Kenneth Klein: Teaching Under the Microscope

by Eve Jacobs

To the naked eye, humor and pathology appear to have little in common. But under the microscope, it’s a whole different story. Kenneth M. Klein, MD, has been teaching pathology at NJMS for 30 years and at least some of his success can be attributed to the fact that his "funny bone" is still intact.

When asked why he thinks second year medical students award him the Golden Apple year after year, he uses cartoon humor to illustrate his point. A visiting lecturer presented this cartoon, Klein explains, and it struck a nerve.

Cartoon panel 1: A little boy and a little girl are talking. There is a dog by their side. The little boy says: "I taught Spot how to talk." The little girl answers: "I don’t believe you."

Panel 2: The little boy says, "OK, I’ll show you." He addresses the dog: "Spot, talk!"

Panel 3: Both children watch Spot.

Panel 4: The girl says, "I thought you said you taught Spot how to talk." The boy answers: "I did. But I didn’t say he learned it."

It’s a point well taken. Klein says that if he gives a fabulous lecture and Spot attends the class, but doesn’t learn the lesson, then his teaching deserves to earn a failing grade. There are many faculty members at all universities who feel their responsibility ends with the delivery of information, he says, and that situation has gotten worse with the popularity of Powerpoint. "There are teachers who only read the bullet points out loud from their slides. Can you imagine?" he says.

Lest you think the pathologist entertains in his lecture hall, think again. His style of teaching is traditional--no bells and whistles, no Saturday Night Live routines. But his plain and simple approach evidently works. He’s received 23 annual teaching awards from his students in 30 years, and only a rule stating that a faculty member cannot be awarded the Golden Apple for more than two out of three consecutive years running gives him an imperfect score.

He says modestly: "I present information that is interesting and useful." But clearly there’s more here than initially meets the eye.

"Pathology is not a specialty that is a popular career choice for American medical students," states Klein. Despite being crucial to the practice of medicine, most of a pathologist’s work is conducted behind the scenes and does not involve direct patient care.

Pathology, however, provides the scientific basis for medical practice by using basic research methods to uncover information that supports or refutes a diagnosis and helps the physician map out the course of treatment. According to the department’s Web site, pathologists look for gross and microscopic changes in cells, tissues and organs caused by disease processes, as well as conducting biochemical and microbiological tests on body fluids, cells and tissues. In other words, a physician’s care plan is based on the pathologist’s work, so no matter which specialty a student eventually chooses, he or she will have to collaborate with a pathologist.

"Useful" learning is the key here. Klein helps students grasp how the volume of information taught under the rubric of pathology relates to health and disease, and so to their future doctoring. Second year students-- overwhelmed with the sheer quantity of facts they’re asked to absorb--often don’t understand the relevance of such a course to their future professional practice.

But Klein has the talent--and also has honed the skills--to engage his students. To what does he attribute his success as a teacher? "I project an attitude that I’m interested in my students." (And he is.) "I look at every student in the room - I don’t talk to the screen.
I know my lectures cold, I talk slowly and try to make myself understood. I have predigested the material and I present what’s relevant. I answer questions during the lecture - I don’t wait until the end and I occasionally throw questions out to the students. I observe what good teachers are doing and incorporate what I can."

In other words, he cares that his students learn. A graduate of the Bronx High School of Science, he says he went to medical school "to learn as much as I could about disease. My goal was to be a researcher." His medical school years were shared between SUNY Downstate Medical Center and Catholic University in Belgium.

After a residency in pathology at NYU-Bellevue, he remained on the faculty at NYU for four years and discovered that he had some talent for teaching. "I didn’t set out to be a teacher," he said. "The students liked my teaching."

When he moved in 1976 to NJMS, Klein had to make a difficult choice. "I enjoyed the teaching and I enjoyed the service. I saw that research would require too much of a time commitment. I didn’t want to be a jack of all trades, master of none." So he homed in on what he liked best, developing a reputation in gastrointestinal and liver pathology, and also as a master teacher. [He was elected into UMDNJ’s Master Educators Guild in 2003 and NJMS’Alpha Omega Alpha-beta chapter in 2004]

Does he think students have changed much since 1976? As a group they’ve changed very little, he says. But he has noticed that many have shorter attention spans and rely heavily on visual material. "Everyone is computer savvy. Everything presented in class must be posted on Web CT so students can access it," he comments.

Labs and small group sessions in pathology are mandatory, but lectures are not. Although all lectures are available on the Web, Klein continues to believe in the value of classroom teaching. Although attendance at lectures started to drop off at all medical schools in the 70s, and has continued to do so, he says: "There is something lost for those students. They miss the human exchange, the stress placed on certain words, the personal anecdotes."

With the new Jubilee Curriculum that was launched at NJMS last year, pathology has been absorbed into a more encompassing course called "Disease Processes, Prevention and Therapeutics." Klein is OK with that. "It’s more cohesive," he says. "We’re tying together the information from what were previously several tightly marked disciplines." He believes the new approach encourages students to see the relevance of the basic sciences to their clinical work and has allowed the faculty to weed out the redundancies as well as fill in the gaps.

"I like what I do," he says simply in conclusion. "And when I bump into former students, which is frequent, they come up and talk to me about something they remember from my class years ago."

Klein’s efforts on behalf of his students do not go unrecognized--and it doesn’t take a high-powered microscope to detect that.