The Veterinary Teacher

Teaching Implications of Different Educational

Theories and Approaches
Dale A. Moore Martin H. Leamon Paul D. Cox Mark E. Servis
ABSTRACT
Educational theory can and should form the basis for teaching in veterinary medicine. Nevertheless, formal training for teachers
in veterinary medicine is uncommon and rarely includes study of different educational theories or perspectives, leaving educators to rely on informal or hidden educational constructs to guide them in their everyday teaching. Using a modified casebased format, we present critiques of a hypothetical teaching scenario from four different educational viewpoints: behaviorist,
cognitive, social learning, and inspired teaching approaches. The importance and utility of formal educational theory in faculty
development is discussed.

INTRODUCTION
Few faculty members involved in veterinary medical education have had extensive formal training in teaching or in the
educational concepts that underlie pedagogical methods.
Yet we develop a teaching style, give lectures, conduct
courses, and facilitate small groups. Many of us attend faculty development teaching workshops, but these usually
focus on specific instructional skills and do not emphasize
the evaluation of different educational theories.1 We have
initiated, facilitated, or weathered curriculum reform, a process that may involve a shift in theoretical orientation but
may be experienced as simply a change in learning objectives and teaching methodology. Some teaching methodologies have been discussed in the veterinary literature, such as
changing lectures to create more active learning, using facilitated student feedback, and experiential learning, but a
description of the theories behind many of these teaching
modalities has not appeared in the veterinary literature.24
Without formal educational training, we rely on other
sources for our thinking about veterinary medical education. For many instructors, conceptual thinking about veterinary medical education may be influenced by
unacknowledged educational approaches, a set of experientially derived, unexamined, and poorly unified beliefs and
ideals about the nature of teaching and learning. Formal
educational theories may be debatably scientific and may
not be useful to generate disprovable hypotheses. They may
more accurately represent educational philosophies that are
metaphorical in nature.5, 6 Nevertheless, an understanding
of educational theories can provide a common vocabulary
for discussions about teaching, clarify the intent of instructional techniques, stimulate our thinking, and enliven the
daily experience of teaching.
In this paper, we present a hypothetical case to demonstrate
how different educational approaches and theories might
influence the daily practice of teaching. Dr. Doe, a junior
faculty member, receives feedback on his teaching from four
experienced teachers, Drs. A, B, C, and D. Dr. A teaches
from the behaviorist perspective, Dr. B represents a cognitive learning approach, Dr. C, a social learning approach,
and Dr. D takes an inspirational approach to teaching. These
four perspectives do not represent the entirety of current
adult educational theory, but they were chosen based upon

JVME 29(2) 2002 AAVMC

our experiences as educators to represent a diversity of

approaches. We have designed the case to highlight differences between the four perspectives, rather than exploring
regions of similarity or overlap. As in any brief presentation,
we do not pretend to have represented any of the four educational approaches in all its richness and complexity. Following the scenario, we discuss the importance of
explicated educational approaches, particularly with regard
to impact on individual faculty development and the acquisition of skill and mastery in teaching.

THE CASE
Dr. Doe is an Assistant Professor in the Department of Clinical Sciences. He takes his teaching responsibilities seriously, volunteering for teaching assignments and making
himself available to students. He has attended several faculty development workshops on instructional technique
and has become proficient in using presentation software.
Dr. Does teaching materials list outcome-oriented learning
objectives, identify key information and concepts, and usually include follow-up study questions on topics covered in
lecture. Student evaluations of Dr. Does teaching give a
mixed picture of his performance; he earns average ratings
for overall teaching quality and amount learned and
above-average ratings for enthusiasm and availability to
students. Student evaluation comments include the following: clearly defined objectives, well-organized; not real
stimulatingactually, kind of boring; just repeated what
was in the text; really useful reinforcement of the learning
material; and seemed good, but how does this apply to
the patients Ill see?
Drs. A, B, C, and D are experienced teachers in the department and are widely regarded within the veterinary school
as effective and knowledgeable educators. As part of a pilot
program to provide peer review of teaching, Drs. A, B, C,
and D each sat in on two of Dr. Does sessions on infectious
diseases of cattle with third-year veterinary students. Their
job was to critique Dr. Does performance and stimulate his
thinking on how to improve his teaching. Each reviewer
met individually with Dr. Doe afterward and provided the
following feedback.

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DR. A: BEHAVIORAL LEARNING THEORY

There is much to be praised in your teaching, Dr. Doe. You
clearly rely on the principles of behavioral learning theory,
promoted by such theorists as John Watson, Edward
Thorndike, Edwin Guthrie, Edward Tolman, and B.F. Skinner. These principles include
observable, measurable behavior as the focus
learning as manifested by a change in behavior
manipulation of the environment as what shapes
behavior
These core tenets focus on observable behaviors in the
teacher and learner rather than on the learners internal
thought processes, which cannot be known, quantified, or
reproduced with any certainty. The elements of the environment, such as the teachers behaviors, and not characteristics of the individual learner are what shape behavior and
learning. Contiguity (how close in time two events must be
for a bond to be formed) and reinforcement (stimuli that
increase the likelihood of an event being repeated) are key
features in the learning process.7 These principles are clearly
seen in operant conditioning, which, in its simplest form,
tells the teacher to reinforce what you want the learner to
do again and ignore what you want the learner to stop
doing.8 I design my teaching techniques to properly
manipulate contiguity and reinforcement.
I focus on using low-inference, observable teaching behaviors that educational research has shown to increase learning. Low-inference behaviors are those that can be specified
and are denotable and objective, whereas high-inference
behaviors are those that require subjective inference to discern.9 For example, I dont teach with enthusiasm (a highinference behavior), but I do vary the volume of my voice,
gesture frequently with my hands, change where I stand in
front of the class, and make a point of looking directly at a
variety of individual students when I speak (all low-inference behaviors). Well-designed behavioral research in education, conducted in the classroom laboratory, has
established the association between these low-inference
teacher behaviors and improved learning outcomes in students.
Other low inference behaviors that I use as a teacher include
the following:
Using students names
Inviting students to express opinions and problems
Avoiding ridicule, intimidation, or interruption
Defining the goals of the instruction as measurable
student behaviors
Stating the goals clearly and concisely and repeating
them periodically
Providing feedback to students using behavioral and
non-judgmental statements related to the goals
Providing combined positive and corrective feedback
using a feedback sandwich10
I have practiced these skills using videotape review of my
own teaching, looking for opportunities to increase the use
of teaching behaviors proven to increase learning.

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Most universally accepted educational techniques, including some you incorporate in your teaching, can be traced to
behavioral learning theory. The systematic design of
instruction with behavioral learning objectives is derived
from the concept of measurable, demonstrable outcomes as
the benchmarks of learning. I always start my teaching with
a list of objectives for the teaching sessions defined as student behaviors. Instead of the vague objective of the student will understand Johnes disease I would use
behavioral objectives specifying that the student will be
able to list the symptoms of Johnes disease, describe the
course of the disease, and discuss control measures. I
develop goals and objectives for teaching that include
knowledge, skills, and attitudes that the student should
master by the end of the teaching session.
To improve your teaching you need to identify, practice,
and refine the teaching behaviors that are known to
improve learning.11, 12 Included in these behaviors are other
elements of the environment, such as the syllabus, the
audiovisual presentation, the size and configuration of the
classroom, and other supporting and structural elements
that promote understanding and retention. If you design the
right environment and use the right teaching behaviors,
learning will occur.

DR. B: COGNITIVE LEARNING APPROACH

You incorporate many helpful techniques in your teaching,
but to help your learners become good diagnosticians you
need to find out what is going on inside their minds. Student behavior is only important in that it reflects what the
learner is thinkingit is an external representation of internal processes. When teaching from a cognitive learning perspective, you want to enter the learners head and think
about what you can do to facilitate his or her development
of clinical expertise. Consider what makes you an expert in
infectious diseases. Is it a collection of behaviors? Or is it the
array of sophisticated cognitive structures in your head that
you access to diagnose and design treatment interventions?
The challenge for teachers is to figure out how to help learners build these cognitive structures in their minds.
Cognitive learning theory focuses on the internal thought
processes of perception, insight, and meaning. The locus of
control is with the learner, not the teacher. The human
mind is not simply a passive exchange-terminal system
where the stimuli arrive and the appropriate response
leaves. Rather, the thinking person interprets sensations and
gives meaning to the events that impinge upon his consciousness.8 The teacher is responsible for structuring the
content of the learning activity to promote perception,
insight, and meaning in the learner. We can learn about
these mental processes through the contributions of information processing theory, studies of the development of
expertise, artificial intelligence, and recent work on memory
and metacognition.1315 Important historical foundations
come from Jean Piaget in understanding the cognitive
developmental process in learning and from Gestalt psychology in recognizing the importance of insight in solving
problems.16, 17
More recently, educators have studied the development of
cognitive expertise in medicine and other professional
fields.1820 They have found that these learners have their
own cognitive stages of development as they progress
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through professional school and practice to become good

clinicians. Good teachers recognize these stages in their
learners and teach accordingly. We need to teach with a
sophisticated awareness and understanding of where learners are developmentally, what they can and cannot assimilate, and what the next step is for them in becoming
clinicians.
Early learners think very differently from experts.21 For
example, when you first learned diagnostic skills as a student, you used complicated algorithms based on long lists
of possible diagnoses tied to specific symptoms, such as the
differential diagnoses for lymph node enlargement. When
you see a patient now, you dont use long, laborious algorithms to make diagnoses. You recognize prototypes of specific diseases and use a best fit to these cognitive
templates to efficiently and accurately make the diagnosis.
Your teaching should focus on how to package content to
make it cognitively most useful to the learner. It should link
new learning to prior knowledge whenever possible, facilitate retention, and provide an expert cognitive framework.2224 For example, think about one of the techniques
that you used to teach the important facts that students need
about Johnes disease. Because these students have had
some clinical experience, you first asked them to recall a
patient with Johnes they might have seen in the teaching
hospital, and then you used that case to develop a prototype
for the diagnosis, the course of the disease, and control measures. Get students to focus on clinical cases and patients,
and contrast these with other clinical experiences, to help
them develop a bank of prototypes upon which to draw.
Use other cognitive structures to help organize the learners
worldview and facilitate the processing of new information
and experiences.25 If you do this, you will be on the path to
master teacher status.

DR. C: SOCIAL LEARNING APPROACH

Dr. Doe, I know that you are committed to teaching and
have learned a lot about being a better teacher. But theres a
perspective on learning that will augment what you already
do. I find Social Learning Theory (SLT) incredibly useful. It
helps me go beyond the facts and concepts I want my students to know, and start to capture how to use their knowledge.
SLT can be a way of life. Actually, it is the way of life.
Most of the complex behaviors and patterns of interaction
that we engage in every day were learned in natural settingsfor example, learning to talk. SLT attempts to delineate how such learning occurs.26 Teachers using SLT-based
skills find their students drawn into the learning because it
is situated in live interaction. The pressure for you to be
engaging or entertaining as a teacher diminishes as the
material and its context take center stage.27 If your class is a
safe, reality-based learning environment with clear learning
tasks, it becomes a largely self-correcting and self-directing
learning community.
Your presentation on infectious diseases of cattle could be
more intellectually challenging and could acknowledge and
utilize other learning modalities. Your learners are thirdyear students and have many other learning experiences to
mobilize in learning about infectious disease. You neednt
simply reformulate textbook chapters or other didactic pre-

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sentations. Bring to bear other modes of learning. SLT can

improve your teaching through the principles of vicarious
learning, reciprocal determinism, and legitimate peripheral
participation.
Students learn by observing each other. Vicarious learning
and participatory learning can be synergistic. Reciprocal
determinism captures the interactive nature of learning. Lets
consider the challenge of interviewing clients with affected
cattle as an example.
Knowing the signs and symptoms of a disease is essential,
but how to elicit a history from the client is more difficult to
learn and teach. We often refer to clinical experience in
order to explain how one progresses as a clinician. We can
accelerate that process by, for example, having students
observe and discuss client interviews conducted by different students or clinicians. This technique facilitates gaining
clinical experience by enlarging the learners pool of experience and allowing the learner to more quickly identify gaps
in learning.28
For vicarious learning to reach its full potential, students
must feel comfortable making mistakes and taking chances.
The discussion must feel safe enough to allow a robust
group process. At first, disagreement will result in creative
tension. If the group is trusting and cohesive, they will
develop a working resolution based on shared understanding. You could increase the impact of vicarious learning in
your sessions through live demonstrations, multiple written
cases, videotaped interviews, and role-playing exercises.16
These real-life experiences and skill development help
give meaning to the facts and concepts about a disease.
The concept of legitimate peripheral participation highlights
the importance of the changes in social setting that are often
inherent in an extended learning process. Progressing from
novice to competent worker to expert involves many learning settings and the picking up and discarding of many different roles. The roles that a first-year student, a fourth-year
student, and a resident have in providing patient care are
hierarchically different from, yet legitimately related to,
those of the fully trained practitioner. In your sessions with
the third-year students, you want to be cognizant of what
their current roles in the teaching hospital are, and you want
your sessions to support and develop those roles. Your sessions are part of the bridge from novice student to licensed
veterinarian. Your goal is to offer a different educational
experience that builds on previous experience, complements current learning, and lays the foundation for subsequent roles.
You should mobilize all the resources available in your
learning setting. You cant expect book-brilliant novice veterinarians to mobilize complex concepts and apply them
appropriately in unfamiliar settings like the teaching hospital. Knowledge must be learned in as natural a setting as
possible. Mobilizing vicarious learning is one way to
develop and broaden learning outcomes. Recognizing the
value of legitimate peripheral participation can deepen
understanding and refine your teaching efforts. The tools of
SLT help students learn to learn and enable them to perform
more effectively in the world in which we live, practice, and
teach.

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DR. D: AN INSPIRATIONAL APPROACH

Dr. Doe, I think you are an extraordinarily committed
teacher and your dedication is commendable. Overall, I
enjoyed your presentations on infectious diseases of cattle.
You covered the material thoroughly, but kept the level of
detail about right for the class. But while you overtly
appeared enthusiasticmoving energetically around the
classroom, approaching students when listening to them or
answering questionsthere were times when it seemed as if
your heart wasnt really in it. Did you feel constrained, perhaps limited by your lesson plan?
The educational approach I find most useful focuses on the
teacher. While I am not sure that my approach is as firmly
seated in formal theory as those of my colleagues, I do find
that it grounds me in the classroom and helps me make consistent decisions about my teaching. Many of my thoughts
have been stimulated in part by the work of P.J. Palmer, and
most of what Ill say has been taken from his writings.29 I
believe that in order for genuine, lasting learning to occur in
students, teaching must start deep within the teacherit
must be inspired. During your class, I found myself questioning whether you, at that moment, were feeling inspired
by your teaching. Do you feel as if your teaching is part of
yourself? You teach with competence, but do the methods
youve chosen allow you, personally, to connect with what
excites you about teaching veterinary students, or with
what truly fascinates you about infectious disease?
Your teaching was good, but it didnt seem to flow naturallynot that teaching always does. Any time you try to
connect a large and complex body of knowledge like infectious disease with a class of veterinary students (another
large and complex body), there are going to be discontinuities, false starts, and re-negotiations. But good teaching
comes from the identity and integrity of the teacher, and
nothing you do as a teacher will make a difference to anyone if it is not rooted in your nature. The students will not
remember factsthose will be forgotten or will change as
new ones are discovered. What they will remember is you
the quality of your individuality and your relatedness to
them. That will be their bridge to learning, to medicine, and
to their future clients and patients.
A teacher must teach from the heart. Its straightforward to
figure out what to teach. The course leader gave you a specific topic to cover. Thinking about how to teach requires
more effort, but that task can become a superficial and arid
one, potentially disheartening to the teacher and harmful to
learning, if the discussion stops there. Ive seen several
enthusiastic teachers who could vividly hold the interest of
an entire lecture hall or who could suffuse intellectual
excitement into a small group become dulled and lackluster
about their teaching when some well-meaning but arbitrary
curricular change has forced them to adopt teaching methods that were not their own.
The what and the how of teaching are the surface challenges.
The more important challenge is for us to know who we are
as teachers. Our capacity to connect with students, and to
connect them with veterinary medicine, depends less on our
methods than on the extent to which we know who we are
and are willing to make ourselves, as teachers and veterinarians, open to our students and vulnerable in the service
of learning. I got the sense that youor some part of you

120

were holding back as you taught. Perhaps it was your

forced commitment to the methods you used. Youd have to
look inside yourself to see whether my hunch is right or not.
Teaching is hard work. Its an act of hospitalitywelcoming
students inand as such is a daily exercise in vulnerability.
Methodology can facilitate or stifle teaching and learning.
What is crucial is how your teaching reveals who you are to
the students. I didnt get the sense from your presentation of
who Dr. Doe isas a teacher, as a researcher, as a clinician.
Find out who you are as a teacher, as a veterinarian. Teach
with the full recognition of your passions, your vulnerabilities, your strengths, and your fears. Look back and think
about who inspired you to teach and what the lessons were,
both good and bad, that you took from those influential
teachers. What motivates you now, personally and professionally? How does that fit with where you are in your life,
where youve come from, and where you see yourself
going? Be honest with yourself about your teaching. The
methods will then fall naturally into place, and your students will learn.

DISCUSSION
Dr. Doe is likely to be confused and discouraged by the conflicting perspectives and feedback in this peer evaluation
provided by Drs. A, B, C, and D. Each educational approach
provides a compelling argument for its point of view and its
application to the teaching setting. In the face of no clear
best alternative, we may be tempted to question the value of
any specific approach at all. Is educational theory really
important, or should we just try to teach as best we can?
It is unlikely that any theory will be complete enough to
explain the entirety of the complex process that is teaching
and learning. Theories are imperfect, approximate models,
yet at some level, most of us have mental models for what
we do as teachers. The advantage of a teaching approach
that is based on well-developed formal theory is that the
model and its implications are more readily available for
discussion and examination. Hidden models for teaching
can produce confusion and frustration when the problems,
conflicts, and disappointments that normally accompany
teaching occur. For example, it would be hard to implement
a small-group problem-based-learning curriculum in a
school where the faculty had little appreciation of social
learning theory and were focused exclusively on the measurable educational outcomes of the National Board examinations. Similarly, without clarifying educational models, it
would be difficult to counsel a small-group leader, whose
students were failing the end-of-course multiple choice
exams, who saw his small group sessions as primarily a
wonderful chance to talk with and inspire the students.
Understanding different educational approaches can facilitate the development of teaching expertise. In the iterative
reflective learning cycle that leads to the acquisition of
expertise, theory can facilitate at all stages. Theory allows us
to quickly incorporate well-developed mental models, and
thus we can structure and enhance the personal experience
we bring to teaching. Theory allows us to more clearly recognize the new, unusual, or unfamiliar teaching/learning
event that calls for a new response from the teacher. Theory
can help us devise new strategies to respond to such events,
and it provides a benchmark or external set of criteria

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become overextended and frustrated struggling to deploy

an educational approach that has not been sufficiently
understood and mastered. Of course, it is also possible to
limit oneself prematurely because of the mistaken belief that
you cant teach an old dog new tricks.

Figure 1: Educational domains

against which to gauge the outcome of our efforts. Finally,
theory provides a structure to organize our own learning
about our own teaching and to assist with the efficient
incorporation of new experience into old.
The major reasons for knowing and using educational theories are that they
1. provide a common vocabulary for discussion and
research,
2. allow for comparisons of pedagogical techniques,
3. clarify conflicts and differences in opinion about teaching and curriculum,
4. guide curriculum design and reform,
5. provide hypotheses for educational research,
6. stimulate new thinking about teaching, and
7. increase motivation to teach.
If knowing different educational theories or approaches is
valuable, how do we choose between them to stimulate and
guide our own teaching? Is it best to stay with one, or
should we choose an eclectic approach that borrows from
different educational theories? Perhaps we can approach an
answer to these questions by looking at educational theory
from the perspective of four principal domains of teaching,
adapting those proposed by McKeachie et al. to the veterinary school setting (see Figure 1).30
The first domain is the teacher. Teachers choose the educational approach that best fits their personal style and their
unique strengths and weaknesses. Past experience, examined or not, may lead teachers to prefer one approach to
another. Some will be inspired by teacher-centered theory
and will inspire their learners when using such an
approach. Other faculty will be more comfortable with a
behavioral perspective and its highly structured approach
to teaching. Some faculty will be able to effectively use several approaches, and other factors may guide their choice of
educational theory in a given teaching setting. Some teachers may be more open to broadening their educational
approach as they gain experience and confidence, while others will become more set in their ways. When considering
the teacher domain, knowledge of oneself and ones skills is
essential. The inexperienced and enthusiastic teacher may
JVME 29(2) 2002 AAVMC

The second domain used to guide the choice of educational

approach is the learner. Educators have discussed and
debated the differences between adult learners and young
learners, between visual and auditory learners, and so forth,
highlighting the fact that different learners learn
differently.31, 32 The wise teacher will use the educational
approach that is most effective for learners. Some learners
are more successful in a social learning framework, utilizing
the vicarious learning that comes through observation of
others and learning professional roles through legitimate
peripheral participation. Other learners are less interactive
with peers and the social environment and are better suited
to teaching that comes from a cognitive framework, focusing on the individuals development of expertise through
the progressive acquisition of organized templates and
expert knowledge. The challenge inherent in using learners
to guide teaching comes when one is dealing not with individual learners but with groups of learners. Here the general stage of the learners may be most helpful. Early learners
may benefit from more behavioral or cognitive approaches
to teaching, while more experienced learners may be better
suited to social learning perspectives. Learners having difficulty or learners with special needs may compel a teacher to
use an approach that is largely unfamiliar or awkward to
them but effective for that particular learner.
A third domain important to consider when deciding
between educational perspectives in teaching is the content
to be taught. Highly structured and quantifiable content
may be easily and effectively taught using a behavioral perspective. Complex and intuitive diagnostic or clinical skills
may be better taught using a cognitive approach to teaching.
Professional skills and roles are often acquired using social
learning. Some elements of personal and professional
growth may be best transmitted using an inspirational
approach. Each approach can be adapted to teach any content, but different theories lend themselves to more effective
teaching of different types of content.33 Teachers should
carefully delineate the goals and objectives of their teaching
and the specific content, then consider the educational
approach most likely to facilitate learning of that knowledge, skill, or attitude. Different content calls for different
educational approaches and, when teachers cannot be flexible in their approach, may necessitate different instructors.
A fourth and final factor or domain used to guide selection
of teaching approaches is the setting. Learning always
occurs in a context, and the setting in which teaching occurs
may powerfully influence the choice of approach. Clinical
teaching settings are quite different from the more formal
teaching setting of the classroom. The large lecture hall is ill
suited to the application of social learning theory but is
nicely tailored to a behavioral approach. Clinical rounds are
natural settings for teaching derived from social learning
theory. Patient-side teaching may be an excellent occasion
for teacher-centered approaches. Teachers need to examine
the setting in which their teaching occurs, modify or change
the setting when needed, and select the theoretical perspective best suited to direct their teaching in that context.
121

Teachers unable to change their style to optimize their

teaching may want to consider changing the venue for their
teaching.

DR. DOE: CONCLUSIONS

This feedback has been instructive. I can see that just as in
the practice of veterinary medicine there are many different
specialties and approaches, so it is with the practice of
teaching veterinary students. A clear educational approach
should guide my teaching. Ill need to re-evaluate my teaching skills, my interests, and my teaching tasks. Im interested in reading more about adult education and different
educational theories. But at least now I have a start on how
to look at my teaching in more detail and am developing a
vocabulary for more productive discussions with teaching
colleagues.

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review of literature on its outcomes and implementation
issues. Acad Med 68:5281, 1993.

JVME 29(2) 2002 AAVMC

AUTHOR INFORMATION
Dale A. Moore, DVM, PhD, Assistant Professor of Population
Health and Reproduction, VMTRC, School of Veterinary Medicine, University of California, Davis, 18830 Rd. 112, Tulare, CA
93274. Areas of research include educational outcomes, continuing education needs and outcomes, and epidemiology. Email: [email protected].
Martin H. Leamon, MD, Assistant Professor of Clinical Psychiatry, School of Medicine, University of California, Davis, CA
95616. Areas of research include health professions education,
evaluation of teaching effectiveness.

JVME 29(2) 2002 AAVMC

Paul D. Cox, MD, Assistant Professor of Clinical Psychiatry,

School of Medicine, University of California, Davis, CA 95616.
Areas of research include health professions education, evaluation of teaching effectiveness, group therapy, and sports psychiatry.
Mark E. Servis, MD, Associate Professor of Clinical Psychiatry,
School of Medicine, University of California, Davis, CA 95616.
Areas of research include health professions education, evaluation and feedback methods, and faculty development.

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