Critical Habits of Learning

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Study led by TIER Senior Scientist explores how physicians actively learn in the workplace.
Posted On: December 14, 2023
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(L-R) Drs. Anne Kawamura, Ph.D. student and first author of the study, and Maria Mylopoulos, TIER Senior Scientist and senior author of this study.

A recent study led by a TIER Senior Scientist reveals that physicians refine their communication skills through hidden learning approaches formed when navigating communication challenges—ultimately, to ensure the best care for their patients. 

Expert physicians are on a lifelong journey of learning. They continually strive to build and improve their skills and knowledge to get better at what they do. Dr. Maria Mylopoulos, TIER Senior Scientist and senior author of this study, set out to understand how some physicians actively engage in continuous learning in the workplace. 

“Especially in patient-facing settings, when challenging health conversations require sensitivity and empathy, effective communication skills are critical,” states Dr. Mylopoulos. “However, physicians rarely seek formal classes to enhance their communication skills.” 

Over two years, researchers observed and interviewed physicians as they interacted with patients and families. The researchers found that the physicians navigated challenging conversations and refined their communication skills by monitoring patient cues and responses, taking risks to try new approaches, and adapting to what worked and what didn’t.  

These strategies, known as ‘habits of inquiry’, are approaches individuals would use to manage challenges in the workplace and help them continuously refine their knowledge and skills.  

“These results prompt us to consider how we can continue to nurture these habits of inquiry and create workplace environments that better support the learning of our physicians and improve patient experience and care,” concludes Dr. Anne Kawamura, a Ph.D. student at the Wilson Centre and first author of this study. 

This work was supported by a Bloorview Research Institute Catalyst Grant and UHN Foundation. Dr. Maria Mylopoulos is an Associate Professor in the Department of Paediatrics and the Institute of Health Policy, Management, and Evaluation at the University of Toronto. Dr. Anne Kawamura is also an Associate Professor in the Department of Pediatrics at the University of Toronto. 

Kawamura AA, Brown L, Orsino A, Zubairi MS, Mylopoulos M. Navigating Challenging Conversations: The Interplay Between Inquiry and Knowledge Drives Preparation for Future Learning. Perspect Med Educ. 2023 Jul 28;12(1):304-314. doi: 10.5334/pme.949. 


In healthcare settings, physicians must skillfully communicate with patients to gain information and respond in empathic ways while providing patient-centered care. Adapting and refining communication skills for different situations, especially in challenging or unexpected events, is critical to providing compassionate care.