Fear as an Educational Technique

In a recent discussion with medical residents, someone asked the question “What’s wrong with fear as an educational technique?” Several people then told about how fear had worked to increase their preparation for class or exams.
I was mildly shocked that someone would even suggest that this was a legitimate teaching technique, but then I sat down and did some more thinking about the theories of teaching and learning.
Spare the rod and spoil the child is a concept that has been around for a very long time. It is part of an authoritarian system that required an authority (church, father, king, husband or teacher) to know what is best for others. The others must be guided to follow the authority figure without question because they don’t have the ability to make decisions. If they don’t obey, then punishment must be used to bring the rebel, unbeliever or lazy student back into the fold for their own good. Those who respond positively to the authority figure are rewarded with praise, promotion and belonging. In educational theory, this is called Behaviorism. If you want passive, unquestioning students, behaviorism works. Non-conforming students are removed from the system through failure or opting out. Industrial economies require an authoritarian educational system.
Constructivism is another educational theory that has become increasingly popular in the last thirty years as we move into the information economy. Constructivism is based on the idea that all knowledge is a construction of the human mind. Knowledge is shared from person to person, but acquisition is always the result of individual learning. This result will differ from person to person based on ability, culture, exposure and motivation. Teachers facilitate the opportunities for student acquisition of knowledge, skills and attitudes, but they don’t control it. The student is expected to bring their personal motivation to learn to the table. They are expected to be or to become self-directed, lifelong learners. Punishment is considered to be disrespectful and counter-productive of that student’s right to learn.
Between these two very different approaches to education is the question we are continually asking, “What is the best way to educate future physicians?”

3 thoughts on “Fear as an Educational Technique

  1. Medical techniques used in the 1970’s worked, but I prefer arthroscopic surgery. The same is true of how we teach. Fear works, but there are better methods of teaching and learning that have fewer risks of adverse consequences.
    Students that are engaged and excited by learning participate in discussions because they crave new ideas, not because they are afraid of the competition or of being embarrassed.

  2. I think you’re giving a kind of black/white dichotomy here. Fear is a valuable motivator. I know there are lots of things I’ve done or learned in medical school (rectal exams, pelvic exams, answers to common pimp questions, etc) purely because I was more scared of being embarrassed by the resident or attending than because I had a driving desire to learn that particular thing. Until I develop an independent professional conscience, trying to satisfy my superiors definitely motivates me to keep to high standards of practice and learning.
    The best teachers I’ve had, both residents and attendings, were people who asked lots of questions, and expected you to know at least some answers – fear there – but also were willing to give in-depth explanations, and could push their students to learn skills outside of their comfort zone. It’s a combination I hope I can use as a teaching resident in the future.

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