Lessons Learned in Character Education: Don’t be Intimidated

From the 8/28/2020 newsletter

 
Lessons Learned in Character Education: Don’t be Intimidated
 
 
Ryan Spellecy, PhD – Bioethics and Medical Humanities
 
 
Dr. Spellecy, who trained in Philosophy, talks about the challenges and rewards seeking to understand and implement the concept of “character in medical education” …
 
 

In the first months after the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education was launched, I attended, as a Kern representative, the annual meeting of the Association for Moral Education. Our goal was to present our initial work on “character” in medical education. The Kern Institute was a new player in the world of character and, since we were the first medical school to attend that conference in its forty-three year history, we were the first to delve into national and international scholarship on character education.  It was clear, even at that early stage, that role models are – and would be – essential in character education.  
 
In fact, medical education has known for years that role models shape our learners.  We call it the “hidden curriculum,” and it has often achieved the opposite effect of what we would want.  
 
At that meeting, I learned important lessons about role models and moral development: we must be mindful of the moral paralysis that can occur when we place role models on pedestals.  If we hold our moral heroes in too high esteem, we become paralyzed, unable to imagine how we could ever be “good enough.”  The result is that we – and our students – don’t begin working on character development because we cannot see how to start toward such a lofty goal.
 
 
Making mistakes is fine
 
So, how do we get past our moral paralysis and make progress?  When Professor James Arthur visited the Kern Institute, he shared a quote from Abraham Lincoln.  “It has been my experience that folks who have no vices have very few virtues.”  Or, as our own definition of character in medical education states, having good character does not mean one never makes mistakes or has lapses.  Rather, people of good character learn from mistakes. Our moral heroes are more like us that we think. To me, this means we must keep moving – and must help our students keep moving – toward character development. 
 
Think about some of your moral heroes.  If they are famous, they likely have had some shortcomings – perhaps even large ones – over the course of their lives.  Despite this, they can still have much to teach us, and by the same token, we can develop character and flourish even if we make mistakes and, at times, fall short. 
 
 
We all have different strengths to offer
 
The second lesson I learned at the meeting is that we are all unique and bring unique sets of strengths, including character strengths.  There is no one character profile for the successful pediatrician, surgeon, or even philosopher.  Rather, what the character literature has shown is that we can leverage our unique constellations of character strengths to achieve goal, often as a team. 
 
Still, do we need to look for certain character strengths as we consider building new, holistic medical school admissions processes? Initially, I believed that we would need to discern which strengths are necessary for medical students to excel at being physicians. I am certain that understanding applicants’ characters will still be a useful endeavor, but I am stuck in my philosophical training that emphasizes the value of specialization.  The recent psychology and education literature on character confirms that each of us is different and unique. This diversity is a good thing.  
 
For instance, I might low be low in “self-control,” and you might be high in the same.  We can complement one another to achieve a task.  More importantly, I can use a character strength that is particularly strong for me to help us both tackle a problem from different angles.
 
 
Understanding and educating for character
 
Of course, successful physicians need equanimity just as successful philosophers need good judgement.  However, our individual character constellations around these fundamental strengths makes us unique and enables us to complement – and even strengthen – each other on teams.
 
Even the same character strengths can manifest differently. In perusing the book, Character Strengths Interventions: A Field Guide for Practitioners by Ryan Niemec, I noticed that the activities recommended to work on the character strength “Zest” did not include things like, “Quit your job and hike around Europe for a month.” Rather, one suggestion was to choose a physical activity you enjoy, follow a plan to do it regularly, and write about the experience, including the benefits and feelings it evokes. Seems like great advice for anyone. 
 
 
Since our first Kern discussions on character, we have added expertise and experiences from several institutions. As an organization that seeks to transform how we educate the next generation of physicians, I believe it is critical to understanding how we best help students develop their professional character.  To be honest, the things our students see and hear while in the classroom, in the hallway, and at the bedside are already central to their character development, even if we call it by a different name. We rarely reflect on the process and certainly don’t fully understand it. 
 
This is not an inconsequential task. We aim to educate physicians who will, by nature, perform wise behaviors and trustworthy acts. We believe that the goal of understanding and then educating for character is not out of our reach, regardless of where we stand with our own moral development, the shortcomings we might have, or the character strengths that we feel are not as strong as they might be. It is exciting to be “early-in” as we explore this important field in medical education together.  
 
 
 
 
Ryan Spellecy, PhD is the Ursula von der Ruhr Chair in Bioethics and Professor of Bioethics and Medical Humanities and Professor of Psychiatry and Behavioral Health at MCW. He leads a National Transformation Network group seeking to define character in medical education. He is part of the Kern Practical Wisdom Workgroup. He is a member of the Kern Philosophies of Medical Education Transformation Laboratory.