In this episode our guest, David Masuda, MD joins Kate Mulligan, PhD to discuss how to incorporate teaching practices that foster wellbeing and encourage resilience to humanize the classroom.
Resources:
Humanizing the Classroom Part 1
Kate Mulligan, PhD, Teaching Professor, Neuroscience and Human Anatomy, Associate Director, Center for Learning and Innovation in Medical Education (CLIME)
David Masuda, MD, MS, Lecturer Emeritus , Department of Biomedical Informatics and Medical Education, Adjunct Lecturer Emeritus, Department of Health Systems and Population Health, School of Public Health, Department of Biobehavioral Nursing and Informatics, School of Nursing
[Intro Music]
Amanda Garza: Welcome to CLIMEcast! I am Amanda Garza the CLIME Program Manager, and I’m excited to introduce the first episode in this 2-part series. In this episode CLIME Associate Director Kate Mulligan talks with Dr. David Masuda about incorporating teaching practices that foster wellbeing and encourage resilience.
Dr. Masuda is a beloved emeritus faculty member of the department of Biomedical Informatics and Medical Education and a pioneer in incorporating techniques for humanizing the classroom at the University of Washington.
Kate Mulligan: David, welcome! Thank you for joining me to talk about ways to humanize the classroom, or more formally how to incorporate teaching practices that foster wellbeing and encourage resilience. I'm so happy to have you as a guest. I have known you over the years hearing you give really innovative presentations on teaching practices.
I had the opportunity to hear you in a learning community forum on wellbeing. After that I tried some of the practices and I'm a complete convert now, and I really wanna share some of your wisdom with the CLIME community, so thank you for coming. I wonder if we could start by you sharing with us something about yourself and your teaching and how you found your way to these practices that you used so successfully in the classroom.
David Masuda: Well, hello Kate and thank you for having me. I really appreciate the opportunity to talk about some of these practices. I know for me, over the last number of years really were revelatory in the way that I thought about my role as a teacher and how we can do better work with students, not only to improve learning, but improve as we're talking about their wellbeing and resilience as well.
And as far as how I got here, I guess I'll try to give the very short version of this. I started off my professional career after medical school going to a residency in diagnostic radiology, practiced medicine in a small town in Idaho for about 15 years. At some point, realized I wanted to take a different approach to the healthcare system, so, got a master's degree in administrative medicine and then spent about half my time practicing and half my time helping to develop an integrated delivery system company.
After about five years of that, I thought I really wanted something new as well, and had an opportunity to come to the University of Washington in the Department of Biomedical Informatics and do a postdoc fellowship in that field, which I did, uh, right about the turn of the century and, uh, had a great opportunity at that point when they asked me to stay on and teach.
I think this was a point in time when a lot of educational programs were starting to think about this thing called informatics and thought it was important, and I guess they felt I might know something about it and could teach it. So, for the last 22 years that's what I've been doing, teaching in several different graduate programs across the School of Medicine, the School of Public Health and School of Nursing as well as some international work to, to talk about things around informatics, healthcare, healthcare leadership, healthcare policy, and more recently this concept of wellbeing for life and learning amongst our students.
Kate Mulligan: Could you speak a little bit about maybe your time with the Resilience Lab or what convinced you that these practices essential?
David Masuda: I had a ultimately fortunate experience, but initially a rather shocking experience. About five years ago, it was a Sunday morning and I got an email from one of my PhD students, a first year PhD student who was in a class of mine who, who very simply announced, well, you know, my homework which is due on Monday, is gonna be late because yesterday morning I tried to take my life. And, I, I, as you might guess, anyone who gets an email like that thinks, what in the world is going on here? I had no idea. Long story short, this all worked out well, we got this student some help and assistance. They were able to go on and complete their degree and I think are doing well.
That's when I started looking at what, what do we know about the health and wellbeing of our students? And the resilience lab was started up, I think in 2015 or so, and I had found them online and got a chance to have some interaction with them and understand what they were doing. And I heard some of the data that they had been collecting both nationally and at UW in terms of health and wellbeing andand I was really kind of shocked.
I, I can't remember the precise number, but I think over the last five or seven years at UDub, we've had somewhere upwards of 20 or 25 suicides among students, again something I was entirely unaware of and it's helped me start thinking about what do I know about my own students and how well they're doing in the classroom, they all seem to be fine, but I realized that underneath that, a lot of them, maybe all of them are struggling at, at fairly profound levels. And when I saw the work that the Resilience Lab was doing, especially around the Initiative for Wellbeing, wellbeing for Life and Learning, I, I thought I have to be involved with this.
And so for the last four to five years, I had been working with them to try to understand how we can develop practices that can help us better understand students, help students better understand us, and find ways to start to ameliorate some of these negative consequences of higher education.
Kate Mulligan: Thanks, David, I feel like the pandemic has exacerbated the anxiety levels of my students at least, and the stress in the classroom is absolutely palpable. So I'm really, really happy that we're gonna be talking about some techniques that help with that. So please do check the show notes because we, we'll have links to the Resilience lab and the guidebook that helps layer foundation for why we academically should think about doing these practices. But maybe we can leap into the how-tos. Now, David, I know that in that guidebook there are four foundations that are laid out for advancing student wellbeing with great examples and resources.
David Masuda: I'd love to go through some of those. I'm glad you'll be able to link out to the guidebook. This is a project that a number of us, I think there were about 40 students and staff and faculty who were involved in the development of this guidebook about 2020 is when it was, we spent a year trying to figure out what would be a, as we mentioned, a guidebook to help, uh, faculty start to think about what are some of the things I can do around the four different areas that can really help us perhaps engender a better sense of the issues around wellbeing for students.
And so I highly recommend that anyone who's interested in this download this. And it's a great way as a, a set of menu items, I think, for you to start trying different things in your own classroom.
Kate Mulligan: Okay, so how about telling us about the foundation or the areas to, to focus on, and then we can leap into some examples perhaps.
David Masuda: So in our work as the fellow group to try to come up with foundations for advancing student wellbeing, we, we decided that there were actually four characteristics, or four categorizations, we might say, teaching for equity and access, which I think you all have talked about in previous podcasts before.
And so maybe what we'll do today is focus on the latter three, which are nurturing connection, building resilience and coping skills, and then connecting to the environment
Kate Mulligan: yeah, that sounds great. I know that teaching for equity and access is a huge topic and an important topic in its own right, and the University of Washington School of Medicine is devoting significant resources to helping faculty cope with that aspect. So let's focus on the other ones today.
David Masuda: Well, let's dive into this second one called Nurturing Connection. And I, and I guess for me, this was a great way to talk about this given the story I just told about how I got involved with this group. One of the things I realized is I honestly, if I didn't know the student was in crisis, it's because I just didn't have a very good connection with the students at all, which then extends to the fact that I probably didn't understand or connect well with all of the students that I've had a chance to teach.
So, as we talked about what nurturing connection means, one of the things we found is that there's a couple of ways we can subdivide that concept. One is this concept of social connectedness, and the second, second one, which kind of follows from that, is the idea of self-connectedness. So, if we think about what is social connectedness means, it's effectively a sense or a feeling that an individual has of interpersonal closeness and group belonging. So if you think about a classroom, it's how can we help every student really feel that they truly belong to that group? And of course, not just the, the other students in the room as well, but as an instructor, we are part of that group as well.
So that social connectedness are ways in which we can really start tying together all the individuals in a room and help them feel like we're all here together, trying to pursue the same thing, which is the development of new knowledge. I think one of the things that has always stood in the way for this for me was, well, I should tell you a little backstory behind how I got into teaching.
As I mentioned before, when I was finishing up my fellowship here, I was asked to teach a class and having gone through what the you know, med school, college residency, fellowship, a master's degree, I was now in the 28th grade basically, but I'd taken no curriculum, no approaches to learning what pedagogy is all about and how do you teach well?
So, I taught the way everyone else who falls into this situation does, I taught the way I was taught. Which meant I lectured in the first year of teaching, I actually got a teaching award from a set of students. However, the award was basically, you are the professor who gave us the most number of slides and the most number of pages to read in the entire semester, which to me was not necessarily the best kind of award.
So I spent some time trying to figure out what do we know about teaching? And one of the things I quickly came to was this concept that lecturing, it has its place. Uh, and I still do it from time to time, but it's really not teaching as well. So the first thing I think I started to do around understanding how to develop social connectedness in the classroom is to try to move away from that.
And, and I always try to tell students, look, I'm not here to teach you I'm here to try to create an environment where we can all learn together, because I certainly don't know everything that needs to be known, and we can all work on that. So, some really simple things, learning their names. I always insist that they call me by my first name, David, and not by my last name or my titles.
I really insist that they try not to do that. It's interesting, and my formal title is actually a lecturer, not a professor, and in 20 years I could not convince people to stop calling me professor. I think that's just that reaction or instinct that they have. So, I want them to use my first name. I also want to learn their names and since I have always had a lot of international students, one of the biggest challenges was learning how to pronounce their names.
And, and I think that's something that if you take the time to do that and do it with sincerity, they'll really appreciate that as well. There is another paper that I might suggest any listeners take a read, and I think we can probably link to that resource. Jane Tompkins wrote this piece called Pedagogy of the Distressed, I think about 25 years ago, and it's a really insightful piece that it was always meaningful to me in the sense of, How do we think about teaching? What's our philosophy? What's our approach? And she had come to the conclusion that as a person who was primarily lecturing, I think she may have been at Duke at the time, she described this thing called the Performance Model of teaching. I mean, I think that the kind of the overarching model before that was the banking model where the idea is, hey, our job as teachers is to take all this knowledge and wisdom and, and experience that we have and bank it into the brains of our students, you know, deliver that.
Tompkins said her fear was the performance model, which is the lecturer or the instructor, is to stand in front of a room and show that you are the brightest person in the room, that you know more about whatever topic you're teaching than anyone else, and that you prepared really, really, well. And that kind of put a barrier between herself and the students.
And so, one of the big consequences she found was that fear is the driving force behind the performance model. And I think we've all been there in teaching. That I come in a classroom, and I don't feel prepared and I'm terrified. So, for me this is a way of saying, how can I drop that and turn my approach to teaching in one where I'm actually much more connected to the students.
I'll just pull a few ideas that come out of the guidebook on things that you can do. Little principles, little practices, little techniques, and many of these are really fairly simple and easy to do. They that might actually start to build this concept of social connectedness. Years ago I had a chance to talk with Jaime Diaz in the Department of Psychology on upper campus, and I watched him actually teach a class and the way he started the class, as soon as everyone was sitting down, he would put up about a two or three minute audio file that was simply a gong, regularly chiming. And this was the point in time when they did their, their opening ritual, which was a two-to-three-minute meditation, and he would say, take a deep breath, close your eyes for the next two to three minutes just relax, just let your mind wander. And I was struck by how effective this was, and it was the very first thing I think I tried even before I got engaged with the resilience lab to just do this meditation and it was terrifying at first. Yes, I'm standing in front of the room. Doing something that I think most students would think, this is insane.
I would close my eyes and I would try to meditate, but my brain was basically saying, Hey, when I opened my eyes, I wonder if they're even gonna be in the room. Have they all left? But what I found to my surprise was that if I ever entered a classroom after that and failed to do that, they would say, Hey, wait, wait, what about the meditation?
So this idea of an opening ritual, I think is really phenomenal. It's a simple thing to try. It is frightening up upfront. But my experience has been more often than not, actually almost always, that this is something that people really appreciate and I'm sure not everyone in the room does, but, but it's one thing that at least start to build that bridge, starts to build that direction towards connection.
The same thing you can do with a closing ritual as well. One of the things I've liked to use is take the last five minutes of class and we'll get to this idea of having students write a learning journal and a reflective journal in a little bit. But one of the things I asked them to do at the end of class is, and I'm sure a number of other people have done this as well, is ask a couple of questions.
So, what one thing in our conversation today surprised you? And what one thing do you now feel that you need to know more about? And we won't talk about it, but I want you to take three or four minutes and just jot this down in your journal. So now this becomes sort of the back end of the initial meditation, towards a personal reflection. Once they know you're going to do that every single class session they get used to that idea and they're prepared for it and they start to learn, okay, how can I use this two to three minutes in, in of time? That really can help me as well.
Kate Mulligan: Yeah, I can testify that it is terrifying when you start to do it, but it quickly becomes, I think, pretty normal.
And I think for me, one of the challenges was using language around this and I what I fell upon was, the idea that you invite them to join you in deep breaths or something like that. And, and that seemed to work pretty well for me, but we've got a lot of creative people out there who can adapt I'm sure.
David Masuda: Well, I, I think that's a great idea. The, the idea that this is not, for example, a quiz, that you don't have any choice you have to take. This is something that you can do if you would like, and that idea of an invitation asking them to come in, I think that's a beautiful way to talk about social connectedness.
Kate Mulligan: How about some others?
David Masuda: A couple others that I think are really important to me. As I mentioned before, I don't lecture that much anymore. I really started feeling that the best way to spend our time together in classroom is to actually try to make sense of whatever topic we were thinking about that week or that day.
I mean, if you think about the plethora of material of content that's out there, whether they be pre-recorded lectures, the entire internet, all the literature that's available, the content is available to all these students. The thing that our job, for me at least, is, is that we, I want to help them make sense of it.
How, what does this really mean in my life? What does this really mean in my profession, in my future career? So, I use most of the time I have in class to say, let's try to figure that out. Let's try to understand what this really means and the thing that I realized I was very poor at was this concept of active listening.
At one of our resilience lab meetings, we had an initial exercise, which was pair up with someone. You each get two minutes, and in the first two minutes, one of you starts talking. It doesn't matter what you talk about, just say whatever you want, and the other person has to actively listen, qnd then reverse that for the second two minutes.
So I was the listener the first time, and I don't recall the name of the person I was talking to, but they were talking about some things related to teaching. And about in the first minute, I started thinking, how am I going to alter what this person is saying because I don't agree with every principle.
And then in the second half or the second minute, I, I started thinking, oh wait, that was a great idea. Here's how I might apply that in my own classroom. And at the end of the two minutes, I was not really paying attention. I had this internal dialogue going on, well, oh, either I disagree with some of these things, or I want to liberate some of these things and bring them in my classroom.
So that was my rather brutal awakening, the idea that I don't listen very well. So that's one of the things I think that is important. If you are going to have a classroom where there's conversation, discussion, dialogue, debate, even understanding how to listen. There are a number of subtle techniques you can do with that, you know, leaning forward, looking eye to eye, a lot of, body motions, head nodding and such.
So, so I think the guidebook even talks about some of the techniques for active listening that that can really help us learn how to do it. And that then really engages the students of, oh, they're really paying attention to what I'm, uh, I'm having to say, even if I'm stumbling and maybe even if I have some incorrect ideas, at least they're still trying to understand.
Kate Mulligan: Well, that's a great life skill too, right?
David Masuda: Oh, yes, I'm sure my wife would attest to that one. The last one I'll mention is this concept of regular check-ins. The idea that on a regular basis you actually check in with students to see how they're doing. One of the things that I found during the Covid period, and actually prior to that, because I spent a, a good amount of my teaching doing executive programs where a lot of the things were online, synchronously online, and one of the tools that we discovered is this tool that's called Jamboard.
I think it might be a Google tool, but nevertheless you can use it for free. It's basically a large electronic whiteboard where anyone who's logged in can post little post-it notes or images or whatever they might be. And I would use this often for this check-in. Um, and I would alternate some fun tasks with some more intimate questions.
For example, like some of the fun tasks was, Hey at the beginning of the class, put up a Post-it note with whatever music you're listening to right now. Or what did you have for breakfast this morning? They could actually take a photograph of themselves, like we had one, which was oh, hilarious hat day I remember that.
So when you come to class, have your goofiest hat and we'll take a picture of it on Zoom and we'll just see how that is. And the nice thing about that is you see just a lot of smiling going on.But occasionally then we, we'd do a more serious check-in, which was, I remember one that seemed to work really well was I posted the question of what one word describes how you're feeling today?
And of course some of them were very positive, but a number of them were routed or negative and, and I think one of the great things about developing connection is, if one student said, I'm feeling anxious or sad or angry, or some negative emotion, and then they saw that four or five others were feeling the same way.
They get a sense of, Hey, I'm not alone in this, and I can't say that. I know that there were any side table conversations between students that had similar. Mm-hmm. emotions come up, but I wouldn't be surprised if that was the case.
Kate Mulligan: Right, should we move into the building resilience, coping skills practices?
David Masuda: Yeah, I think that that's certainly a good one. This, so this is the third, pillar we might say within the wellbeing model that we have in the guidebook. And resilience coping skills actually has four categories within it, mindfulness, growth mindset, gratitude and self-compassion.
And there's one thing I will say in preface to this is actually that a lot of the things that come under each one of these, the various practices you see can be useful in some of the other areas as well. And, and I will say it, let's talk just about mindfulness. This idea of how, you build resistance to stress and bringing your own attention to each moment going forward, even if you have some of these emotions, discomfort, anger, sadness, other emotions.
So, this concept of being mindful of where you are right now. I remember one student at one point in time really made this clear to me, and it was a point in class, I can't remember exactly what the details were, but, but basically I got rather upset about something, perhaps, we were talking about politics and I upset myself and they sensed that I was kind of angry and, and actually challenged me on that.
We, we developed, this is a, a set of students that I'd had for an entire year, so they trusted me. I trusted them and one of them said, you know, it sounds like you're kind of angry right now. And I said, yes, I am angry right now. And this student basically said, you know, there's a way to approach this in a mindfulness direction.
When you feel any emotion, let's say it's anger and you think I'm angry right now, kind of rephrase that in your own mind to saying, Hmm, I'm experiencing the emotion of anger right now, and that kind of pulls you away from being controlled by that emotion towards recognizing, being mindful of the fact that you have that emotion and you might then say, I wonder what's causing that, and I wonder if my reaction is actually justified.
So that's, that's to me kind of the best way to describe this concept of mindfulness, a number of different things that we've done in the guidebook and that I've tried to model as well, and I think that's one of the key things about many of these practices. You can explain them to students, but the best way to help them understand how to do it is for you to model it yourself.
And so the one model that I came up with, and it's kind of goofy and simplistic, I have an electric toothbrush, right, and all of the dentists say when you brush your teeth with one of these two minutes, you know, 30 seconds on each of the four quadrants of your mouth. And the, the brush actually vibrates, at least mine does every 30 seconds and say, Hey, move the other side. So, I told them that this is my moment to be mindful. I'm going to actually stop my brain going a hundred miles an hour and wait for those instructions from my toothbrush to spend my full two minutes.
So that's my moment of mindfulness, and, and it is a goofy story, but the idea is for any of these practices, if you can show them how you've tried to adopt them yourself in your own life and in your own work, it helps them realize, well, maybe this is kind of in interesting or maybe important stuff. If, if this person, if the instructor's doing this and they like it, maybe I can try it as well.
Kate Mulligan: Well, going back a little bit, I have to say I'm impressed and I think it's a testament to your classroom that you actually had a student help you understand the idea of reframing an emotional moment.
David Masuda: Yeah. Yeah. Well, we all know that we get some really brilliant students. Exactly. A lot and if you give them the trust and the belief that they can say what they want in class, they'll teach you a lot. And that, you know, I always love to tell students, you know, I'm gonna learn more from you than you're ever gonna learn from me. And this is one of those wonderful moments, the kind of the best teaching feedback you can possibly get.
Kate Mulligan: All right, I'm sure you've got some more tricks up your sleeve.
David Masuda: Yeah, let's talk about growth mindset, because this is the one that really has been meaningful for me. So, I'm sure many of you know that this concept came from a, uh, psychological researcher on Stanford, Carol Dweck a number of years ago, and, and she developed this model that people tend to either have a growth or a fixed mindset.
The idea that of having a fixed mindset is that anyone's intelligence is rather innate and fixed and can't be changed. You know, there's some, some memes that have gone on, you know, girls and women saying, well, math is hard. Well, we know that's not true. But it is that mindset that if you say math is hard then I can't possibly get better at it.
And I've actually had students say in my class, you know, I'm just not a creative type. And I bring up the point that, from this research, that that's actually a fixed mindset because I think the research tends to shows that anyone can improve in any task or any skill or any knowledge base if they believe they can.
And so I tell all my students that every one of you has the ability to be creative as long as you believe you can be in that space. And, and so again, coming back to this concept of modeling, one of the ways, after having talked about this growth versus fixed mindset model and some of the research behind it, and how we can each work towards moving from any aspect of a fixed mindset to a growth mindset, I, I tell them again, here's how this worked for me.
You know, a good example I think was when I was an undergraduate, I was in the top of my class, I'd say top 5%. And then when I got to medical school, I very quickly jumped to the middle. In fact, I was I think, slightly below the mean in terms of grades, as long as that's a measure of anything, and that was a huge ego blow to me, the fact that I was no longer at the top anymore.
And, uh, I remember thinking after I had now learned about this concept of the growth and fixed mindset that, gee, maybe I was thinking at that point in time that this kind of proves that I'm not at the top, I'm actually kind of fixed somewhere in the middle. And years later I started realizing, oh, that wasn't the case.
I ended up, you know, getting through the school or the program, getting a degree, moving on to a practice as well. And so that idea of saying, here's how that worked out for me, here were the emotions that I went through, the fear that I went through, the uncertainty that I went through. I've also told them about every mistake that I made as a clinician because in radiology sometimes you don't know that you miss something as well. So that idea of showing them that I failed. And yet I'm still around I'm still doing what I hope is good work. And so that notion of modeling this growth versus fixed mindset, I think is, is helpful. I have to say, one of the best examples of this that I can tell you about is Anne and Megan in the resilience lab, the two people running this had this brilliant idea years ago, they took a huge whiteboard, stuck it in a dorm on upper campus at UW, and they entitled it The Face Plants and Failures, A Whiteboard. And they basically said, Hey, if you want share with us sometime that you had a face plant or a failure, and it was just left up there.
And they wanted to see would anyone put things up there, and so people started putting up little notes, sticky notes, and such of all the failures that they had. I think there's an image of this somewhere, but there are things like, you know, I failed the Compsci 101 the first time through, and then, or, uh, one of my favorite was I, I accidentally set the lab on fire.
I applied for a job, said everything wrong tore the carpet with my high heel as I walked out the door and, and it was really, these were all anonymous and it was really fascinating that students were willing to say these things what was even more fascinating were other students would say, I failed Compsci 101 too the second time I passed it you'll get there. So you started seeing this connectedness come back together where people were kind of supporting each other for having admitted their face plants and failures. So, I used this in my classroom as well. Again, we used the Jamboard and Zoom for people to put up whatever failure or face plant they had.
One time I actually asked students what did that feel like? And, and one of the students who was willing to put up a significant failure for them said, you know, that felt really liberating. I've been worrying about this and thinking about it and sharing it with no one, but now that I've admitted it, it's like I can breathe again.
Let it go. Yeah. So, I love that, that technique.
Kate Mulligan: If I can add a little bit about the growth mindset, I have incorporated this idea of the word yet or the power of yet. So when I find myself saying, oh, I can't do that balancing exercise, just add yet and then it just sort of exactly reframes it.
David Masuda: So that's certainly one of, one of Dweck's, concepts is, is to say, it's not that you can't do it, it's such you just can't do it yet.
And this kind of gets us to some of the pedagogical aspects, this idea of summative versus formative assessments, you know? If most of the grade is based on a final exam where you can't do any more improvement, that can be problematic as well. So I know in any of the assignments I do, I always have them submit drafts and such so that we can always say, well, it's not quite there yet.
And then give them more opportunity to continue to work on it. And even if they get to the end of the quarter and have not yet mastered it, you can say, look, you've, you're gonna pass the class. You can continue to go learn more about this and develop your skills as you need going forward.
Kate Mulligan: Thank you David! So, we covered mindfulness and growth mindset, I think this may be a good point to pause and we will puck up the thread in episode 2 thank you!
Amanda Garza: Thanks for listening to episode 1 in this two-part series.
We hope you join us for episode two, where Kate & David continue their conversation on building resilience and coping skills with students and dive into the concept of connecting to the environment. Don’t forget to check out the show notes for the resources mentioned in this episode.