“See many, Do many, Teach many”

Paige Ruffier, PharmD
PGY1 Pharmacy Resident
Children’s National Hospital

In 1890, William Halsted became the first Chief of Surgery at John Hopkins Hospital. At the time, surgical residents were either self-taught or underwent an apprenticeship1. Halsted’s model of “see one, do one, teach one” is a procedural training methodology that seeks to promote progressive skill development while prioritizing adequate supervision and patient safety2. It is important to note that Halsted was not only interested in developing a methodology to train surgeons, but also interested in developing teachers and role models1. The “see one, do one, teach one” approach has now expanded far greater than just the setting of aspiring surgeons. Before we dive into how “see one, do one, teach one” can be extrapolated into settings outside of the medical field, let’s first further explore each aspect of it.

The first component, “see one”, represents the learner’s direct observation of the skill. In addition to strictly observing the skill completed with expert technique, this is when the learner can take advantage of asking the expert any clarifying questions. The next component, “do one”, represents the learner’s completion of the skill independently. It is here when the expert may chime in with feedback that will be crucial to the learner’s continued success. The last component, “teach one”, represents the learner teaching the skill to a new learner. At this point the learner has essentially transitioned from the learner to the expert, as they begin to instruct a new learner. The “see one, do one, teach one” approach is a cycle that continues to pay it forward to each future generation of learners.

“See one, do one, teach one” can be attractive to many. The process not only has educators instructing students initially, but also encourages students to be autonomous with their own learning early on3. Additionally, the “see one, do one, teach one” approach is simple and relatively easy to follow. However, as with any instructional design model, it poses challenges. For example, what if you have a learner that is able to complete the skill independently, but has many errors? Do we want that learner teaching a new learner when they haven’t yet mastered the skill themselves? There are no guardrails in place.

In today’s times, the phrase “see one, do one, teach one” has transitioned to “see many, do many, teach many4.” We know that not all people learn the same way or at the same speed. By changing one to many, this considers the differences in rates that learners learn, as well variation in complexity of the skill (as we would suspect that more challenging skills will need more repetition). Furthermore, when we bring this methodology back to its original audience of surgeons-in-training, the adaptation to “see many, do many, teach many” is preferred in terms of patient safety and ensuring patients are provided the utmost level of care.

Outside of the medical field, we can find the “see many, do many, teach many” practice applied in a variety of learning environments. For example, learning to drive a car. You first need to observe an expert (someone with an active driver’s license) driving on many occasions. It is typical for a teenager (who is the learner), to observe a parent (the expert). The next component, “do many”, is typically when the teenager will practice under supervision of the parent. The teenager will then obtain a driver’s license and be able to drive oneself independently. The last component, the “teach many”, is demonstrated when the teenager is then comfortable to drive other’s around (thus serving as the expert). We can also apply this to pharmacy education. Whether a pharmacy student is learning to administer immunizations, provide medication counseling, or even perform patient chart review, the “see many, do many, teach many” method can be applicable to various aspects within pharmacy school curriculums.

The “see many, do many, teach many” instructional process really can be appropriate in almost all settings in which a learner is learning any sort of new skill.

References:

1. Kotsis SV, Chung KC. Application of the "see one, do one, teach one" concept in surgical training. Plast Reconstr Surg. 2013;131(5):1194-1201. doi:10.1097/PRS.0b013e318287a0b3

2. Heath JK. See One, Do One, Teach One, Tell All. Chest. 2020;158(5):1820-1821. doi:10.1016/j.chest.2020.05.566

3. Cooksey A. See One, Do One, Teach One. Knowledge Quest: Journal of the American Association of School Librarians. September 11, 2017. Accessed September 25, 2021. https://knowledgequest.aasl.org/see-one-one-teach-one/

4. Rohrich RJ. "See one, do one, teach one": an old adage with a new twist. Plast Reconstr Surg. 2006;118(1):257-258. doi:10.1097/01.prs.0000233177.97881.85