking skills. If every teacher designed individual problems for students to solve problems on their own, it will convey the signal to students that thinking is a necessary ingredient of learning. And sooner or later, students will form a habit of thinking independently as a result of repetitive practice. 

2.   Be creative yourself^3,4 
Some educators are resistant to change. They can teach the same material, use the same strategies, and ask the same questions throughout their entire teaching career.  In order to cultivate creativity in their students, teachers have to be creative themselves. For example, a teacher shouldn’t always provide detailed protocols in the lab and ask the students to follow each step. And teachers shouldn’t expect each student to come up with the same result.  Ask students to write their own protocol, design their own experiment, and analyze their own data. When the experimental results are not optimal, ask them to troubleshoot on their own and provide only the amount of guidance that is necessary. This way, not only will students feel more excited and challenged, but this will also promote self-discovery. 

3.  Reward creative ideas or products^3,5 
Educators need to create an encouraging atmosphere in the class to promote student creativity. They need to let students know that creative ideas and products are welcomed. Otherwise, students may not be willing to share due to a lack of confidence and recognition. Rewards and encouragement are very important for learning, especially children. In students’ eyes, teachers are the authority and role models, so any words of encouragement from the teacher means a lot to them. One of my friends told me a story that affected him enormously. When he was little, he loved to read and always came up with “strange” ideas or questions. One day when he asked a question in class, his teacher humiliated him in front of the whole class by saying “you think you are smart by asking strange questions?” Those words hurt his self-confidence and he felt defeated for a long period of time.  He lost motivation to learn and became a very quiet student. Fortunately, as he grew up, he realized that it was not his fault, but rather an irresponsible teacher who did not appreciate his creativity. Later, he re-gained his confidence and became a very successful researcher. This example demonstrates how educators are powerful influences on students.  Creativity can only be cultivated in a proper environment.

References

1. Black RA. 32 Traits of Creative People. Bridge Storage and Art Space company [internet]. 2010 Aug 25 [cited 2013 Feb 4].
2. Robinson K. Do schools kill creativity? [Internet]. TED Conferences, LLC  (US); 2006 Jun [cited 2013 Feb 4]. Videocast: 19min.
3. Sternberg RJ, Williams WM. How to Develop Student Creativity. Alexandria, VA: Association for Supervision and Curriculum Development, 1996. 52p
4. Kashdan TB. 3 Ideas to Prevent Schools from Killing Creativity, Curiosity, and Critical Thinking. Psychology Today [internet]. 2011 May 11 [cited 2013 Feb 2].
5. Taylor M. Do schools kill creativity? If so,what can we do about it? Parenting [internet].2012 July 12 [cited 2013 Feb 4].

Patients with Language Barriers: Getting the Message Across

by Lubna Kousa Pharm.D., PGY1 Community Pharmacy Practice Resident, Johns Hopkins Home Care Group

The United States is notorious for its diversity. Over the past several decades the use of a language other than English at home has increased by 148 percent.¹  The number of non-English speakers increased from 23.1 million in the 1980’s to 57.1 million in 2009.  This rapid change can be seen throughout the country, whether it’s a Chinese language television station or a road sign in Spanish, the linguistic diversity continues to evolve.

Language barriers are becoming progressively more challenging for the delivery of health care services. Given the heterogeneity of ethnic origins and the primary languages among these groups, individuals who have limited English proficiency have significant challenges when communicating with health care providers. Patients with poor communication skills have difficulty accessing care and conveying their health concerns to practitioners.  In many health care settings, there is a lack of interpreters. This often results in misdiagnosis, inappropriate treatments, and the delivery of suboptimal care.²  Moreover, patients with limited English proficiency report being less satisfied, less likely to understand medication instructions, and more likely to have problems adhering to their medication regimens.

But why should this be? It shouldn’t. We invest billions of dollars in systems and programs for providing medical care and finding cures for diseases.  Why can’t we invest resources in systems and programs for patients with language barriers?

As pharmacists, we are responsible for providing excellent care in order to achieve optimal outcomes for our patients and enhance their quality of care.  It is our mission to provide our patients with a level of comfort and an opportunity to be understood.  And we should communicate clearly with our patients so that we can arrive at the best decisions together.  Being a pharmacist isn’t about filling prescriptions for our patients, but creating a bond that enables us to ensure a positive outcome, regardless of any barriers. Whether the patient is in a hospital, outpatient clinic, or a community pharmacy, this process requires excellent communication between the patient and the pharmacist to ensure the quality and safety of drug therapy.³  Patients who don’t fully understand their treatments are less likely to follow-up, which in turn puts them at greater risk of being hospitalized or experiencing drug complications.  For example, patients with asthma are at greater risk of intubation if they fail to properly use their treatments.⁴

Using visual methods can help. Going to the drawing board, showing pictures, and drawing examples can paint a clearer picture for our patients.  If nothing else, it demonstrates the effort put forth to help them. Using plain language and avoiding technical jargon is a strategy for making written and oral information easier to understand.  Written materials can be referred to at a later time.  Printed instructions for patients that contain pictographs and photographs that demonstrate medication-use techniques can be very useful in this patient population.² However, a better long-term solution to this problem is for our healthcare system to invest in a powerful interpreter service that is consistently available in order to facilitate optimal communication between providers and patients.  This will, in turn, improve patient satisfaction and safety.^5,6

Despite ongoing efforts to increase awareness of communication difficulties in patients with limited English proficiency, health disparities continue to exist.  Our challenge as pharmacists involved in the direct care of patients is not only to provide medications, but create a welcoming environment that encourages them to seek care even when language barriers exist.  Our job is to build a system that can mitigate communicate problems and deliver the best possible care to diverse patient populations.

References

1.    Ortman JM. Language Projections: 2010 to 2020. Population Division, U.S. Census Bureau.  Accessed on January 28, 2013.

2.    Diamond LC and Jacobs EA. Let's not contribute to disparities: the best methods for teaching clinicians how to overcome language barriers to health care. J Gen Intern Med 2010;25 Suppl 2:S189-93. Accessed on January 28, 2013.

3.    Bubalo J, Clark R, Jiing S et al. Medication adherence:Pharmacist perspective.  J Am Pharm Assoc 2010;50: 394-406.  Accessed on January 30, 2013.

4.    Flores G, Laws MB, Mayo SJ, et al. Errors in medicalinterpretation and their potential clinical consequences in pediatric encounters. Pediatrics 2003;111:6-14.  Accessed on January 30, 2013.

5.    Flores G. Language Barriers toHealth Care in the United States. N Engl J Med 2006; 355:229-231. Accessed on January 30, 2013.

6.    Phokeo V and Hyman I. Provision of pharmaceutical care to patientswith limited English proficiency. Am J Health-Syst Pharm 2007; 64: 423-429.  Accessed on January 30, 2013.

Preceptor, Mentor, or Both?

by Carmen Nobre, Pharm.D., PGY2 Oncology Resident, University of Maryland

Lines between being a preceptor and mentor often blur.  To be a preceptor is to participate in a prearranged role where one assumes the responsibly of fostering and building the core professional skills of a trainee.  As outlined by American Society of Health-System Pharmacists for pharmacy post-graduate residency programs¹, a preceptor is one that models, coaches, and facilitates a trainee's performance as a professional. 

To be a mentor is to function as a role model within your given profession.  Research on mentoring indicates that a mentor should:²

·      be nurturing

·      be a role model

·      function as teacher, sponsor, encourager, counselor and friend

·      focus on the professional development of the mentee

·      sustain a caring relationship over time

This type of relationship is traditionally freely entered by both parties (i.e. not as a requirement of a curriculum or program).  The mentor and mentee build a closer, more personal relationship than that of a preceptor and student.  Of no surprise, this often means that the two parties share similar interests and characteristics.  A mentor may participate in professional activities with the trainee, and may also engage in discussions relating to the trainee as an individual and not solely as a member of a larger group of professionals.  Topics of discussion often include families, hobbies, frustrations, and ambitions.³

Despite their differences, the terms preceptor and mentor are often interchanged.  This may be due to their shared goal of fostering the development of a young professional.  Yes, both roles have the common goal of guiding a trainee in their professional development, and coaching them through their journey.  Each role may also serve to challenge the trainee, evaluate their performance, or offer advice.  However, there exists a different tone between these relationship.  Most obvious are the differences in the goals and benefits of these relationships, their duration, the socialization process, the support for learning and feedback given.⁴  Simply put, a preceptor is more of an authoritative figure while a mentor acts more like an older sibling.

Can these lines ever be blurred?  Should they be blurred?  If so, when is it appropriate to play this dual role?  Furthermore, how do you juggle between the two?  Playing this dual role can be tricky.  As a preceptor there is a responsibility to evaluate the trainee, and provide constructive feedback to further their growth.  But as a mentor there is an expectation that you offer support and advice in how to handle even the worst of situations.  Is it possible to provide necessary criticism while being supportive?

In my experience, it can be difficult for both the preceptor / mentor to have this overlapping relationship.  From the trainee's perspective, it is difficult to maintain a goal-oriented working relationship with a preceptor, and then switch modes and disclose personal thoughts and feelings to that person.  In addition to identifying when it is appropriate to have a mentoring discussion, it is also difficult to reveal your weaknesses and frustrations (or even pleasant feelings) to a person who will be evaluating your performance.  From the preceptor’s perspective, it must be difficult to transition between nonjudgmental casual conversations and to formal discussions and evaluations of the trainee's performance.  Although it may be possible to carry this dual role, it requires a certain degree of balance.

Nonetheless, the benefit of having a mentoring relationship with a resident outweighs the risk of blurring the line between being a preceptor or a mentor.  There is much to gain.  There are opportunities to exchange ideas, improve job satisfaction, and build networking relationship.  Many institutions have developed formal mentoring programs where the mentor and mentee are paired and given guidance about how to develop an effective relationship.⁵   

Creating a formal mentoring program is one way of incorporating this fundamental practice into a resident's experience.  Another way is to purposely integrate it into the objectives of the residency curriculum.  By including instruction about mentoring, it will clarify the intent and expectations of the mentor-mentee relationship, and would also ensure that important professional development topics are addressed during the year.  This would serve to establish goals and clarify expectations (such as frequency of meetings).  An example: mentors should set aside time to discuss potential career opportunities after residency.  It is important to keep in mind the fundamental distinction between being a preceptor and a mentor, and that any relationship requires effort from both parties to be successful.⁶

Learning to be an effective preceptor and mentor requires training for a successful and positive experience.  As a recent graduate and having precepted my first student, I commend those who are able to fulfill these dual roles.  However, I would encourage new preceptors and mentors to have an open exchange with their trainees about expectations, and even seek advice from more experienced mentors (i.e. become a mentee yourself).

References:

1.  American Society of Health-System Pharmacists. Education and training.   Accessed 2012 Oct 22

2.  Kerry T, Mayes AS.  Issues in Mentoring,   Routledge Publishing Company in association with The Open University; New York, New York: 1995.

3.  Wensel TM. New Practitioners Forum:  Mentor or preceptor: What is the difference? Am J Health Syst Pharm 2006; 63:1597.

4.   University of Medicine & Dentistry of New Jersy (UMDNJ) Center for Teaching Excellence. Teaching Portfolio: Precepting and Mentoring [Web page]. Accessed 2012 Oct 22

5.  Johnson MO, Subak LL, Brown JS, et al. An Innovative Program to Train Health Sciences Researchers to be Effective Clinical and Translational-Research Mentors.  Acad Med. 2010; 85: 484–9.

6.  Sambunjak D, Straus SE, Marusic A. A Systematic Review of Qualitative Research on the Meaning and Characteristics of Mentoring in Academic Medicine  J Gen Intern Med 2009; 25: 72–8.