workshop on redefining role of teacher in medical education
TRANSCRIPT
Workshop on Redefining Role of Teacher in medical education
Motivation
Dr. Syed Hasan Shoaib
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What is Motivation?
An internal state that arouses, directs, and maintains behavior.
Motivation Definition
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Motivation refers to all the internal conditions that stir up activity and sustain activity of an individual
Motivation is derived from the Latin word ‘movere’ which means ‘to move’ or ‘to energize’ or ‘to activate’.
Directs behavior toward goals
Increases effort and energy
Commencement in activities is sooner
Increases persistence in activities
Enhances thought processes
Leads to improved performance
How Does Motivation Affect Learning and Behavior?
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Types of motivation
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self-fulfillment
love for the culture
love for the language
pleasure
grades
teacher
job
requirement
parents
salary
Associated with seeking out and conquering challenges in pursuit of personal interests and the exercise of capabilities
Associated with activities that are their own reward
Enjoyment of a task or the sense of accomplishment that it brings
Intrinsic Motivation
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Motivation created by external factors like rewards and punishments
Not interested in the activity for its own sake, but instead for possible gains
Extrinsic Motivation
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Try It Yourself
Put an E next to the examples of extrinsic motivation or I for example of Intrinsic behaviourA teacher assigns points for good behavior that can be exchanged for better grades at the end of each week.
A student goes to the library after school to find more information about an especially interesting topic that was introduced in class.
A student crams hard for an upcoming exam in order to maintain her perfect GPA.
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IntrinsicEager to learn
Enjoy learning
Welcome challenges
Process information effectively
ExtrinsicReluctant to engage
in learning tasks
Dislike learning
Avoid challenges
Process information superficially
Effects of I vs. E Motivation on Student Learning
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The relationship between intrinsic and extrinsic motivation is complex.
Sometimes motivation can start out extrinsic and lead to intrinsic.
For example, Bilal studies geometry because he believes studying will lead to a good job in the future. The more Bilal learns, the more he becomes intrinsically interested in the subject.
The Effectiveness of Intrinsic and Extrinsic Sources of Motivation
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People can be intrinsically and extrinsically motivated at the same time.
Ideally, intrinsic motivation should be used, but sometimes extrinsic motivation, in the form of attendance policies for example, can be effective.
The Effectiveness of Intrinsic and Extrinsic Sources of Motivation
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What type of motivation do you have for this class?
Why are you taking this class?
List 3-5 reasons that you are in this class today.
Label the reasons as I (intrinsic) or E (extrinsic)
What do the results tell you about yourself and how you are likely to perform or behave in this class?
Review and Discuss
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How to improve motivation in Colleges
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Most educators agree that motivating students is one of the critical tasks of teaching
In order to learn, student must be cognitively, emotionally, and behaviorally engaged in productive class activities
Students' motivation has a direct and powerful impact on their social interactions and academic achievements
Motivation affects performance
Motivation in Learning and Teaching
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Help students understand the value of the task or learning a particular skill
• Attainment value—why learning a particular content or skill is important
• Interest value—make learning fun
• Utility value—explain connections between classroom learning and the “real world”
Strategies to Improve Motivation
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Use variety and familiarity to capitalize on student interests
Help students set learning goals
Enhance students’ self-efficacy through repeated successful experiences
Provide students with choices
Strategies to Improve Motivation
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Help students view themselves as in charge of their behavior and learning Take responsibility for both successes & failures
Focus on student effort
Increase opportunities and expectations for success
View intelligence and ability from an incremental viewpoint
Strategies to Improve Motivation
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Self Efficacy
"People with high assurance in their capabilities approach
difficult tasks as challenges to be mastered rather than as threats
to be avoided." Albert Bandura
Introduction
Self -efficacy is a person’s belief in his or her ability to succeed in a particular situation.
Bandura described these beliefs as determinants of how people think, behave, and feel (1994).
Role of Self-Efficacy
People with a strong sense of self-efficacy:
View challenging problems as tasks to be mastered.
Develop deeper interest in the activities in which they participate.
Form a stronger sense of commitment to their interests and activities.
Recover quickly from setbacks and disappointments.
Role of Self-Efficacy
People with a weak sense of self-efficacy: Avoid challenging tasks.
Believe that difficult tasks and situations are beyond their capabilities.
Focus on personal failings and negative outcomes.
Quickly lose confidence in personal abilities
(Bandura, 1994).
Sources of Self-Efficacy• Mastery Experiences
– Performing a task successfully strengthens our sense of self-efficacy.
• Social Modeling– Witnessing other people successfully completing a task is another
important source of self-efficacy
• Social Persuasion– Consider a time when someone said something positive and encouraging
that helped you achieve a goal.
• Psychological Responses– Moods, emotional states, physical reactions, and stress levels can
all impact how a person feels about their personal abilities in a particular situation.
References
http://psychology.about.com/od/theoriesofpersonality/a/self_efficacy.htm
http://psychology.about.com/od/profilesofmajorthinkers/p/bio_bandura.htm
http://en.wikipedia.org/wiki/Self-efficacy
LECTURING SKILLSDr. Syed Hasan Shoaib
Jens Dørup,
Section for Health InformaticsUniversity of Aarhus, Denmark
ACKNOWLEDGEMENT
WHY LECTURING?
One of the oldest methods of teaching
One can transform large amount of information in short time
Economical for large group of students
WHEN TO USE LECTURES Lectures are conducted for:
Presenting new material
Emphasize key concepts
Explain difficult concepts
To relate to PBL case by clinicians
Preparation
Why are you doing this lecture ?
Who are you speaking to ?
What is THE most important message ?
Finding materials and inspiration
Why prepare ?
A strategy for preparation Think of the student, not the
textbook
Time !
Børge Meibom
Practise in front of friends
Børge Meibom
Who are you talking to ?
Speak their language Explain your selves Dont talk down – Dont talk up
Levers for Learning
Assessment
Engagement
Getting attention
Ask a question Look at the audience Tell about a recent problem Use stimulating photograph A joke
Jigsaw Learning
Each team member is assigned a different reading or topic
In-class project depends on each person’s contribution
Anonymous Cards
Effective for getting opinions or perceptions on sensitive topics
Encourages participation by less vocal students
Can be made active with variations Can be combined with group work
“My Best Professors Ever…”
Did not teach me what to think, but taught me how to think
Helped me make connections between a serious academic curriculum and my own personal life, values, and experiences
Worked with me one-on-one outside of class
Asked questions or posed problems that helped me learn to think like a professional in my field
Encouraged students to disagree with them, as part of teaching them how to think like professionals
Taught students the importance of evidence, how to collect it, and how to use it to make decisions
Engaged students in the learning process
(Light, 2001)
Why is this interesting ?
The level(s) of your voice Sell it Set contents in context
TRICKS
Surprise Ahaaa ! A nice picture Be kind We are in this together
The CLEAR MESSAGE
Maximum of 3 or 4 points Define special word Use examples – analogies
AV media: Be cautious !
Not meant to be your memory list Superfluous slides Too much colors / gimmics Red/green Variation
Avoid SuperfluityAvoid Superfluity Your slides are meant to support your ideas - not you.Your slides are meant to support your ideas - not you.
DonDon´́t read up the text on your slidest read up the text on your slides
The data on a graph are the reason for the existenceThe data on a graph are the reason for the existenceof a graph. It is too easy to forget this. There areof a graph. It is too easy to forget this. There aremany ways to obscure the data such as allowingmany ways to obscure the data such as allowingother elements of the graph to interfere with the dataother elements of the graph to interfere with the dataor not making the graphical elements encoding theor not making the graphical elements encoding thedata visually prominent.data visually prominent.
Spread several points on several slides. In stead ofSpread several points on several slides. In stead oftrying to put all your ideas down on one slide - decidetrying to put all your ideas down on one slide - decideupon which points are the most important andupon which points are the most important andreserve one slide for each point.reserve one slide for each point.
Make the data stand out.Make the data stand out.
These are two broad principles that guide the specificThese are two broad principles that guide the specificprinciples.principles.
Powerpoint : Tips & Tricks
Speak to the auditory – not to the computer
Rehearse Powerpoint Test installations in due time Make a printed backup of your
slides on overheads
3 – 4 points
Select the most important conclusions Select the most important conclusions and build your lecture around themand build your lecture around them
PreparationPreparation
EngagementEngagement
ClarityClarity
Thank you for your attention
Børge Meibom
Being an effective role model
Objectives of the Session
Define role modelling
Identify characteristics of role model in terms of on job working
Identify characteristics of role model as a teacher
Definition
“Research indicates that being a positive role model is a set of skills, attitudes and behaviours which may be taught and acquired by doctors…”
TASK (Plenary Session)
Who are / were your role models in terms of on job working?
What was their influence on your learning and career choices?
Who are you a role model for in terms of on job working?
What do you think are your attributes as a role model?
“In order to be successful in the workplace, you have to be confident and secure in yourself. Those are the skills that you must enjoy developing
in your students.”
TASK (Plenary Session)
Who are / were your role models in terms of teaching?
What was their influence on your learning and career choices?
Who are you a role model for in terms of teaching?
What do you think are your attributes as a role model?
Studies have established the attributesreported in medical role models:Individuals who: Excel in their clinical knowledge and skills Through communication skills they maintain good
professional relationships Are effective and enthusiastic teachers
A tall order! Students & trainees have multiple role models,
learning different things from different individuals; the “composite” role model
How learning from role models happens
This is a complex process! Aspects have been explained through various learning theories:
Individuals learn “to talk, from talk” Students & trainees learn professionalism through
the “Hidden Curriculum” :This is a process of assimilation into a community
of practice, not only by possession of shared expertise, but also the development of professional values and standards
Positive role model attributesPersonal characteristics Compassion Caring Empathic Patient-centred approach Excellent communication skills Good inter-professional
relationships Respectful Good team player Demonstrates leadership Integrity Honesty Good sense of humour Calm Positive attitude
Clinical skill Practically skilful
Demonstrates clinical competence
Knowledgeable
Sound clinical reasoning
Ability to reach the correct diagnosis
Strives for excellence
Presentation skills
Aware of own strengths and weaknesses
Positive role model attributes
Teaching abilities
Taking an interest in students and trainees Spending time with students and trainees Enthusiasm Patience Provide clear explanations Versatile, learner centred teaching style Constructive feedback Demonstrating clinical reasoning Facilitation patient interaction and learning opportunities Identifying opportunities for reflection
PEARLS OF WISDOM On a Good Teacher
“Believing in what you teach and teaching what you believe creates
a powerful role model for our students.”
“Student success is “the engine that pulls the train.” This is at the core and the reason we do what we do.”
“I consider myself to be a "curious character," always analyzing how things
function. This is lived out in the classroom. I hope that my enthusiasm is contagious in the sense that my students become passionate and curious about
their world, especially since physics is a major part of everyday life!”
“I try to treat all students as adults capable of making
decisions about their education. An attempt is
made to create an environment that fosters
participation in class and in the community; an environment where
mistakes, made during honest attempts at success,
are seen as valuable learning opportunities.”
“ALWAYS err in favor of the student. Be a little
understanding: Even if 50 students have told you the same story, give the 51st
student the same wide-eyed look you gave the first. Be a
little forgetful: When a student asks you the same question you just heard 30
seconds ago, forget you already answered it.”
“It is necessary to invest in student interests as they relate not only to the classroom, but also to their dreams and future endeavors.
You must practice not only to learn the names of your students, but also to inquire
about what motivates them.”
“The challenge is not for you to pontificate; the challenge should be for your students to interrogate. You must
encourage your students to ask you more questions in class than you ask them.”
“When I stop having fun, then I’ll stop teaching.”
“The best tool to inspire students is to share real life experiences. Learning
occurs when knowledge is applied in real-life situations. Your role is to connect that
gap in-between.”
“Learning is a journey that takes a lifetime. Inevitably, some will stumble and fall along the
way. Your job, though, isn’t to stop and pick them up but to provide them with the guidance that is necessary to move them from this part of their
journey and help them succeed in the next.”
“Toss it in the air, and let all your ideas for teaching fall on your students. Every
student will find something they like. It might be working in groups, role playing, interactive lectures where they teach, or it
may be a teacher that allows them to reach for their goals. Motivation for me is a smile, a thank you or a card that says,
“you’re a first rate teacher.”’
“The mediocre teacher tells. The good teacher explains. The
superior teacher demonstrates. The great teacher inspires.”
“Believe in simplicity and plain speech. —"Try to see materials
through students' eyes.”’
You teach everyday but the most important lessons you teach are not what comes out of books it is how you live your life and the examples you set in your daily actions, this is what students remember and
what they admire most about you. Work very hard at what you do in order to be a positive role model to
everyone you teach.”
A true teacher is inspired and motivated by
students learning and achieving goals
they thought impossible. Their
excitement becomes contagious as they
gain confidence and dream of unlimited
possibilities.”
“Know your material; know your students,’ Mutual respect in the student-
teacher relationship, a contagious enthusiasm in the enjoyment of science,
a high expectation for achievement nurtured by generous encouragement,
and the development of critical thinking skills for scientific literacy and global
service is teaching at its best.”
“A teacher is encouraged when
he/she sees his/her passion of
nursing transform the student into a
compassionate, competent caregiver.”
“Education is not simply about stuffing information into students’ heads. What really matters is enabling people to do something with that information – to
analyze it, evaluate it, apply it meaningfully to their own lives. When students begin to use information, they
become confident, engaged human beings. That is my everyday
inspiration.”
Facilitation Skills
What is a facilitator?
Literally means: ‘making things easy’ A person who helps a group or team to: achieve results in interactive events by using a range of skills and methods to bring the best out in people as they
work together focuses on the process of how
Role: Conductor
Role: Impartial Helper
belonging to no political coalition within an organisation
being seen as having no stake in the outcomes
Facilitator’s Role: Overview
cope with uncertainty use power of credibility to help address
issues be calm in times of emotion support and counsel others
be understandable mobilise energy surface difficult
issues and help others to do so
take themselves less seriously
empathise
Group processes: intervening
model appropriate behaviour ensure involvement enable understanding keep a task-related focus push for action outcomes manage time ensure that a record is created
Interpersonal Skills/Basic Facilitation Skills
listening
questioning
language &
communication
using
feedback
conflict handling
Ten Commandments of Effective Listening
1. Stop talking
2. Put your people at ease
3. Show you want to listen
4. Remove distractions
5. Empathise
6. Have patience
7. Hold your temper
8. Don’t argue or criticise 9. Ask questions
10. STOP TALKING
Questioning
Use O P E N to probe: “Who, why, what, when, how?”
Use CLOSED (yes/no answers)
to redirect/ summarise: “Are you saying that…?”
Questioning
Use YOU questions How do you see this? What are your priorities? How important is ...... to you? Tell me more about ......? What if.......Why........How......?
Using Feedback
Help participants to think through
these questions:
1. What did you do well?
2. What could you have done
even better?
3. What prevented you from doing
even better; what’s the plan to
do even better in the future?
Conflict Handling
identify points of agreement reformulate contributions to highlight
common ideas encourage people to build on others’
ideas test for false consensus test consensus for
relevance/motivation
Good Facilitation Brings
Co-operation
Results
Presentation Skills
4 Key Aspects
1. Voice
2. Language
3. Body Language
4. Visual
Speed
Effective speakers change their rate of speed to fit their purpose, content, listeners & personal style
Pace is the speed at which
speaker presents different topics or thoughts within a topic
speaker adjusts pace according to listeners’ and speakers’ interest
Tone
emphasis placed on a word to create meaning
variation prevents monotonous presentations
Volume / Variety / Vocabulary
project your voice
- aim for the back go faster to excite to gain maximum attention, say some words
louder repeat important words
go s l o w e r to emphasize major points
give emphasis with voice & body pause often & look round audience
Volume / Variety / Vocabulary
Language
avoid…
acronyms
being too formal
long sentences
try to…
use everyday language
use concrete words
don’t point at anyone don’t move while presenting
key points don’t stand rooted to the spot don’t leave your hands by
your sides don’t avoid eye contact
Body Language – Don’ts
move hands & arms move around the room move towards audience move your eyes around the
audience
Body Language - Dos
What about your audience?
What does their body language tell you?
Body Language
Using Visuals: Don’ts
don’t hide behind your visualsdon’t let technology or visuals
be more interesting than youdon’t use visuals as detailed
notes
Using Visuals: Dos
do let your visuals aid youdo use visuals to clarify and
emphasisedo make one point per visualdo introduce each visual before
showingdo practice beforehand
Flip Chart / Projector / Posters / Cards…
big and bolduse drawingsuse coloursface audience, talk, write, talkremove when finished
Be Careful with PowerPoint
4 Colours Max Use graphics Check how it looks on
projector Use text sparingly
Making it Interesting
stories/anecdotes
explain by analogy
involve them
- ask questions
- pause until reply
The teacher as a mentor
What is mentoring?
Mentoring is about “helping people to become the person they want to be”
-Pasloe & Wray, 1999
Mentoring is an intentional process to guide a protégé to proficiency.
-Unknown
Mentors are:
•Guides•Virtuous•Trusting and trustworthy•People lovers•Empathetic•Non judgmental•Authentic
What does a mentor doMotivate, Empower and Encourage,Nurture self-confidence, Teach by example, Offer wise counsel, Raise the performance bar.
Souba W: Mentoring young academic surgeons, our most precious asset.J Surg Res 1999, 82:113-120.
Goals of mentoring
•Usually defined by the mentor and mentee in the initial encounters.
•Increase professional competence and interest in research and in further specialization
• To build up a professional network for the mentees•Developing professional and personal growth
Read More: http://informahealthcare.com/doi/abs/10.1080/01421590500313043
Some famous mentor-mentee pairs
•Oprah Winfrey mentored by Mrs. Duncan (4th grade teacher)
•Dr. Martin Luther King mentored by Dr. Benjamin E. Mays•Marian Wright Edelman mentored by Howard Zinn
Can you name some others?
What the mentor requires:
Adapted from the Mentor support Program , 2008 Mentor Support Program
the skills to build a successful relationshi
p
knowledge about
and respect for each others’
stage of
development
skills in: • active listening• observation• reflective practice• feedback
expertise in the field of medicine
What the mentor should do
• Be available• Allow for differences in personalities• Let trainees make their own decisions• Teach by words and example• Keep learning about effective mentoring
For effective mentoring• Keep a stable presence in the mentee’s life. • Show up for scheduled meetings• Focus on the mentee’s needs––not the
mentor’s own wants and needs. • Look to improve the mentee’s prospects
while respecting the young person’s life circumstances and perspective.
• Keep in mind, the mentee’s need for fun.• Seek out and use the help and support of
mentoring program staff.
Identify career plans
Locate prospective mentors
Keep learning
about effective
mentoring
Be clear about
needs and expectation
s
Distinguish between
supervisors and mentors
Keep the mentor updated
with progress
Benefit
s to mentee
s
Guidance on settling into
the environment Can receive lots
of information and advice
Develop faster as a student
Get a personal face in a large
institution
Can feel a sense of belonging
Contact with an experienced
person
Long term relationship
with an experienced
teacher
Help with career
decisions and
management
Performance
improvement
Benefits for
Mentor
Broadening of skills and
knowledge
Provision of a new
dimension to current job
Seeing others develop from
your experience(s)
Can increase personal and professional networks
The ethics The protégé: • Should not spend so much time working on
mentor’s projects that there is little time for their own
• Should not be pushed to do work towards a patent or mentor’s financial gain
• Should not have constraints (e.g. on publication in research projects)
• Should not disengage or undermine or compete
Adapted from : Jonathan R. Cole The Research University in a Time of Discontent
Various kinds of mentoring
Traditional one-to-
oneE-mentoring
Peer mentorin
g
Team Mentorin
g
Group mentorin
g
• Mentors feel satisfaction in doing something worthwhile, having fun, and building a long term relationship.
In traditional, e-mentoring
and peer mentoring:
• Time with students, group/team structure, and training are all seen as beneficial and meaningful.
In team or group
mentoring:
Types of mentorin
g Program
s
School-based
Faith-based
Agency-based
Community-based
The effect of a good mentor on the academic career• The influence of the mentor begins with
collaboration.• Collaboration increases student’s
productivity and academic placement .• Collaboration increases student’s later
publications and citations.
Adapted from Scientometrics Volume 7, Numbers 3-6, 255-80, 2005
BarriersStudents from UCSF, in a study conducted
in 2005, identified the following as barriers to effective mentoring:
•The short duration of courses,• Abrupt change from classroom learning
to clerkships•Limited exposure to clinicians
Read More: http://informahealthcare.com/doi/abs/10.1080/01421590500271316
References• Guidance for Mentoring
Medical Research Council
• INFORMATIONAL OVERVIEW OF TYPES OF MENTORING PROGRAMSCompiled from Mentoring School Age Children (1999) by Public/Private Ventures and MENTOR/National Mentoring Partnership, Understanding Mentoring Relationships (1992) by the Search Institute, Elements of Effective Practice, second edition (2003), MENTOR/National Mentoring Partnership, and The Connecticut Mentoring Partnership, Business Guide to Youth Mentoring.
• The importance of mentor/mentee relationships [ppt]Johns Hopkins Medical Institution
• Formal mentoring programmes for medical students and doctors – a review of the Medline literature2006, Vol. 28, No. 3 , Pages 248-257ProfessorBarbara Buddeberg-Fischer and Katja-Daniela Herta
Department of Psychosocial Medicine, University Hospital Zurich, Switzerland
• Souba W: Mentoring young academic surgeons, our most precious asset.J Surg Res 1999, 82:113-120.
Thank you
Providing Students with
Effective Feedback
What is Feedback?
“Feedback is an objective description of a student’s performance intended to guide future performance. Unlike evaluation, which judges performance, feedback is the process of helping our students assess their performance, identify areas where they are right on target and provide them tips on what they can do in the future to improve in areas that need correcting.”
~ W. Fred Miser
What is Feedback?
“Research has shown that effective feedback is not a discrete practice, but an integral part of an instructional dialogue between teacher and student, (or between students, or between the student and him/herself).”
What is Feedback?
“Feedback is not about praise or blame, approval or disapproval. That’s what evaluation is – placing value. Feedback is value-neutral. It describes what you did and did not do.”
~ Grant Wiggins
What is Feedback?
“Effective feedback, however, shows where we are in relationship to the objectives and what we need to do to get there.
“It helps our students see the assignments and tasks we give them as opportunities to learn and grow rather than as assaults on their self-concept.
“And, effective feedback allows us to tap into a powerful means of not only helping students learn, but helping them get better at learning.”
~ Robyn R. Jackson
What is Feedback? “Effective feedback not only tells
students how they performed, but how to improve the next time they engage the task. Effective feedback is provided in such a timely manner that the next opportunity to perform the task is measured in seconds, not weeks or months.”
~ Douglas Reeves, p. 227
Feedback Focus
AcademicBehavioral
Primary Purposes of Feedback
To keep students on course so they arrive successfully at their predetermined destination.
~ W. Fred Miser
“It is one thing to collect feedback about students’ progress, but if you simply collect this feedback and never use it to adjust your instruction, then you are collecting it in vain. The data you receive from grading your assignments and assessments will give you feedback about the effectiveness of your own instruction.”
~ Robyn R. Jackson
What Does the Research Say?
grade, socioeconomic status, race, or school setting….When feedback and corrective procedures are used, most students can attain the same level of achievement as the top 20% of students.”
~ Bellon, Bellon & Blank
“Academic feedback is more strongly and consistently related to achievement than any other teaching behavior….This relationship is consistent regardless of
What Does the Research Say?
“Feedback seems to work well in so many situations that it led researcher John Hattie (1992) to make the following comment after analyzing almost 8,000 studies:
‘The most powerful single modification that enhances achievement is feedback. The simplest prescription for improving education must be dollops of feedback.’”
~ Robert Marzano
Power of Accurate Feedback
Immediate impact on results Lower failures Better attendance Fewer suspensions Failure here undermines EVERY OTHER EFFORT in
curriculum, assessment, and teaching~ Douglas Reeves, Asilomar Conference 2009 Powerpoint
Feedback Timing
Good Timing
Returning a test or assignment the next day
Giving immediate oral responses to questions of fact
Giving immediate oral responses to student misconceptions
Providing flash cards (which give immediate right/wrong feedback) for studying facts
Bad Timing
Returning a test or assignment two weeks after it is completed
Ignoring errors or misconceptions (thereby implying acceptance)
Going over a test or assignment when the unit is over and there is no opportunity to show improvement ~ Susan Brookhart
Amount of Feedback
For students to get enough feedback so that they understand what to do but not so much that the work has been done for them (differs case by case)
For students to get feedback on “teachable moment” points but not an overwhelming number
~ Susan Brookhart
Strategies to Help Students Learn to Use Feedback
Model giving and using feedback yourself.
Teach students self- and peer assessment skills to:Teach students where feedback comes from. Increase students’ interest in feedback
because it’s “theirs”.Answer students’ own questions.Develop self-regulation skills, necessary for
using any feedback.~ Susan Brookhart
Strategies to Help Students Learn to Use Feedback
Be clear about the learning target and the criteria for good work. Use assignments with obvious value and interest.
Explain to the student why an assignment is given – what the work is for.
Make directions clear.
Use clear rubrics.
Have students develop their own rubrics or translate yours into “kid-friendly” language.
Design lessons that incorporate using the rubrics as students work.
~ Susan Brookhart
Strategies to Help Students Learn to Use Feedback Design lessons in which students use feedback
on previous work to produce better work.Provide opportunities to redo assignments. (Comparing
a rough draft to the rubric/criteria/exemplar.)Give new but similar assignments for the same
learning targets.Give opportunities for students to make the connection
between the feedback they received and the improvement in their work.
~ Susan Brookhart
Attaining Excellence
“Students must have routine access to the criteria and standards for the task they need to master; they must have feedback in their attempts to master those tasks; and they must have opportunities to use the feedback to revise work and resubmit it for evaluation against the standard. Excellence is attained by such cycles of model-practice-perform-feedback-perform.”
~ Grant Wiggins
References
Bellon, Jerry, Bellon, Elner, & Blank, Mary Ann. Teaching from a Research Knowledge Base: A Development and Renewal Process, New York: Macmillan Publishing Company, 1992.
Black & William, “Inside the Black Box: Raising Standards through Classroom Assessment” Phi Delta Kappan, October 1998.
Brookhart, Susan M. How to Give Effective Feedback to Your Students. ASCD, 2008.
Davies, Anne. “Involving Students in the Classroom Assessment Process” Ahead of the Curve: The Power of Assessment to Transform Teaching and Learning. Douglas Reeves, Editor. Solution Tree, 2007.
Jackson, Robyn R. Never Work Harder Than Your Students & Other Principles of Great Teaching. ASCD, 2009.
Marzano(1), Robert. Classroom Instruction that Works. ASCD, 2001.
Marzano(2), Robert. “Designing a Comprehensive Approach to Classroom Assessment.” Ahead of the Curve: The Power of Assessment to Transform Teaching and Learning. Douglas Reeves, Editor. Solution Tree, 2007.
References, page 2
Marzano(3), Robert. What Works in Schools: Translating Research into Action. ASCD, 2003.
Miser, W. Fred. “Giving Effective Feedback”
“Providing Students with Effective Feedback” Academic Leadership LIVE: The Online Journal; Volume 4, Issue 4, February 12, 2007.
Reeves, Douglas. “Challenges and Choices: The Role of Educational Leaders in Effective Assessment.” Ahead of the Curve: The Power of Assessment to Transform Teaching and Learning. Douglas Reeves, Editor. Solution Tree, 2007.
Stiggins, Rick. “Assessment for Learning: An Essential Foundation of Productive Instruction.” Ahead of the Curve: The Power of Assessment to Transform Teaching and Learning. Douglas Reeves, Editor. Solution Tree, 2007.
“Synopsis of ‘The Power of Feedback’” by Center on Instruction, 2008. [Hattie & Timperley’s research]
Wiggins, Grant. Educative Assessment: Designing Assessments to Inform and Improve Student Performance. San Francisco: Jossey-Bass Inc., 1998.
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BEDSIDE TEACHINGDr. Syed Hasan Shoaib
What is so UNIQUE ABOUT BEDSIDE TEACHING?
• IT IS A REAL LIFE SITUATION
• IT COVERS ALL THREE DOMAINS OF EDUCATIONAL OBJECTIVES• Cognitive Domain
• Psychomotor Domain
• Affective Domain
OVERVIEW OF PRESENTATION
• What is Bedside teaching
• Rights of Patient
• What is One minute preceptor?
• Process of INWARD teaching
What is Bedside Teaching?
What is bedside teaching?
• In modern times our definition of bedside teaching includes any teaching done in the presence of the patient, regardless of the setting (e.g. ambulatory clinic, inpatient ward or conference room).
•There should be “no teaching without a patient for a text, and the best teaching is that taught by the patient himself.”
HISTORICAL PERSPECTIVE
Hippocrates first two principles
• Observe all
• Study the patient not disease
Rights of Patient
DROIT – A framework of patient rights for clinical education
• Dignity is a human right that recognises the worth of every person.
• Respect is an affirmative acknowledgement of individual circumstances.
• Obligation to act in the best interests of the patient is fundamental to medical professionalism.
• Information is the foundation of healthcare decisions for patients and doctors.
• Trust in the competence and ability of the doctor is a pre-requisite for confidence.
(Lewkonia, 2011)
Teaching in Ambulatory setting
One Minute Perceptor
The “One Minute Preceptor” teaching model was developed at the Department of Family Medicine at the University of Washington,
Seattle.
See: Neher, J. O., Gordon, K. C., Meyer, B., & Stevens,
N. (1992). A five-step "microskills" model of clinical teaching. Journal of the American Board
of Family Practice, 5, 419-424.
The “One Minute Preceptor”
Questioning
Discussion
Presentation
10 Minutes of “Teaching Time”...
3 Minutes (Questioning)
6 Minutes – (student’s presentation)
1 Minute for (discussion)
The 5-Step Microskills Method
1. Get a Commitment
2. Probe for Supporting Evidence
3. Reinforce What Was Done Well
4. Give Guidance About Errors or Omissions
5. Teach a General Principle
Get a Commitment
Why?…
Encourages learner to process the information further and solve problem.
Examples...
“What do you think is going on here?”
“What would you like to do next?”
Probe for Supporting Evidence
Why?…
Helps you to assess the learners knowledge and thinking process.
Examples...
“What factors support your diagnosis?”
“Why did you choose that treatment?”
Guide Errors/ Omissions
Describe what was wrong (be specific), what the consequence might be, and how to correct it for the future
Why?… Corrects mistakes and forms foundation for improvement.
Example… “During the ear exam the patient seemed uncomfortable. Let’s go over holding the
otoscope.”
Reinforce What Was Done Well
Describe specific behaviors and likely outcomes
Why?... Behaviors that are reinforced will be more firmly established.
Example… “I liked that your differential took into account the patient’s age, recent exposures, & symptoms.”
Teach a General Principle
Symptoms, treatment options, or resources to look information up
Why?… Allows learning to be more easily transferred to other situations.
Examples… “Remember 10-15% people are carriers of strep, which can lead to false positive strep tests.”
Conclusion
Why?...
Directs remainder of the encounter.
Example…“Let’s go back in the room and I’ll show you how to get a good throat swab. Tell me when we have the results, and I’ll watch you go over the treatment plan.”
ONE MINUTE PERCEPTOR VIDEO
How is teaching done in Wards?
Ask patient permissionEstablish goals and time
limit with groupAssign each group member
a role
Enter patient room
Introduce everyone
brief overview
Diagnose learners and
PatientObservation,
Question
Conduct focused teaching
(Role Model, practice)
Discussion & feedback
Ask patient if he/she has Questions
Encourage & close by thanking
Debrief with group feedback
Follow-up with patient
Begin outside room
End outside room
4-3
SUMMARY
“Trainees do not perform required skills incorrectly on purpose…errors in
performance are typically the result of insufficient feedback. They are seldom
the result of insufficient interest or caring.”
-Westberg and Jason, 1991
180
Summary
The more the student processes and the less you say ….the more successful the encounter is likely to be.
SUMMARY
• Definition
• DROIT
• One Minute Perceptor
• PROCESS IN WARD
Adapted from Materials……
• Effective Clinical Teaching, Rohan Jeyarajah, MD and Hari Raja, MD• Lehman LS,et.al. The effect of bedside case presentations on
patients’ perception of their medical care. NEJM 1997;336:1150.• The “One Minute Preceptor”:
Time Efficient Teaching in Clinical Practice. Preceptor Development Program, developed by MAHEC. Funded by HRSA Family Medicine Training Grant # 1D15PD50119-01
• The One-Minute Preceptor &The One-Minute Observation Effective & Efficient
• Outpatient Clinical Teaching. JHUSOM Department of Neurology, December 21, 2006
THANK YOU
Applying the One-Minute Preceptor Microskills- AN EXAMPLE
• Preceptor: What do you think is going on?
• Student: I think he has upper respiratory infection, probably otitis media.
• Preceptor: What led you to that conclusion?
• Student: He has a history of repeated otitis media and currently has a fever, a painful right ear and a runny nose.
Applying the One-Minute Preceptor Microskills- AN EXAMPLE
• Preceptor: What would you like to do for him?
Student: First, I would like you to confirm my findings on the right ear. If you concur about otitis media, then we should give him some antibiotics. Since he doesn't have any allergies to medication, I think amoxicillin is a reasonable choice.
Applying the One-Minute Preceptor Microskills- AN EXAMPLE
• Preceptor: You did a good job of putting the history and physical exam findings together into a coherent whole. It does sound as if otitis media is the most likely problem. There is great variability in ear problems. The key features of otitis media that I look for in the physical exam are the appearance and mobility of the ear drum, landmarks, opacity of the drum, and mucus discharge, and in the history prior upper respiratory infections and past problems with the ears. This child would seem to fit these criteria. Amoxicillin is a logical choice for an antibiotic if the patient does not have an allergy. I'll be glad to confirm your ear exam findings. Let's go and see the patient.