The Role of Teacher-Learner Relationships in Medical Education

  • Richard G. Tiberius
  • Joanne Sinai
  • Edred A. Flak


Teacher-learner relationships are distinguished from other relationships by several characteristics: an imbalance of power between the teacher and the learner; relative vulnerability and discomfort of the learner compared to the teacher; and constraints imposed on the relationship by social convention, by policies and norms of the educational institutions and by perspectives of teaching and learning held by educators. Beyond these few common characteristics there is no universally accepted definition of the teacher-learner relationship. Both teachers and scholars in the field of education hold different perspectives on teaching and learning and each of these perspectives has its own slant on the teacher-learner relationship.

The chapter begins with a brief review ofthree ofthe major philosophies of education and their implications for the teacher-learner relationship. Objectivists tend to view relationships as a frill, not important to the central role ofteaching which is the transferring ofinformation to students. Experimentalists tend to be interested in interaction (and derivatively in relationships) because their responsibility as teachers includes the psychological engagement of learners. Existentialists tend to view the relationship as the central vehicle through which the teacher stimulatesgrowth in the learner.

The body ofthe chapter reviews several research literatures from the point of view of their implications for teacher-student relationships: biological and neurophysiological, higher education, clinical supervision, role-modeling and mentoring. The conclusionfrom these reviews is that teacher-learner relationships have an enormous impact on the quality of teaching and learning. By some estimates the teacher-learner relationship explains roughly halfofthe variance in the effectiveness of teaching. Yet it has largely been ignored in the educational research literature. This imbalance is particularly ironic in medical education where obvious parallels with the physician-patient relationship should stimulate interest in interpersonal relationships in teaching.

Afinal section addresses the question of how teachers canfoster teacher-learner relationships that enhance learning. Although a number ofhelpful suggestions can be extractedfrom the literature, the suggestions cannot be organized into a simple list of “do’s” and “don’ts”. It is more validly expressed as a set ofcontradictions or “dilemmas”. We identified seven such dilemmas critical to the teacher-learner relationship: (1) Expert Authority and Flexibility; (2) Institutional Authority and Collegiality; (3) Communication: Inclusion and Separateness; (4) Support and Challenge; (5) Emotionality: The Good and The Bad; (6) Authenticity: Expertise andRole Modeling; and (7) Accessibility:A ConflictofPriorities between Practice, Scholarship, and Teaching.

Unlike simple problems, dilemmas are not completely resolvable. For example, teachers should not be forced to choose between challenging students and supporting them. They need to do both. We provide some recommendations and references to help teachers and administrators understand these dilemmas and establish effective teacher-learner relationships.


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© Springer Science+Business Media Dordrecht 2002

Authors and Affiliations

  • Richard G. Tiberius
    • 1
  • Joanne Sinai
    • 1
  • Edred A. Flak
    • 1
  1. 1.University of TorontoCanada

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