Serenity To Accept the Things I Cannot Change

The following causes of behaviour are impossible to change without tremendous effort and willingness on the part of everyone involved.

1. The Generation Gap

Every generation as they approach the level of experts complains about the younger generation's behaviour while the younger generation assumes they will avoid the stodginess of their elders. Plato wrote "What is happening to our young people?.... They have bad manners, contempt for authority, they show disrespect to their elders.... They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and are tyrants over their teachers."
The process of moving from child to adult requires self centered, authority challenging behaviour as part of the transition.

2. Cultural Differences

Every human culture has different rules about polite and impolite behaviour. For example, Canadian aboriginal cultures think it is rude to look someone directly in the eye unless you are challenging them, while North American business people are suspicious if you don't look at them. Cultural habits are deeply embedded in who people are and require a lot of effort and motivation to change. Many Asian students never use a professor's first name, whereas North Americas can be less formal.

3. Learning Differences

Visual people have trouble understanding why auditory people have to talk so much, auditory people complain that they just told the visual people ... weren't they listening. Concrete people think abstract people are complicating the problem, while abstract thinkers think concrete people don't want to get to the root of the issue.

4. Student's Issues

For some reason unrelated to the class or the issues above, the student has a personality that is aggressive, uncooperative, challenging or impaired.

Courage to Change the Things I Can

You have a certain amount of power to create a classroom atmosphere that supports learning. To watch a video about this issue made in the 1940's, but still relevant today, click here.

1. Class Rules

There are three approaches to discussing expectations; the rules are set at the beginning of the session or course by:

• the instructor; dealing with rule breakers is the responsibility of the instructor
• the students; rule breakers are the responsibility of the class
• negotiation (the instructor suggests a list which the students edit)

2. Motivation

The more engaged students are in their learning, the more motivated they are to learn. Help students make links between what they are learning and how they will use the content later on. The more respected students are, the more respectful they will be.

The following table represents The ARCS Model for motivating students.

Attention	Relevance	Confidence	Satisfaction
Perceptual arousal Inquiry arousal Variability	Goal orientation Motive matching Familiarity	Learning requirements Success opportunities Personal control	Intrinsic reinforcement Extrinsic rewards Equity

3. Appropriate Feedback

Students who behave inappropriately need to know that their behaviour is an issue and have the opportunity to change.

4. Personal Issues

Reflecting on your teaching will make you aware of where you need help, ideas and direction. Talking to students, peers and experts about teaching will energize and motivate you.

Wisdom to Know the Difference

Observation will help you determine what triggers the problem. Is it something within your sphere of influence?

• When students don't understand the relevance of what they are being taught, they talk to their friends, miss class, and ask questions for approval, not knowledge.
• When students don't think they have a voice, they fall asleep, read email or aggressively challenge the presenter.
• When students are afraid of punishment, they withdraw or become oppositional.
• When students are over dependent on rewards, they become competitive and attention seeking.

If the problem is severe (threatening, bullying, extremely disruptive) and/or you are uncomfortable with changing what is happening, talk to someone in a position to assist you.

Resources

Is it me or is it them? Factors that influence the passing of underperforming students Academic Medicine 2008

The LIFE Curriculum is designed to help residency program directors prevent, identify, and manage fatigue and impairment in their residents and fellows. Although intended as a tool for graduate medical education, the curriculum has themes that are pertinent for medical students, practicing physicians, and others in the health professions. This case-based curriculum, derived from a literature review and needs assessments by North Carolina program directors, includes seven vignettes of typical situations to demonstrate impaired performance and inappropriate behavior. Because all the vignettes involve providing clear, timely feedback, an eighth case addresses the facilitation of instructive feedback.




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