Fixing the impression

The education of psychiatrists involves all three of these means of communication with students. Still more, however, is required from a teacher. The facts and opinions that a student learns must cohere ultimately into a mature understanding of the subject matter and how that understanding translates into matters of practice. Gilbert Highet refers to this consolidation of knowledge as 'fixing the impression'. This final aspect of a psychiatric education rests on daily encounters between students and faculty in the exercise of patient care and study. The information derived from the primary teaching methods is 'fixed' by emphasis in practice and review during every clinical day. The repeated efforts at enhancing clarity of the opinions underlying practice makes the abstract ideas specific and tangible at the level of application.

As definition of the clinical problems increases so does the student's appreciation of what remains unknown and in need of future investigation for progress. The sense that there is much to discover evokes enthusiasm for the careful scrutiny of the subject. Finally, as every successful teacher will attest, the most crucial way of 'fixing the impression' offered to students is simply being with them as much as possible during their educational life. This produces a shared experience on which cross-referencing to lectures, tutorials, recitations, and simply ordinary events of the day can occur. What is taught as principle on one day can be confirmed by example on another. But only if the teachers and the students are spending days with each other and are talking together formally and informally about their common experience over patient care and research does an advanced capacity develop.

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