One of my favorite books on education is Susan Ambrose’s How Learning Works: Seven Research-Based Principles for Smart Teaching. And until reading that book I had never heard the term “unconscious competence” in relation to mastery. And when I think about unconscious competence, it makes perfect sense (at least to me). Dental hand skill professors like myself don’t have to think about our hand skills anymore. Our hands just seem to know how to do whatever our brain says we need to do to prepare and restore (also know as drill and fill) teeth and we do this without much conscious effort (in other words, unconscious competence). However, when we (at least I) look back to when we were twenty two years old and just starting to prepare and restore teeth in our first year of dental school we are reminded (at least I am reminded) of how difficult and awkward and frustrating it was. There were days in dental school when we (maybe it was just me) wanted to scream and pull our hair out yet nowadays we hand skill professors are SO quick to forget those days (probably for survival purposes). But our students are smack in the middle of that struggle. And then we hand skill professors get so forking frustrated and scream and say shit like “they just don’t get it and maybe they’ll never get it…they’re hopeless”. Well now I know why the students don’t get it and why we professors get frustrated at students: our unconscious competence AND our expert blind spot (thank Susan Ambrose and her book for those two terms).
So how do I need to manage my unconscious competence AND my expert blind spot (keeping in mind that I am NOT a course director and have no control over lecture content given to students)? I have to constantly push through my expert blind spot (Ambrose, 2010, p. 112). In other words, I have to be ever vigilant to where the students are in their learning (if I have no clue as to where students are in their learning and development then I am blind to what they know and I am completely compromised in my realizing what I need to give students in order for them to excel). For instance, dental hand skill text books have been around for many years and have been perfected incrementally time and again (I still reference back to my hand skill text books). So I always need to be aware of student’s required text readings and what the text book’s author(s) have suggested. My course directors work hard to develop and present lectures in concert with the text book readings. So I always try to attend lectures so that I know exactly what the course directors are teaching and so that I can speak with a unified message when I get my opportunity to work with students. Also, my course directors work hard to develop learning objectives and it is my job to stick to those learning objectives. Further, my course directors work hard to develop rubrics for evaluating dental hand skills and it is incumbent upon me to rely on rubrics for a unified voice and a clear message to the students. And I always have to remember to put myself in my student’s shoes so that I can remain sympathetic to the things my students don’t know and the struggles my students face. Only after students have become comfortable with the the prescribed learning objectives can I then offer the new challenges of advanced techniques that may be of benefit but only after the basics have been experienced.
And how do I use learning objectives to guide students and help them gauge mastery? In my current role as a hand skill professor working under a course director and assigned to ten students at a time in the dental hand skills simulation laboratory, my options are limited. However, that doesn’t mean that I lack for good options. The best strategy at my disposal is to daily focus students’ attention on key aspects of the daily assignment (Ambrose, 2010,p. 114). I have to keep my ten students on task and I have to keep them focused on key components of that task. So I try to give them bullet points before they start their simulated patient treatment. As I know what they have learned in each of their dental hand skill classes my bullet points (or explicit instructions) help students to focus on what’s needed to get the job done and helps students to remember where they’ve been in order to bring old learning to bear on the current task. For instance, recently in one of the courses I help teach we were working on a particular task that required the students to use skills from a class they had over a year ago. By explicitly reminding students of: specific bullets from the current class; then asking students to remember bullets from a previous class; then me actually demonstrating what I was requiring of their work; then me explaining WHY we were doing things a certain way, I was MOST pleased by the results of their work (and I let them know that on the spot).
And how do I give feedback? As a hand skill professor working under a course director in the simulation lab I am limited in the ways I can give feedback. So my feedback has to be quick, direct, succinct, on-the-spot, and face-to-face. This type of face-to-face can be fraught with downsides so I have to manage myself well so as to only work toward a good end. For me I rely on balancing strengths with weaknesses when giving feedback (Ambrose, 2010, p. 149). I personally like praise so I strive to begin all feedback with praising those things that went well and/or improved from a previous attempt. I believe this keeps the students motivated and allows for an open environment where we can truly share ideas and learn from the experience. Then I get into talking about things that didn’t go as planned. It’s never easy to receive criticism (I usually hate it) so I am always very careful to not be attacking and/or provoking. In other words, I strive to have criticism be a part of the best learning environment as there are so many things we can learn from things that don’t go so well.
And after giving feedback I always ensure that the student understood what I was saying. So I always have a conversation with the student about my comments. I may give a demonstration. I may even have the student demonstrate the skill. This way I know the student has the idea of the goal in mind. Mastery shouldn’t be expected but seeing improvement in a particular procedure from a particular student the next time I work with that student (later that day or even later that semester) is proof that the criticism was warranted and pertinent. I will go out of my way to talk with students to see how a particular piece of advice has served them. And I always love it when students take criticism, make it their own, learn from it, and excel as a result. Students excelling at dentistry and developing mastery…isn’t that what we are (or should be) all about?
Ambrose, Susan A. (Ed(s).). (2010). How learning works: seven research-based principles for smart teaching. San Francisco, CA: Jossey-Bass
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