新任教員はなぜ去ってしまうのか（後編）医師が最も講義を受けたい教授高橋泰氏インタビュー
※看護展望 2015-1 Vol.40 no.1掲載、ブログにするにあたりメヂカルフレンド社より許可を頂いております。
新任教員はなぜ去ってしまうのか（前編）はこちら
高橋泰氏
国際医療福祉大学大学院 医療経営管理学科分野 教授
1986年金沢大学医学部卒 東大病院研修医、東京大学医学系大学院（医学博士）、米国スタンフォード
大学アジア太平洋研究所客員研究員、ハーバード大学公衆衛生校武見フェローを経て、97年より国際医療福祉大学教授、2004年医療経営管理学科長、09年より現職。
目次
「医師が最も講義を受けたい教授」高橋泰氏インタビュー
学生に物事や知識をうまく伝えるための３要素
「新任の先生方は、まずは臨床現場では身につけられない「教える力」を身につけることが第一優先なのでは？」
と医師から大学教授へと転身された国際医療福祉大学大学院教授の高橋泰教授は話されます。
「医師が最も講義を受けたい教授」と評される高橋教授いわく、教員の資質で大切なのは「伝える力がどれだけあるか」で、さらに、学生に「知識をうまく伝えるためのコツは３つ」だそうです。
学生に物事や知識をうまく伝えるための３要素
①伝えたいという情熱
②物事を伝える能力
・聞き取りやすくハキハキと抑揚のある言葉
・読みやすく見やすい板書、（ビジュアル教材やパワーポイントなどの教材も含む）
③目の前の相手に合わせて柔軟に伝え方を変えられる能力
３要素のなかで最も大切なことは「伝えたいという情熱」だとおっしゃったとき、私は正直ホッとしました。
これなら私も自信があるからです。
看護師として働いてきたときの思いや経験、心に残っている患者の話、
「看護って本当にすばらしいな」と感動した出来事、もっと勉強しないと患者に申しわけないと落ち込んだこと、
奇跡がたくさん重なって患者の命が助かった出来事、どんなにがんばっても救えない命がある無念さ、
そしてどんなに愛おしくても人間は必ず死んでゆき、そのなかでどんな看護をしていくのがよいのか、
など、伝えたいことはたくさんあります。
きっと看護師としての経験がある読者の皆さんもそうではないでしょうか。
「看護ってこうだよ、こんな経験ができるんだよ！」と学生に話したいことは看護師なら山ほどあります。
まずは、この情熱が大事であるならば、看護教員の素質はほとんどの看護師にあるのではないでしょうか。
つまり３要素の一番は看護師ならばクリアだなと思って安心しました。
髙橋教授のように長年教鞭をとっていらっしゃる方でも、
「情熱が減っていないかどうか」
を自己チェックされて教壇に立たれるそうです。
物事を伝える能力
伝えたい気持ちはたくさんあっても、声が小さくぼそぼそ話していたのでは相手に物事は上手に伝わりません。
メラビアンの法則（図１）によれば、人が何かを他者に伝えるとき、
言葉そのものからメッセージが伝わる率は7%で93%は話し方（音声表現）やボディランゲージから伝わるものなのだそうです。
そうするとやはり、講義のときの話し方や教材（プリントやパワーポイントなど）は重要なわけです。
話し方はまずは数をこなすことが解決の近道ですが、自分自身の講義を動画に撮影して確認するというのもかなり効果があります。
筆者は年間200回ほど講演や研修を行いますが、そのうちの３分の１はビデオ撮影をして、
そのあとから自分の講義を見直すようにしています。
すると、「ここはもっと抑揚をつけたほうがいいな」「ここはずいぶん早口だな」と自分の課題がわかります。
詳しくいうとこの方法は私が行っている講師トレーニングでお伝えしている２点分離法というものです。
おすすめは、同じ動画を２回見ること。２回目を見ながら「ここはもっとゆっくり間をおいて」と、
映像の自分に声をかけながら見るようにします。
すると、次の講義中に、以前動画を見ながら自分にかけた自分の声が聞こえてきて、
実際にゆっくりと間を置きながら話せるようになります（２点分離シミュレーション）。
見やすい教材に関しては、
パワーポイント１枚のスライドの行は８行以内で文字の大きさは小さくても20フォント以上にしたらいいとか、
細かいテクニックは多々ありますが、基本的には
「講義を受ける相手の立場にたってつくる」ということを念頭に作成すればよいです。
普通の講義は１つの教室で40人ですが、国家試験対策は２組合同の講義で80人。
場所は講堂で行うというようなとき、40人の教室で使用したパワーポイントをそのまま使用すると
後ろの人が見えなくなることがあります。
建物の構造にもよりますが、講堂は教室より大きいので40人の後列では見えた文字でも
80人の後列では見えなくなる可能性が高いので、文字の大きさを変えておく必要があります。
つまり、講義の場所に実際に行き、後列の人が見えるかどうかを確認しておけばよいということです。
そして、講義を受ける学生の立場になって教材準備をしっかりとする習慣をつけておけば伝える力はぐんぐん伸びていきます。
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【性格分析ファイル（自己成長エゴグラム）】
なぜ、あの学生がかわいく思えないのか？ 教員だって人間ですから（笑）
自分と合う学生、合わない学生はいるものです。
学生や他の教員との相性を見るには「オーバーラップエグゴラム」をオススメします。
まずは、５０問の質問に答えて、自分自身のエゴグラムを完成させてみましょう。
課題をもって生活すれば、エゴグラムは自由自在に変えることができ、その意味で「自己成長エゴグラム」といいます。
大人しすぎてカンファレンスで発言できない学生、逆に挑戦的な自己主張をしすぎの学生がなぜそうなのか、わかります。
クラス全員のデータを見て、騒がしいクラス、大人しすぎるクラスがなぜできるのかもわかるので、集団分析にも看護研究にもオススメです。
一度ダウンロードすればデータを消して、半永久的に活用できます。
ダウンロードはこちら
＊分析の解説を希望される方はこちら
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目の前の相手に合わせて柔軟に伝え方を変えられる能力
講義をしていると、ある学生はすごくうなずいておもしろそうに聞いているけど、
ある学生は首をかしげていてどうもわかっていないかも……と、こんな場面があります。
そんなとき、わかっていない学生に対してわかりやすくたとえを用いたりしながら理解させることができる人は
「伝える」という行為そのものが楽しいと思えるでしょう。
人は自分自身のフィルターをとおして物事を理解していますので、１つの表現が必ず相手に伝わるとは限りません。
ですので、その相手に伝わるような表現や事例を使ったりして相手の理解を促すことが重要です。
たとえば、国家試験対策講座などは学習意欲が高く知識が多い人がいる反面、
学習意欲が低くて知識も少ない学生が１つの教室に一緒にいます。
国家試験問題を１問解説しようとするとき、その問題を解ける学生とそうでない学生が出てきます。
問題を解けない学生にわからせるために、あまりにも長い時間を費やしてしまうと教えなければならない問題数は終わりません。
ですので、短時間でわからない学生に理解させる必要がでてきます。
できるだけ短時間で多くの人に物事を伝え、理解させることができるというのが講義力といえるでしょう。
では、その講義力を磨くにはどうすればいいのでしょうか。
私がやっているのは聴衆分析という方法です。
聴衆分析をして各エリアの学生がクラスに何パーセントいるのかを予測し
（担任ならば各エリアの学生はだれかまでを想定できると思います）、授業の進め方を考え、準備するという方法です。
図２は数年前に出題された国家試験の問題ですが、この問題の解説に７分使えるとします。
よくあるのは、この問題でカリウムと答えられない学生に７分を使い切ってしまうことです。
そうすると講義は学力が低い学生に合ってしまい、解ける学生は暇になります。
ですので、内職を始めたり、ほかの人と話をしたりとなりがちです。
それを避けるために私は、図３の聴衆分析で各エリアの学生ごとに学ばせる課題を変えながら講義するように工夫しています。
右下の「教えてゾーン」は答えがカリウムと解けない学生のエリアですので、
心臓とカリウムの関係性や腎臓の機能を、５分間使って調べ学習をさせます。
その間、カリウムと解けた学生のうち右上の「即行動決定ゾーン」の学生には発展問題を用意して取り組ませます。
たとえば、
「実習であなたが受け持った透析患者さんは果物が大好きです。
患者さんが、「何をどのくらい食べていいのかわからない」と訴えてきたら、なんと答えますか？」
などの問いに５分間の調べ学習をさせます。
このエリアの学生は学習のニーズが強く知識も豊富で調べ学習も得意だったりします。
座学の学習のニーズはもともと強いので、知識を実習とつなげてあげると
「実習ってこんなふうに個別性っていうことを学ぶのか、面白そうだ！」と、実習への意欲を高めることができます。
左下の「初めて聞いたゾーン」は知識も少なく勉強しようとするニーズも低いので、
このままいくと国家試験の合格があやしいかもしれません。ですので、少々不安の動機づけの必要があるかもしれません。
このゾーンの学生も実習とつなげて
「あなたは受け持ちの透析患者さんにパンフレットで退院指導をしました。
メロンが大好きな患者さんだったので、「メロンは一日半分までにしてくださいね」と書いて手渡しました。
月曜日に訪室すると患者さんは、あなたのせいで土曜日に体調が悪くなり大変だったと怒鳴られました。
どうして怒鳴られたのでしょうか」
という問いに答えを考えさせます。ここでもやはり５分で調べ学習をさせます。
そして最後に左上の知識は多いが学習ニーズが低い「いまさらゾーン」。
実はこのエリアの学生が最も動機づけが難しいので準備が必要です。
たとえば准看護師の経験が豊富にあり、進学コースに入学してきたような学生や
医師会立の学校で勤務しながら学習している学生で、「そんな理想論を言ったところでどうせ現場ではできないんだから」と
少しななめに構えているような人がこのエリアにはいたりします。
このゾーンの学生には現場に近い学習をさせていくのが効果的だったりします。
たとえば図４のような臨床場面の事例を用意し、
「いまさらゾーン」の学生に５分間を使ってどう対応したらいいのかを調べ学習させます。
医師にどんなセリフで返答するのがよいのか、なぜT4はよくないのかなどをリアルに現場で働くことが
どんなことなのかも話せるようにし、自尊心をくすぐるようにすると学習の動機づけができたりします。
そして５分間の調べ学習を終えたのち、２分で各エリアの学生に調べ学習の結果を話してもらいます。
「教えてゾーン」の学生はカリウムと心臓の関係、腎臓の機能という基本を振り返った内容を発表し、
この問題は解けるようになります。
「即行動決定ゾーン」の学生は「個別性の大切さと実際の食品のカリウム含有率」を学びことができます。
「初めて聞いたゾーン」は、食品のカリウム含有率もわかりますが、
自分が誤った知識で患者を指導するとダイレクトに患者に迷惑をかけてしまうのだ、ということを学び、
勉強しないと自分が困るのかもしれないと、多少なりとも学習への動機づけができます。
そして、「いまさらゾーン」の学生は現場で起こりがちな事例と結びつけることで
行為へのエビデンスを知ることが大切だと再確認し、知識と業務を結び付ける面白味に気づいたりします。
目の前の学生の理解度に合わせて様々な手法や道具を使うということは、柔軟に伝え方を変えることができる能力があるいうことです。
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ほめ方・叱り方 ⑤ 集団のほめ方・叱り方テクニック
※ その他沢山の動画があります！ こちらから（チャンネル登録お願いします。）
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教員の仕事は楽しいと思うことが大切
私は教員ってすごく楽しいと思ってきたんですが、なぜ教員になってすぐに辞めてしまう人がでてしまうんでしょうか。
泰先生も大学教授という役割をとても楽しんでいらっしゃいますよね？
僕は相手にどうやってわからせるか、わかりやすいって何かを考えるのが好きだし、何十時間もかけてつくった教材で学生が「おおっ！これならすごくわかる」なんて言われたらすごくうれしいんだよね。
そういう意味では役割を楽しんでいるし、教えることが向いているんだと思うね。
教員になってすぐ辞めちゃう先生っていうのは、やっぱり教えることの喜びを体験しないうちに、失敗だけ経験してしまうからなんじゃないのかな。
だからまずは、「物事や知識をうまく伝えるための３要素」を備えて、「教えることが楽しいという経験を失敗より先に積むこと」が大切だと思う。
また、ここ10年くらいで看護系大学がすごく増えましたけど、そのことと教員の離職率の高さって何か関係があるんでしょうか。
だから新任教員の離職と言ったなかには実はほかの大学に移ったという数も多く入っているんだと思うよ。
辞めた学校や同僚にはやっぱり言わない人も多いだろうからね。
つまり、教員を辞めたわけではなく、場所替えをしたという人の数も含まれての話だと思う。
今後はこれまでの勢いで看護系大学が増え続けるということはないので、離職の数はこれまでより高くなることはないと思うな。
そういえば私の看護学校の同期の教員も新設の大学に行きましたけど、移って１年くらいしてからそういう話を聞きました。
では今後は引き抜きは落ち着くのならば、いよいよ離職の本質は何なのかを解明する時期が来たということでもありますね。
この連載では１年をとおして実際に看護学校を早期離職された先生方の体験談から、どんな教育システムやしくみやサポートがあれば新任教員が安心して働くことができるのかを考えていきたいと思っています。
また泰先生にアドバイスをいただくこともあるかと思います。
そのときはどうぞよろしくお願いいたします。
本日はどうもありがとうございました。
新任教員はなぜ去ってしまうのか（前編）はこちら
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こんな事例でお困りではありませんか？？
・学生に「この人の問題点を考えて下さい」と言われた。
・スタッフの状況を考えないで、「ハンコ押して下さい」「チェックまだですか？」と言われる。
・技術チェックを受ける際、学生が自分で患者選定ができない。
・バイタルサインが異常値でも、すぐ報告に来ない。
・患者さんと仲良くなると言葉使いが敬語ではなくなる。
・スタッフが言ったことが、行動記録にそのまま書かれている。学生の考えが記入されていない。
・指導しても返答がない。言い訳をする。など。
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奥山塾（オンラインサロン）がスタートしました。
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