"No! Not another boring lecture"
Educational theory provides a sound basis for more effective teaching
Sally Santen, MD, and Robin Hemphill, MD, MPH
"Teaching without learning is just talking." —K. Patricia Cross
We recognize that the standard lecture format is a wonderful way to teach and there are situations in which this format is appropriate. For example, a lecture is a good format when an audience is unfamiliar with the content to be learned. The goal of this brief article is to expand the range of options teachers might use to better involve the learner. Research shows that engagement with learning material leads to better retention. So the questions are: “How can I engage the learners so that they will learn more?” And, "How can I improve my lectures or use alternative formats?" To that end, we would like you to understand three basic educa-tional frameworks and see how they apply to the teaching you do.
Keys from cognitive psychology research
We know that learning is an individual and an active process. Learning is enhanced when multiple sensory modalities are active and new knowledge, skills, and attitudes are connected with existing knowledge and are meaningful. Retention is enhanced when new neural connec-tions are strengthened, when new learning is "output" proximal to "input," and when contextual cues for output are present during input.
Understanding by Design, by Grant Wiggins and Jay McTighe, offers a powerful framework for designing learning experiences called "backward design."
1. Identify desired results
First, you establish your learning goals and objectives. What should students know, understand, and be able to do? Wiggins and McTighe provide a useful process for establishing curricular priorities and focusing on the content.
- What should participants hear, read, view, or explore? This knowledge is "worth being familiar with."
- What knowledge and skills should participants master? Determine the facts, concepts, principles, or skills that are important for your students "to know and do" in this learning experience.
- What are big ideas and important understandings participants should retain? These are the "enduring understandings" that you want students to remember.
Answering each of these questions will help you create concrete and specific learning goals that will lead you to determine and prioritize the best content.
2. Determine acceptable evidence
In the second phase of backward design, you think about the basis for determining whether students are mastering the knowledge and skills you want them to gain. What will you accept as evidence that students are making progress toward the learning goals? There are a wide range of assessment methods, but the subject is beyond the scope of this article.
3. Plan learning experiences and instruction
Finally, after you have decided what results you want, and how you will know you’ve achieved them, then you start planning how you’re going to approach the task of teaching the material. You can now move to design your instructional strategies and students’ learning activities. Think about the format of the exercises, problems, or questions that will develop students' ability to meet learning goals. Use the tips described above and plan meaningful, active, multimodality learning experiences. You want to foster understanding and critical thought, not rote memorization.
Bloom’s Taxonomy (revised)
Bloom set out this framework as a way to categorize the levels of teaching, learning, or assessment.
- Remembering—Retrieve, recognize, and recall relevant knowledge from long-term memory, ie., find out and learn terms, facts, methods, procedures, and concepts.
- Understanding—Construct meaning from oral, written, and graphic messages by interpreting, exemplifying, classifying, summarizing, inferring, comparing, and explaining them. Understand uses and implications of terms, facts, methods, procedures, and concepts.
- Applying—Carry out or use a procedure. Apply practice theory, solve problems, and use information in new situations.
- Analyzing—Break educational material into constituent parts. Determine how the parts relate to one another and to an overall structure or purpose by differentiating, organizing, and attributing. Take concepts apart and break them down—analyze their structure, recognize their assumptions and poor logic, and evaluate their relevancy.
- Evaluating—Make judgments based on criteria and standards through checking and critiquing. Set standards, judge using standards, evidence, and rubrics and accept or reject on the basis of criteria.
- Creating—Put elements together to form a coherent or functional whole. Reorganize elements into a new pattern or structure through generating, planning, or producing. Put things together; bring together various parts; write theme, present speech, plan experiment, put information together in a new and creative way
Often when we teach, we set our learning goals at the bottom levels of remember and under-stand. However, we want residents and physicians to be learning at the higher levels of the taxonomy. The key is to develop learning experiences that would require the learner to analyze, evaluate, and create.
Let’s use "splenic lacerations" as an example. Lectures on the surgical anatomy can help residents remember/understand the location of structures and the types of injuries. However, higher levels of learning are achieved when patient case presentations are used for teaching, as learners are asked to apply the anatomy that they have learned and to analyze the clinical scenario. In the management of patients with spleen lacerations, learners should be required to evaluate the literature and determine the appropriate treatment, surgery, intervention, or observation. Teaching at this level can be accomplished clinically or through other methods such as a journal club or problem-solving sessions. Finally, an example of learning at the "create level" might be to ask the learners in teams to develop an algorithm for the management, a protocol for the treatment, or to take morbidity and mortality learning points and work them into a system change around the management of splenic lacerations.
To review, the standard lecture can disseminate knowledge and lead to understanding. For the most part, lectures tend not to require the learner to think at higher levels on the Bloom’s Taxonomy. Therefore, other methods of teaching might be integrated into the lectures given to help residents attain higher levels of learning. The following are some examples of ways to engage learners and use higher levels of thinking:
- Think-pair-share: This can be used in large group settings. Ask the group a question that requires it to apply or analyze the information presented. Pause and let the residents think about the answer. Then ask them to discuss their answers with others sitting around them. This activity allows them to analyze others responses. If there is time, the group might report what was discussed.
- Role play: Learners are assigned a topic or disease to present or act out.
- Case-based teaching: Usually done in a lecture setting, information is presented through a series of cases. It is important to allow learners the opportunity to apply and analyze the case before the answers are discussed.
- Team-based learning: Learners are expected to remember and understand material prior to sessions. The session begins by first testing knowledge and then it moves into team-based problem solving. Resource: http://www.teambasedlearning.org.
- Problem-based learning: Learners work through the case by asking questions, applying knowledge, and analyzing responses. It is important to identify learning issues or topics that residents need to know more about. The facilitator does not teach but rather provides information.
- Jigsaw small groups: Each learner studies an assigned area before the event and brings the knowledge to the group. Then the group is assigned a task, such as creating an algorithm, recommendations, or guidelines. Example: How do you manage a patient with traumatic cardiac contusion? Each learner will be given a different reading assignment.
- Jeopardy game: This format is easily created using a Power Point slide show with hypertext links to navigate. Depending on the questions, you can test “remember” and "understand" by asking learners to analyze cases. Another advantage to this format is that you can assess what the learners know through their responses.
- Debate or pro-and-con discussion: Learners prepare to debate two sides of an issue.
- Journal club: This format allows for comfort in ambiguity and requires learners to analyze, evaluate, and create using the literature.
- Morbidity and mortality conference: If this is a presentation, then the learners are not actively learning at high levels. It is important that learners are involved in the discussion.
- Other venues such as simulation and procedure labs can provide significant learning.
Employing educational principles may help to improve learning outcomes. The first step is to determine what the learning objectives will be, and be sure to include the higher levels of learning outlined in Bloom’s Taxonomy. Then determine how you will know the learners have achieved the learning objectives. Finally, work to create active learning experiences to be certain your learner can use the information that you have imparted.
Online May 18, 2009