Introduction

There is a story about a sign on the office wall of the late Albert Shanker, president of the American Federation of Teachers.  It had two lines.  The first read, “I taught the material, but the students didn’t learn it.”  The second line was, “Define the meaning of ‘teach’ in that sentence.”

Teaching is about people learning.  What is known about how people learn informs and guides effective teaching.  Teaching and learning are complex social activities that involve making sense from present and past experiences. They depend on curiosity, exploration, discovery and understanding.  Teaching and learning involve questioning, reflecting and giving feedback in multiple settings and at multiple levels over time.  Throughout the ESME Course, when we speak of teaching we mean teaching/learning, learning that necessarily involves feedback and reflection.  This leads us to considerations of assessment and evaluation.  For the effective medical educator, teaching, learning, reflection and assessment are inseparable and dynamically linked. 

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 Specific Outcomes

At the end of the Course, participants will have begun to be more effective teachers as demonstrated by their ability to:

1. Describe and apply key principles and concepts of learning in their teaching
2. Match and use different forms of questions and feedback to their teaching
3. Compare and contrast teaching methods for large groups, small groups, and individuals
4. Discuss and demonstrate the effective application of conventional and new learning technologies to learning
5. Describe the teacher as a role model and mentor
6. Compare and contrast effective methods for teaching in the classroom, ambulatory/outpatient setting, at the bedside, and in the community

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 Outline of Topics:  Effective Teacher

• Teaching/Learning:
  Principles of learning
  Questions and feedback/reflection
  Effective communication
  Humanization of teaching/learning
• Teaching Toolkit:
  Large group teaching skills
  Small group facilitation skills
  The teacher as a role model/mentor
• Teaching/Learning Context:
  Ambulatory/outpatient setting
  Bedside teaching
  Community settings
  Professional meetings

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 Case Studies

Case Study 1: “I’ll Do What I Can”

Alan drinks a cup of coffee as he waits to see the chairman of the Pathology Department.  He has been teaching pathology for 15 years at Pan National University Medical School and been director of the general pathology course.   He likes teaching and is considered a good teacher by his colleagues and students.  He is comfortable giving lectures and supervising laboratory sessions.  Two years ago there was a curriculum review and now he is no longer director of a course but instead a member of a multidisciplinary group of teachers in a third-year unit “Mechanisms of Health and Disease” that involved both small-group and large-group teaching plus related practical laboratory sessions. The Unit leader is from the Department of Microbiology.

The door opened.  “Hi Alan, please come in,” says Mary Mathews, Chair of the Department of Pathology.  After the initial pleasantries are exchanged, Mary leans back in her chair and says, “Alan, you’re an effective teacher.  Your course on general pathology was well organized and very successful and your work in the new multidisciplinary unit is well received by the students.  I would like to ask you to help Susan, our newest faculty member, with her teaching.  She is feeling a bit insecure although her initial presentations to the class even though they have been OK.  Would you be willing to guide and mentor her for a year or so until she is more effective as a teacher, in lectures, small groups and laboratory settings?” “Sure, I’d be glad to offer what help I can,” replies Alan.  “Great, I really appreciate it.  Let me know if there is anything you need and keep me informed about how it’s going,” says Mary. 

Now Alan is back to his office wondering what he’s gotten himself into. True enough, he is a good teacher but he doesn’t know if he can help anyone else with their teaching.  He doesn’t know where to begin.  What makes him, or anyone, an effective teacher he wonders, and how can he help Susan?

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Study Guide:  Effective Teacher

Teaching & Learning

1.00     Principles of Learning

• What are the current concepts and principles of learning?
• How and to what extent were basic concepts and principles of learning addressed?
• Which teaching/learning activities best illustrated specific concepts and principles of learning?

1.10     Using Questions, Reflection/Feedback

• How were questions used by the teacher and the students to facilitate learning?
• What different types or forms of questions were used during the teaching?
• What were the most common types of questions used? 
• To what extent were questions part of the feedback or assessment process?  What made their use more or less effective? 
• How was effective reflection and feedback used in and adapted to different learning situations?
• How were questions from learners handled?

1.20     Effective Communicator

• What are the characteristics of an effective communicator?
• How were effective communication and organizational skills integrated with leadership and management skills?

1.30     Humanization Of Teaching/Learning In Medical School

• How did it feel as a person to be involved in the teaching/learning  process?
• What does humanization of teaching and learning mean and how is it relevant to your teaching/learning process?
• What is the evidence that humanization is present?

Teaching Toolkit

1.40     Large Group Teaching Skills

• How was the presentation structured? Organized?
• Were clear objectives presented and used effectively?
• How and to what extent were the students/listeners actively involved in the      presentation?
• What, if anything, could the presenter have done to improve the presentation?
• How could you assess the extent to which the presentation achieved its purpose?
• How clear and helpful were visual aids?
• Did the presenter emphasize key points?
• Did the presenter summarize periodically as well as at the end?

1.50     Small-Group Facilitation Skills

• What is the evidence that the session was learner-centered? Teacher-centered?
• How were reflection and assessment conducted?
• What are the key components of PBL?  What is the evidence that they occurred?
• How were learning issues and questions handled?
• How were the group and individuals assessed?  How often?
• To what extent did the facilitator model self-assessment for learners?

1.60     Role Model, Mentor (Metacognition)

• How are the responsibilities and actions of role models, advisors, mentors and supervisors similar and different?

Teaching/Learning Contexts

1.70     Ambulatory/Outpatient Setting

• What aspects and principles of learning are most evident in the            ambulatory/outpatient setting?
• To what extent were the expectations of the learners made explicit?
•  How was learning assessed?
• How were questions used effectively for teaching/learning?

1.80     Bedside Teaching

• How does bedside teaching compare and contrast with ambulatory/outpatient teaching?  
• How does teaching in urgent or procedural settings differ from bedside teaching? 
• What challenges are presented by these conditions?
• How was the patient included in the teaching/learning process?  To what extent was it humanistic?
• How was reflective feedback to learners presented?  What criteria were used  to determine its effectiveness?

1.90     Community Settings

• What were the differences and similarities between learning in a community and in a hospital?
• How were learning possibilities developed when working in the community?
• How was the learning experience organized and evaluated?
• How and to what extent did students interact with other health care professionals?
• How much time did the students have in the community setting?
• What responsibilities did students have with and to the community?
• How was learning assessed and formative feedback provided?
• What was the role and responsibility of the community in the students’ experience?

1.100   Professional Meetings

• How do presentations at a professional meeting compare with other types of presentations?
• Are core elements of effective teaching are still important regardless of the setting?
• How clear and understandable were visual aids?
• Were visual aids explained and used as an integral part of the presentation?
• To what extent did the speaker summarize the key points?

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 Resource Material 

Bransford, J.D., Brown, A.L., Cocking, R.R. (eds.).  (2000).  How people learn: brain, mind, experience, and school.  National Academy Press, Washington, D.C.  Available on line at http://www.nap.edu/catalog/6160.html

Dolmans, D.J.H.M., De Grave, W., Wolfhagen, I.H.A.P., van der Vleuten, C.P.M., Winjnen, W.H.F. (2005).  Problem-based learning: future challenges for educational practice and research.  Medical Education 39: 732-741.

Lynch, D.C., Surdyk, P.M., Eiser, A.R. (2004)  Assessing professionalism:  A review of the literature.  Medical Teacher 26:  366-373,

Miller, G.E. (1990) The assessment of clinical skills/competence/performance Academic Medicine. 65(9):S63-7, September.

Regehr, G., Norman, G.R. (1996)  Issues in cognitive psychology: Implications for professional education.  Academic Medicine 71:988-1001

Schmidt, H.G. (1993).  Foundations of problem-based learning: some explanatory notes.  Medical Education 27:422-432

http://hsc.unm.edu/SOM/TED  Multiple teaching resources for all types of teaching from the Office of Teacher and Educational Development, University of New Mexico School of Medicine, Albuquerque, New Mexico.

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