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How an Excellent Clinician Becomes an Excellent Teacher
At academic medical centers like the University of Utah, clinicians are expected to teach — but aren’t necessarily taught how to teach. Karen Gunning and Joanne Rolls come from divergent backgrounds — Gunning is a lifelong pharmacist, Rolls a physician assistant — but both are passionate about the principles of instructional design. Turns out, it’s the power of story that supports comprehension for both students and patients.

1950, the time it took for medical knowledge to double was 50 years. In 1980, it had fallen to 7 years, and by 2010, it was just 3.5 years. By 2020, it’s projected to be 0.2 years—just 73 days. It’s hard enough for students to keep up with such changes; how do you keep up as a teacher?

The culture at University of Utah Health is one that expects amazing clinicians who are great with patients to be great educators, too. But even the best teacher might panic when presented with the challenge of teaching a new course.

“Most of the time, people panic, open up PowerPoint, start writing, and end up with 150 slides containing information they’ll read word for word,” says Joanne Rolls, who is pursuing her master’s degree in instructional design from Johns Hopkins University while working at the Sugar House Health Center and teaching in the School of Medicine’s Division of Physician Assistant Studies. “That’s why instructional design made so much sense to me—it’s something clinicians can apply both to the curriculum they teach as well as their clinical work.”

Karen Gunning, who’s worked as a pharmacist for decades while teaching in Family and Preventive Medicine and Pharmacotherapy, recognized the need from a first-hand perspective. “Having a structure to hang your hat on helps,” Gunning says. “There are still subjects I teach in the medical school that give me pause. I think, ‘I really don’t know a lot about this.’ That hinders people—especially new faculty. They struggle and become frustrated. They think, ‘I can only teach what I know deeply.’ In primary care, we don’t know anything extremely deeply. For the generalist, you certainly know enough.”

#1 How can clinicians become better teachers?

Clinicians at the University of Utah Health know how to tell a story, make an impression, and meaningfully relate to patients. “Connecting the dots of information is a fundamental part of good patient experience,” Rolls says. “You never want someone to feel like they’re just a check mark.”

Listening with intent has tremendous power. “That’s why I stay in primary care,” Rolls adds. “To develop these great relationships with patients and really hear their stories. Once you figure out what’s emotionally resonant with them, that’s where an opportunity for transformation exists.”

The same listening skills translate directly to teaching. “I connect principles that people need to learn by telling a story,” Gunning says. “You teach, but you also listen. In pharmacy school, there are only 60 students. You can hear their stories, ask questions, and get feedback while working on how you listen and how craft what you say.”

#2 Tailoring the information to the learner makes you an effective teacher

Both Rolls and Gunning advocate for a multi-pronged approach to teaching: didactic, experiential, and encyclopedic. Sharing stories from the patient and provider perspective is powerful, instead of just drowning students in minutiae. Rolls says she finds that her anecdotes about making mistakes often resonant the best.

“Your learners are going to make mistakes,” she says, “and understanding that in a healthy way helps them grow instead of closing off, hiding, and maybe making more mistakes. That kind of learning is more powerful than giving a lecture about the ethics of medical errors. What you’re trying to do is teach them how to analyze the patient, versus just teaching them to regurgitate information. Don’t overwhelm your students with a 250-slide PowerPoint. Don’t let the minutiae prevent them from the joy of the patient experience.”

#3 Follow the process

Although Rolls and Gunning come from different educational backgrounds, they both emphasize the need to follow formal and informal processes. Resources like clinical teaching programs, instructional design certification, and even online tools like exist to help educators be more efficient. Meanwhile, training for skills once thought to reside exclusively in the realm of “unconsciously competent” can still have an impact.

“In the past year or two, pharmacy education has placed this huge emphasis on the process of care,” Gunning says. “That’s great because there has never been a published process of care for pharmacists like there is for nurses, physicians, and dentists.”

#4 Embrace change

Although Gunning and Rolls have worked in their respective fields for years, they both acknowledge the fact that medical knowledge is always evolving and growing. What makes the difference is how educators and students think about things as they change. How do you discover new information or critically evaluate research in your field?

“I taught a lecture on diabetes several years ago, and since then 16 new drugs have come out,” Rolls says. “How can you possibly keep up with that? It requires you to be a communicator and find out what’s important to your patient; then, you have to know how to conduct research and understand how medical studies work. If you can assess things with a critical eye, you can determine what’s safe for your patients—and, ultimately, what’s best for your students to learn.”

“The change in curriculum and the shift in education isn’t just a pharmacy thing or a PA-C thing,” Gunning adds. “It’s a health care thing. Essentially, we want all learners who will be taking care of patients to know the same things.” Those include value, quality, patient experience, and—most important of all—team-based learning. “No matter how old a student is or what their position is,” Rolls finishes, “we have to prepare people to work better in teams.”


Karen Gunning

Pharmacist, Professor of Pharmacotherapy, University of Utah Health

Joanne Rolls

Associate Professor (Clinical), Associate Director, Master of Education in Health Professions, University of Utah Health

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