Editorial
Socratic Method/Creative Failure Richard H. Daffner, MD, FACR
I
have spent the major portion of my life as a teacher training medical students, residents and fellows in my chosen specialty (Diagnostic Radiology, with special interest in musculoskeletal abnormalities and spine injuries) as well as Boy Scouts, aged 11 to 18-years old. I was fortunate to have encountered many excellent teachers along my journey. These men (considering the era in which I trained) exposed me to the Socratic Method and one of its branches that I call Creative Failure. As a result, having adopted those principles, I am most likely to answer a question from a student with another question. Socrates of Athens (470 – 399 BCE), an early Greek philosopher/ teacher, engaged in the disciplined practice of thoughtful questioning, allowing his students to examine ideas logically and to determine (challenge) the validity of those ideas. The Socratic Method is a form of cooperative argumentative dialogue between individuals, based on asking and answering questions to stimulate critical thinking and to draw out ideas and underlying presuppositions. The student asks a question, the teacher often replies with a different question, and the process continues until the student arrives at the answer to his/ 8
her original question. Socrates based his method of teaching on the premise that the student already had the answer within himself. The disciplined, thoughtful dialogue was steered by the teacher to elicit the answer from the student. The classic Socratic Method uses six philosophical “tools” designed to: 1) Clarify concepts, 2) Probe the student’s assumptions, 3) Probe rationale, reasons, and evidence, 4) Question different viewpoints and perspectives, 5) Probe implications and possible consequences, and 6) Question the question itself. My first encounter with a teacher who used the Socratic Method was in my freshman year at Albany College of Pharmacy. I was having difficulty understanding the principles of calculus (math was never my forte) and gingerly approached the professor, the late Dr. Joseph Lapetina. And, after several hours of personal tutoring, I figured it out. His mantra was, “Get the data, plug it in and turn the crank, and out will come your answer”. (Joe became a life-long friend and we served together on the College’s Board of Trustees until his death at age 95 in 2019.) My next exposure to the Socratic Method occurred during my first clinical rotation during my junior year of medical school. The late Dr. Casimir
Pietraszek was a pulmonologist assigned to my floor at the E. J. Meyer Memorial Hospital (now Erie County Medical Center) in Buffalo, NY. One day on morning rounds, I asked him if there was any way of balancing admission diagnoses of new patients so we could see a variety of diseases. At the time two-thirds of our patients had COPD. He looked at me and replied, “Are you an expert in managing COPD?” I was not; the lesson was learned. More importantly, the seeds were planted for the method I would use when I became a teacher. Three of my radiology mentors, Drs. William Barry, George Baylin, and Lawrence Davis also used the Socratic Method. All were also philosophers who taught me the ins and outs of academia (and curmudgeonry1). My mentors added a seventh philosophical “tool”, Creative Failure. Creative Failure is the practice of allowing a student to make mistakes (provided those mistakes pose no danger to self or others) in the hope that the learner will realize his/her error(s) and, more importantly, the reasons why they occurred. I used this concept with my medical students and my residents and continue to use it with my Scouts. Two examples follow: Prior to installing PACS (Picture Archiving and Communication System), I would not allow first-year www.acms.org