October 5, 2008 – 4:34 am
Many principles of good teaching, however, can (and should) be incorporated into clinical teaching. One of the most important is the need for planning. Far from compromising spontaneity, planning provides structure and context for both teacher and students, as well as a framework for reflection and evaluation. Preparation is recognised by students as evidence of a good clinical teacher.
How doctors teach
Almost all doctors are involved in clinical teaching at some point in their careers, and most undertake the job conscientiously and enthusiastically. However, few receive any formal training in teaching skills, and in the past there has been an assumption that if a person simply knows a lot about their subject, they will be able to teach it. In reality, of course, although subject expertise is important, it is not sufficient. Effective clinical teachers use several distinct, if overlapping, forms of knowledge.
How students learn
Understanding the learning process will help clinical teachers to be more effective. Several theories are relevant. Read More »
October 4, 2008 – 9:48 am
Clinical teaching—that is, teaching and learning focused on, and usually directly involving, patients and their problems—lies at the heart of medical education. At undergraduate level, medical schools strive to give students as much clinical exposure as possible; they are also increasingly giving students contact with patients earlier in the course. For postgraduates, “on the job” clinical teaching is the core of their professional development. How can a clinical teacher optimise the teaching and learning opportunities that arise in daily practice?
Strengths, problems, and challenges
Learning in the clinical environment has many strengths. It is focused on real problems in the context of professional practice. Learners are motivated by its relevance and through active participation. Professional thinking, behaviour, and attitudes are “modelled” by teachers. It is the only setting in which the skills of history taking, physical examination, clinical reasoning, decision making, empathy, and professionalism can be taught and learnt as an integrated whole. Despite these potential strengths, clinical teaching has been much criticized for its variability, lack of intellectual challenge, and haphazard nature. In other words, clinical teaching is an educationally
sound approach, all too frequently undermined by problems of implementation. Read More »
October 2, 2008 – 10:34 pm
Another feature of one to one teaching is the opportunity to adjust what you teach to the learner’s needs—“customise” your teaching. In 1978 Ausubel and colleagues suggested that the secret of education is to find out what the learner already knows and teach accordingly. In a lecture, tutorial, or seminar you cannot hope to diagnose and respond to every individual’s learning needs, but a one to one relationship provides an opportunity to match the learning experience to the learner. One to one teaching is perhaps one of the most powerful ways of “influencing students.” You can create opportunities for active learning in authentic clinical settings while modelling
desirable personal and professional attributes. Stott and Davis in 1979 promoted the idea that one to one primary care consultations offer exceptional but often unrealised potential. The principles used in primary care consultations can be applied to one to one teaching, and the secret is forethought and planning. Read More »
October 2, 2008 – 12:25 am
You can minimise your internal involvement in the group process by organising or structuring groups into smaller units, especially when the group process is likely to be problematical. This is particularly so when you wish to mobilise a sense of coherence and full participation among a largish group of students. A sequence of tasks might then be set. For example:
x Students work individually for five minutes drawing up a list
x They share their ideas in pairs for 10 minutes
x In groups of four to six, students write up categories on a large sheet of paper
x This is followed by 25 minutes of open discussion among the groups
Your role in this kind of situation may be to move round checking that everyone understands and accepts the task and is doing it in an appropriate way and to encourage completion as the end point approaches. You could leave the room for a while and let the groups work without supervision. The following group structures require some assertive leadership to set up but allow you to take a back seat as the process itself takes over the direction of events. Read More »
October 1, 2008 – 5:00 am
Group discussion plays a valuable role in the all-round education of students, whether in problem based learning and team projects or in the more traditional academic scenario of the tutorial or seminar. When it works well, discussion can allow students to negotiate meanings, express themselves in the language of the subject, and establish closer contact with academic staff than more formal methods permit. Discussion can also develop the more instrumental skills of listening, presenting ideas, persuading, and working as part of a team. But perhaps most importantly, discussion in small groups can or should give students the chance to monitor their own learning
and thus gain a degree of self direction and independence in their studies. All these worthy aims require active participation and the ready expression of ideas. Yet it frequently doesn’t work out this way. Indeed many tutors too readily fall back on their reserve positions of authority, expert, and prime talker. Many of the problems associated with leading small groups effectively are likely to be exacerbated with larger groups. So how can we avoid the common traps? If you are leading a group discussion you will need to consider both the configuration of the group and your own behaviour. Groups often communicate poorly because the physical conditions make it difficult to communicate. For example, in a group of 10 students seated round a rectangular table, at least four students on either side of the table have no eye contact with each other, thus reducing participation. Read More »
September 29, 2008 – 10:01 pm
Practice does make perfect, but the process of developing as a lecturer is greatly helped if some effort is made to evaluate performance. Evaluation involves answering questions such as “how did I do?” or “what did the students learn?” A lecture can be evaluated in different ways. If the students are to be used as a source of feedback, the following methods are useful:
x Ask a sample of the students if you can read their lecture notes—this exercise gives some insight into what students have learned and understood
x Ask for verbal feedback from individual students
x Ask the students to complete a one-minute paper
x Ask the students to complete an evaluation questionnaire.
If you want to evaluate your teaching style and delivery,
peers can be a useful source of feedback:
x Ask a colleague to observe part or all of a lecture and provide feedback afterwards. It is important to inform the observer what aspects of the lecturing process you want evaluated—for example, clarity, logical flow, effectiveness of the media used
x Videotape the lecture for private viewing, and arrange a joint viewing with a colleague later. Lectures are still a common teaching method in both undergraduate and postgraduate medical education. Their continued popularity is due to the fact that they represent an effective and efficient means of teaching new concepts and knowledge. This article has emphasised the importance of good lecture planning and of the inclusion of student interaction to
ensure effective learning.
Read More »
September 28, 2008 – 5:55 am
It is important to distinguish between the knowledge and concepts that are essential (need to know) and those which, though interesting, are not part of the core message (nice to know). The aims of the lecture should be clearly defined (“what do I hope to achieve with this lecture?”). These will help to define the teaching methods and the structure. If, for example, the purpose of the lecture is to introduce new knowledge and concepts, then a classic lecture structure might be most appropriate. On the other hand, if the purpose is to make the students aware of different approaches to a particular clinical problem, a problem oriented design in which alternative approaches are presented and discussed might be a more appropriate format.
September 27, 2008 – 4:39 am
Lecturing or large group teaching is one of the oldest forms of teaching. Whatever their reputation, lectures are an efficient means of transferring knowledge and concepts to large groups. They can be used to stimulate interest, explain concepts, provide core knowledge, and direct student learning.
However, they should not be regarded as an effective way of teaching skills, changing attitudes, or encouraging higher order thinking. Large group formats tend to encourage passive learning. Students receive information but have little opportunity to process or critically appraise the new knowledge
offered. How can lectures be used to maximise learning and provide opportunities for student interaction? This article will supply some of the answers and should help you to deliver better, more interactive lectures.
September 25, 2008 – 5:36 pm
Evaluation may cover the process and/or outcome of any aspect of education, including the delivery and content of teaching. Questions about delivery may relate to organisation—for example, administrative arrangements, physical environment, and teaching methods. Information may also be sought about the aptitude of the teacher(s) involved. The content may be evaluated for its level (it should not be too easy or too difficult), its relevance to curriculum objectives, and integration with previous learning. Outcome measures may show the impact of the curriculum on the knowledge, skills, attitudes, and behaviour of students. Kirkpatrick described four levels on which to focus evaluation; these have recently been adapted for use in health education evaluation by Barr and colleagues. Some indication of these attributes may be obtained by specific methods of inquiry—for example, by analysing data from student assessments.
September 24, 2008 – 11:02 pm
Lecturing or large group teaching is one of the oldest forms of teaching. Whatever their reputation, lectures are an efficient means of transferring knowledge and concepts to large groups. They can be used to stimulate interest, explain concepts, provide core knowledge, and direct student learning.
However, they should not be regarded as an effective way of teaching skills, changing attitudes, or encouraging higher order thinking. Large group formats tend to encourage passive learning. Students receive information but have little opportunity to process or critically appraise the new knowledge
offered. How can lectures be used to maximise learning and provide opportunities for student interaction? This article will supply some of the answers and should help you to deliver better, more interactive lectures.
