As this year's Harvard Macy Program for Educators in Health Professions course drew to a close, celebrating the 25th anniversary of the Harvard Macy Institute, I spent some extra time reflecting on what I learned this year, and why I keep coming back. The answer, I realized, surprised me.

I first came to the course in 2013 as a scholar. Like many others, I was in awe of the learning environment, and overwhelmed by the work. I spent long days and nights trying to keep up with the readings and assignments, and faced the humbling experience of having my project, which I had worked so hard on, get (significantly) revised by the new information I was taking in. When I left, I was physically and emotionally drained, yet I couldn't wait to come back. What was wrong with me?

I first learned about Kolb’s experiential learning cycle at Harvard Macy, and we have been inseparable ever since. I see Kolb’s cycle everywhere – There’s a new upgrade to EPIC I have to learn about - what's my motivation? (Quadrant 1). I have to write a case about abnormal uterine bleeding - I need information (Quadrant 2). A friend gives me a new recipe - we need to cook it together first (Quadrant 3). In some ways, then, it shouldn't be a surprise to me that as I reflect back about my experiences at Harvard Macy I divide them into the different quadrants.

I will start with quadrant 2 (what), because that was the first thing I noticed about Harvard Macy - this whole new body of theory and literature that I didn't even know existed! And there was a lot that I didn't know! I very quickly moved from the unconsciously incompetent to the consciously incompetent - not a comfortable feeling - but I could not get enough! Realistically, as a participant I was able to process maybe 15% of everything that was in the course. One big motivator to come back, then, was to try to grab another 5 or 10% with each returning visit - and I do learn something new each time. No matter how many times I have heard the same lecture, or read the same articles, I still learn something. I like to think that it is partly due to the spaced learning - my foundation of knowledge gets a little bigger each year so I am able to put new facts on top of that foundation. The cognitive load decreases a little each time I come back, which helps process the information. But of course as any Kolb lover will know, the magic is not in quadrant 2, but in quadrant 3 (how). So.....

Without a doubt I have the most excitement facilitating small groups. Being a project group co-facilitator is such an honor, and yet so nerve-wracking at the same time. There is really no way to prepare to be a project group facilitator. You can be mindful of your facilitation skills, but now all of that information that has been presented (of which you have only gotten about 25%), you have to apply it - and how can you prepare for that? That is what makes each course unique - even though each year consists of the same educational theories and the same methods, how you and your co-facilitator and other project group members choose to apply these theories and methods, is what makes it truly unique. This unique application is what increases my learning each year, exponentially. The same is true for microteaching, my second favorite session to facilitate. I always learn something at every small group session I attend.

Quadrant 4 (if), is in some ways the toughest. I think of this when I get back home and try to incorporate all the techniques and methodologies within the system in which I work. It seems so much easier when I am in Boston and surrounded by people who speak the same language and have a shared mental model of what a robust educational system is supposed to look like! The constraints are always more present, the limitations always larger, the time even more fleeting. 

This brings me to quadrant 1 (why). Why do I keep coming back? Why do I keep trying to make changes back home? The answer is because I want to be a better educator. When I am at Harvard Macy, I am overwhelmed by all of these amazing people who are trying to better themselves as well - it is the most humbling and sincere environment I have ever experienced! I have also learned that I get more out of this experience if I take extra time to reflect - on myself as a person, myself as an educator, and even myself as a clinician. I am reminded of all of the possibilities of what could be, when I am here, and it forces me to think inward but forward at the same time. It forces me to re-prioritize my goals for myself as a person and as an educator. Did I spend the last twelve months in a focused drive to achieve the goals I set for myself last year when I was at Harvard Macy? Usually not - what can I say, I am a work in progress! So what goals am I going to set for myself now, and how will I work to achieve them before I come back? Fortunately, with the new schedule I will have an extra four months to meet these goals - I am sure I will need it. 

So the answer to why I come back each year is actually very simple. I am convinced that the environment at Harvard Macy, and most importantly the people at Harvard Macy, help me make myself better - not perfect, but just a little better than last year, I hope. My commitment to change is a commitment to ALWAYS change, and all of you help me do that. That's why I am counting down the days to my 25th Harvard Macy anniversary - who knows what person I will be then.


Did you know that the Harvard Macy Institute Community Blog has had more than 190 posts? Previous blog posts have explored topics including medical education and global health, microresistence, and  reflections across the career continuum.


Leslie R Ellis, MD, MSHPEd, FACP

Leslie Renee Ellis, MD, MSHPEd, FACP (Educators, ’13; 20th Anniversary Symposium, ’14; Assessment, ’14; Leaders, ’15) is a medical educator and leukemia specialist. Leslie currently holds a position as Professor of Medicine at Wake Forest Baptist Health. Leslie's areas of professional interest include the Kolb cycle, assessment, resilience, and wellness. Leslie can be followed on Twitter at or via email.