
A Professor of Surgical Education and Engagement Science at Imperial College London and co-director of the Royal College of Music–Imperial Centre for Performance Science, Roger Kneebone, MD, PhD, will be visiting McGill University to deliver the 47th annual Osler Lectureship on November 6. The lecture, titled “Medicine – the art of the expert performer: What clinicians can learn from the performing arts,” will be held at the Jonathan C. Meakins Amphitheatre (room 521) in the McIntyre Medical Building at 6 p.m.
Prof. Kneebone took some time to answer a few questions from Profs. Thomas Schlich and Annmarie Adams from the Department of Social Studies of Medicine ahead of his lecture.
Thomas Schlich (TS): Your book Expert: Understanding the Path to Mastery is about expertise across many disciplines and occupations. What do you think makes a good doctor in 2024 and is there anything we can learn from William Osler about being a good doctor?
I think what makes a good doctor in 2024 is what made a good doctor in William Osler’s time – a combination of knowledge, skill, curiosity and a compassionate interest in other people. There is a huge amount we can learn from Osler, through his approach and his writing – especially the way he places patients at the centre.
TS: In what ways should a doctor be an “expert performer”?
Clinical practice depends on performing – not in the sense of putting on an act, but of bringing selected aspects of your authentic self into each encounter with a patient. That’s a skill that can be developed, but it needs practice, repetition and an awareness of other people.
Annmarie Adams (AA): You have changed directions in your own career several times, from being a surgeon to an academic. Is this something you recommend for everyone?
It’s certainly something I’ve found stimulating and exciting, but I don’t think it’s for everyone. I’ve moved from trauma surgery to family medicine to academia and engagement science and I’m still finding new challenges. I’ve greatly enjoyed each stage of my career, and I’ve been fortunate to spend long enough in each to get a sense of what it’s really about. Whenever I’ve changed, it’s been because I’ve been pulled by something new rather than because of becoming fed up with what I’m currently doing. I think it’s a question of personality and preference – some people are energised by exploring across disciplines, whereas others get their satisfaction from delving deeper and deeper in a single field. Both are equally valid, but it’s helpful to get a sense of where your aptitudes lie.
AA: From your book Expert, we understand that you believe in learning by repeating. Have new ways of training physicians, for example the reliance on virtual simulations, changed your perception of the value of repetition?
I’m a firm believer in the value of repetition in laying the foundations for expert practice. Often this value isn’t apparent at the time – repetitive work can just seem boring and tedious while you’re in the midst of it. Yet it’s how you build up the skills you will depend on later – including the ability to cope with boredom. Virtual simulations can allow you to practise some aspects of clinical work, such as the motor elements of technical procedures. But that’s only part of the picture. Learning to work with other people – to read and respond to them – is a crucial skill, and one you only acquire through practice and experience with patients and colleagues.
AA: You make a strong case for the portability of expertise. Do you ever wish for a university with fewer disciplinary boundaries?
I don’t think there’s anything wrong with disciplinary boundaries in themselves. They provide an essential framework for anyone’s work. What I think we do need is a greater willingness to explore across such boundaries, asking what aspects of someone else’s expert work might illuminate our own. That means developing the confidence to engage with people who think in entirely different ways – and the key is curiosity.
AA: Your popular podcast series Countercurrent features conversations with people you describe as “unorthodox.” What have you learned from them? Could you perhaps tell us about one or two of your favourite episodes?
When I started Countercurrent 10 years ago, podcasts were only beginning to become a thing. I never imagined that my series would have so many episodes – 225 to date. It’s been a fascinating experience, and I’ve used it to develop the idea of long-form unscripted conversations rather than formal interviews. These give me a sense of improvisation and freedom, as I’m never sure where the conversation will lead and I always find new ideas to challenge my thinking. Selecting favourites is invidious – but some of the ones I’ve particularly enjoyed are with Richard McDougall (close-up magician); Lewis Macleod (voice mimic and comedian); John Launer (family doctor); Merlin Strangeway (artist and illustrator); and Helen Anahita Wilson (musician and composer who used her breast cancer chemotherapy as a form of musical inspiration).
Don’t miss Prof. Kneebone’s Osler Lectureship on November 6.