SELF-ASSESSMENT FOR TEACHERS OF HEALTH WORKERS
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- SELF-ASSESSMENT FOR TEACHERS OF HEALTH WORKERS
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GILL TREMLETT
WHO OFFSET PUBLICATION No. 68
SELF-ASSESSMENT FOR
to be a better teacher
ARIE ROTEM AND FRED R. AB BATT
World Health
Organization
Geneva
SELF-ASSESSMENT FOR TEACHERS
OF HEALTH WORKERS
How to be a better teacher
ARIE ROTEM
FRED R. ABBATT
Senior Lecturer,
WHO Teacher Training Centre,
University of New South Wales,
Sydney, A ustralia
Senior Lecturer,
Department of International Community Health.
Liverpool School of Tropical Medicine.
Liverpool, England
WORLD HEALTH ORGANIZATION
GENEVA
1982
WHO Offset Publication No. 68
WHO offset publications are intended to make generally available material that
Tor economic, technical, or other reasons cannot be included in WHO’s regular
publications programme and would otherwise receive only limited distribution.
They are usually reproduced by photo-offset from typescript, rather than by
letterpress, and do not necessarily receive such detailed editorial revision as
other WHO publications.
ISBN 92 4 170068 8
© World Health Organization 1982
Publications of the World Health Organization enjoy copyright protection in accordance with
the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or
translation of WHO publications, in part or in toto. application should be made to the Office of
Publications, World Health Organization. Geneva. Switzerland. The World Health Organization
welcomes such applications.
The designations employed and the presentation of the material in this publication do not imply
the expression of any opinion whatsoever on the part of the Secretariat of the World Health
Organization concerning the legal status of any country, territory, city or area or of its authorities,
or concerning the delimitation of its frontiers or boundaries.
The mention of specific companies or of certain manufacturers’ products does not imply that
they are endorsed or recommended by the World Health Organization in preference to others of
a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary
products are distinguished by initial capital letters.
The authors alone are responsible for the views expressed in this publication.
PRINTED IN SWITZERLAND
82/5486-Imprimeries Populaires-7000
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- 3 CONTENTS
Page
Introduction
...........................................................................................................................................
5
Chapter 1.
What makes a good teacher?..........................................................
7
Chapter 2.
Planning.............................................................................................................. 16
Chapter 3.
Communication ..................................................................................................
24
Chapter 4.
Providing resources
.................................................................................
29
Chapter 5.
Counselling
........................................................................................................
33
Chapter 6.
Assessment
........................................................................................................
35
Chapter 7.
Continuing se1f-educat ion................................................................
39
Chapter 8.
Finding out
from others......................................................................
41
Chapter 9.
Evaluation instruments
Recommended reading
......................................................................
44
....................................................................................................................
59
ACKNOWLEDGEMENTS
The authors of this booklet have benefited from advice given by dozens of
teachers around the world.
An early version was given a wide circulation and
the feedback received was most appreciated.
We have done our best to incor
porate the suggestions in this revised version.
A special note of thanks is due to the late Dr Fred Katz, formerly Chief
Scientist, Division of Health Manpower Development, WHO, for his encouragement
and guidance.
The contribution of Mr Colin Flood-Page to an earlier version
of this booklet is gratefully acknowledged.
Arie Rotem
Fred Abbatt
INTRODUCTION
One of the very
We have talked to many teachers while writing this book.
best was A.
A fairly senior teacher, he was well liked by students and the
He was often described as a
students learnt a great deal during his courses.
"born teacher", but he said this was not true.
He told us:
When I was a young teacher, I made all the usual mistakes and the
students didn't learn very much.
Of course I had not had any training in
teaching so I had to learn by myself.
Steadily over the years I have
worked to improve my ability as a teacher - and I hope that I will keep on
getting better and better until I retire.
When I started teaching I soon realized that one cannot be expert at
anything without practice and a systematic attempt to improve.
This is
true whether one has a lot of natural talent or just a little.
So I talked
to other teachers about the way they taught.
I also asked students what
they thought of the way I taught.
I even asked them to suggest things that
I could do better.
Some of my teaching colleagues were horrified.
They
told me 'the students can't know enough to be able to help', or 'the
students won't respect us if we ask their opinion'.
But I persisted and
over the years I have used the advice and built it into the way I teach now.
Naturally, some of the advice I didn't use.
Some of the advice turned
out to be unhelpful.
But by always looking at the effect of my teaching, I
have been able to learn what I can do to improve.
Even now I am still
working to improve my teaching.
It's never too late to learn.
Another thing that I have discovered is that it isn't only the students
who benefit - but I do myself.
For me, teaching is always interesting
because I am always trying different ideas to find out how they work.
This book is based very much on the philosophy that A put into practice.
The main parts of this approach are:
- Teaching is an activity involving a number of skills.
be developed and improved.
These skills can
- Teachers can improve their own skills by critically examining what they
do and with what effect.
6
- Feedback from students and colleagues helps teachers identify aspects of
their teaching that can be improved.
- There is no single method of teaching well.
Each teacher should adapt
his methods to his own capabilities, to the students, to the situation, and to
the nature of skills and competencies that are to be learnt.
Therefore the aims of this book are to:
1.
Suggest some ways for teachers to assess the effectiveness of their
teaching.
2.
Stimulate teachers to use these methods in monitoring their teaching
on a regular basis.
3.
Offer some specific suggestions that teachers may like to use in their
teaching.
To this end, this book includes a number of checklists for you to assess
your own teaching, and several assessment instruments that will enable students
and colleagues to give you feedback.
It is not assumed that you will use all these instruments.
What we hope
is that you will use at least several of the instruments, that you will adapt
some instruments or maybe develop new ones, and above all that you will
regularly spend some time thinking about your teaching and how you can improve
it.
7
1.
WHAT MAKES A GOOD TEACHER?
To teach is to help people to learn.
Teaching is effective if it results
in desirable learning.
In teaching health care, the fundamental aim is to
prepare students to provide effective and appropriate health care.
So the
question of how good the teaching has been can (in theory) be best answered by
finding out how well the student provides health care after the course.
In practice, this approach is not always helpful to the individual teacher.
First, learning is not affected just by one teacher.
Learning is influenced by
many teachers and by conditions over which the individual teacher has little
control.
Second, information about how graduates perform in practice often
reaches the teacher too late.
The teacher cannot use such information to help
the students affected.
Third, information about the effect of teaching alone
does not help to improve teaching because it does not tell what went wrong and
how teaching should change.
To improve the process of teaching it is necessary to consider the process
itself.
What do teachers do?
How do they help students learn?
How can
teachers find out what they should do differently?
How can they get feedback
from others that will help them teach better?
These are the types of question
we attempt to deal with in this book.
THE IDEA OF SELF-EVALUATION OF TEACHING SKILLS
To assess your own teaching we suggest that you follow a number of steps.
The first essential step in self-evaluation is to recognize that improvement is
possible for you.
If you don't believe that you can improve, this book may not
be as useful to you as it could be.
The second step is to become aware that teaching is a complex activity that
has many parts.
To study your own teaching you will need to become aware of
these parts of the teaching process.
The following section introduces six
primary teaching tasks.
The rest of the book is organized around these tasks.
The third step is to decide what aspect of your teaching you are most
interested in examining.
You may choose aspects that you are simply interested
in pursuing or that you feel need most attention at this time.
The point is
that we would like you to make a commitment to look at those aspects of your
teaching that are of greatest interest to you.
The final step involves using the materials provided in this book to make a
critical review of what you do as a teacher and the effect you have on students.
- 8 1.1
WHAT DO TEACHERS DO TO HELP STUDENTS LEARN?
At the beginning of this chapter we said that to teach is to help people to
learn.
So anything that helps learning is teaching.
This very general state
ment - while true - is not detailed enough to help you to work out how to teach
better.
So the whole job of teaching can be divided into parts, or tasks.
These include:
- Planning
- Communicating
- Providing resources
- Counselling
- Assessment
- Continuing self-education.
From this it follows that teaching should be thought of as all those activities
that the teacher does in order to help the student to learn.
The tasks
identified are not the only ones into which the total job of teaching may be
divided - but their choice represents a useful way of looking at teaching,
especially if the aim is to decide how teaching can be improved.
Each of the
tasks is explained below.
Planning
Planning as a part of teaching involves deciding:
- what students should learn
- how they will learn it (i.e., what teaching methods will be used, where
and when)
- how you will find out whether they have learnt (i.e., what kind of
assessment methods will be used and when).
9
In other words, planning involves making decisions about the whole teaching
process.
Teachers are inevitably involved in planning, at one level or another.
They may plan the overall curriculum of an institution or, at the other extreme,
they may plan how they are going to teach just one small part of a course within
a predefined curriculum.
For example, in a course for community health workers
the teacher may be told that he should cover the subject "protection of water
supplies" and that ten hours are available.
Within these limits the teacher
has to decide:
- exactly which methods of protection the student should learn about,
- whether the student needs to be able actually to protect water supplies
or just draw diagrams and write essays describing protection methods,
- whether the teaching methods will be based on providing information to
the students or whether the teacher will use the experience that
some of the students will already have had,
- whether the time will be spent on discussions or whether the students will
have time actually to protect a spring or well,
- whether the students will be tested at the end of the complete course or
whether the teacher will try to find out during the teaching how
much the students are able to do,
- whether the assessment of students will be based on written or practical
tests.
So, for all teachers, planning is part of their daily life.
Clearly,
much of the success of a course will depend on whether the planning decisions
have been made correctly.
Some guidance on this planning process is provided
in Chapter 2.
Communication
To communicate means to convey meaning, not merely to talk.
The teacher’s
task is to help students understand the meaning of concepts and to acquire skills.
To achieve this the teacher promotes the exchange of ideas with the students and
among the students.
He provides opportunities for practice and rehearsal, for
experience and feedback.
Included are such things as:
- telling, explaining, advising
- asking questions
- listening
- 10
- leading (or participating in) discussion groups
- demonstrating
- using audiovisual equipment to help in any of the above
- using techniques like role-play, simulation, and games.
The communication process is the part of teaching that many teachers are
most concerned about.
It is also the part about which it is relatively easy to
obtain helpful feedback.
For example, one teacher spent a lot of time
explaining to his class of medical assistants why, for patients who might be
suffering from pneumonia, a general antibiotic should not be prescribed before
the necessary tests had been carried out.
Yet he found that the students still
prescribed such antibiotics.
Clearly the communication process had failed.
Failures in communication will also have occurred if students say things
like:
"I can't understand what B says.
He always seems to use such long words
and makes things more complicated,"
"That graph had so many lines on it that I didn't know what it meant."
"I couldn't get close enough in the ward to see what Doctor C was doing
when he was examining that patient's thyroid."
"What D was saying didn't seem to be the same as he had written in his
hand-out."
Communication is at the heart of the teaching process.
If it is inef
fective, students may not learn at all or will learn much more slowly than if
communication is good.
Some guidance on communication and some methods of
finding out how well you communicate are given in Chapter 3.
Providing resources
The communication process is supported by various resources, which the
teacher will have to provide or organize.
Health, care teachers will use
resources such as hospitals, health, centres, and dispensaries to provide a
11
setting for clinical or nursing experience.
Homes, markets, and factories in
the community will be used as settings for data collection, exercises, and studies
of environmental factors affecting health.
Resources can also be people, particularly people in the health service.
They are especially important in teaching health care because they will be
needed for the students to make full use of all health facilities.
They are
also important in helping to supervise field studies and in providing special
expertise.
Other resources are books, journals, posters, films, self-learning
materials, educational exercises, patient management problems, health-centre
records .
In many countries teachers feel (quite rightly) that the resources are
very limited.
However, as a rule, teachers underestimate the variety of
resources available to them.
Even where there is little money and few of the
resources mentioned here, there are always some resources.
So the teacher's
job is to make the most appropriate use of whatever resources there are.
Teachers should always consider what resources exist or could be made
available at little or no cost.
Sometimes teachers should develop or adapt
their own resources.
Some ways of assessing how well you use the available
resources and some ideas for resources you might use are given in Chapter 4.
Counselling
Counselling is not concerned with teaching knowledge or competencies;
rather it is concerned with helping students to deal with learning or personal
problems.
In some schools and colleges there are staff appointed to take this
responsibility.
A more common situation is that students turn to teachers or
other students for help on a less organized basis.
Even where counselling is
highly organized, students will still tend to seek help from teachers whom they
trust, so all teachers are potentially involved.
This counselling task is an
important part of the overall teaching process, since students with serious
personal or general problems are unlikely to be able to learn effectively.
12
Sometimes, the teacher needs to take the initiative, particularly with
students who under-perform.
Capable students may fail to reach an appropriate
standard owing to bad study habits or extraneous factors (social, psychological,
economic).
It is also possible that a student embarks on the wrong course of
study in spite of the selection process.
In all these cases, it is important
to find out why students perform at a level below their ability and to help
students overcome difficulties that stand in their way.
Teachers may well feel uncomfortable or uncertain when they are counselling.
They may not want to be involved in students' personal affairs.
They may feel
that other matters are more important.
They may feel worried about the way in
which they listen to students' worries and the way in which they help students
to find their own solutions.
Counselling techniques and ways of evaluating your own counselling skills
are given in Chapter 5.
Assessment
Assessment involves the design, administration, and interpretation of tests.
It is used to provide detailed information on student progress, to certify that
students are competent to practise and, most importantly, to guide their
learning.
This process includes observation of students' performance and
examination of their knowledge at frequent intervals.
In some institutions the responsibility for setting and marking the final
examination is taken by external examiners or a restricted group of senior
teachers.
So some teachers might feel that assessment is not their
responsibility.
However, assessment is an important part of teaching throughout
a course.
Teachers should always be trying to find out how much students are
learning so that they can adapt their teaching to what the students know.
Concerns about examinations and assessment are often expressed when teachers
say things like:
"A was a much better student than B, but he hasn't got the right examination
technique."
"Even though C passed quite comfortably, I don't think he will be any good
as a health- inspector."
13
"I spend my time teaching students how to work with patients, how to
communicate and listen.
Then they are judged by their performance in
answering multiple-choice questions,"
"I really don't know whether the students understand what I'm saying or
not."
"How could they answer that exam question so badly?
they understood and nobody said that they didn't."
I asked them whether
You can check how you use the assessment methods and for what purposes tn
Chapter 6.
Continuing self-education
Knowledge about health and health care is developing continuously.
This
knowledge is partly to do with understanding the processes of diseases and their
treatment, partly to do with methods of preventing diseases and methods of
organizing health care services.
These developments clearly have implications
for what students should learn during their health care training.
So teachers
have an obvious responsibility to keep up to date in their own field, as well as
in trends in health care generally.
Yet it is often the case that teachers do have difficulty in keeping up to
date, partly because of limited opportunities, partly because of the competition
of other interests and activities.
Some help in deciding how well you are keeping up to date and some
suggestions for how you can continue your self-education are given in Chapter 7.
1.2
HOW WELL DO TEACHERS PERFORM?
So far six main tasks of teachers have been described.
At this stage you
may want to think about whether these tasks correspond to the work you do as a
teacher,
A checklist is provided overleaf and you are invited to decide whether you
do the following things in your teaching.
The numbers beside each item show the
chapter and subsection in which more detailed checklists are to be found.
Planning
2.1
Decide what students should learn (prepare learning objectives).
2.2
Put the content in a suitable sequence.
2.3
Allocate amounts of time to different learning activities.
2.4
Select learning activities and teaching methods.
2.5
Choose assessment procedures (including methods and timing).
2.6
Identify resources needed.
2.7
Inform the students about the plan.
Communication
3.1
Tell, explain, advise.
3.2
Help students to exchange ideas.
3.3
Provoke students’ thinking.
3.4
Use varied teaching techniques.
3.5
Detect whether students understand.
Providing resources
4.1
Prepare, select, or adapt educational materials (hand-outs,
exercises, books).
4.2
Arrange learning experiences, especially opportunities to practise
skills (field visits, attachments, projects).
4.3
Involve health service personnel in teaching.
4.4
Arrange access to materials (such as libraries, audiovisual
programmes, microscopes).
Counselling
5.1
Show students that you care.
5.2
Help students identify their options and make their decisions.
5.3
Provide advice and information that helps students.
Listen and attempt to understand.
15
Assessment
6.1
Design an assessment that measures how much students have learnt.
□
6.2
Use the assessment to guide students' learning.
□
6.3
Use the assessment to give feedback, that modifies teaching.
□
6.4
Use the assessment to decide whether students are competent to
provide health care.
6.5
Encourage students to use self-assessment and peer assessment.
Continuing self-education
□
□
7.1
Know the subject matter that is taught and where to find relevant
information.
7.2
Know the way in which health care is provided locally.
7.3
Set an example as a continuous learner.
Having considered whether you do each of these tasks, you may wish to review
the list again and choose aspects of teaching that are of greatest interest to
you.
- 16
2.
PLANNING
B is a popular teacher.
His various courses on environmental health are
attended by nurses, medical assistants and health inspectors in the College of
Health Sciences.
Almost all the students enjoy the lectures because B has
always been able to make his subject of interest.
He uses a joke now and then
and he gives lots of examples from his own experience in the field.
Recently he met one of his former students who had worked as a health
inspector for several years and asked him "How are you getting on?".
Their
families had known each other for many years and so the former student felt free
to make some very direct comments.
He said "I'm doing quite well now and was
promoted six months ago.
But for quite a long time I did find it very difficult
to do the work I was expected to do.
As you may remember, I was a good student,
but when I got into the field things were different.
In the college I learnt a
lot of facts, but when I got into the field I needed to apply them - and I didn't
know how.
Let me tell you about what happened in the first few weeks.
I was
inspecting houses down near the harbour to check for mosquito breeding sites and
I found one house where the gauze protecting the water was broken.
I told the
householder about this and told him to put it right.
He immediately became very
cross and said 'Who are you to tell me what to do in my house?
You people from
the government interfere too much.
It is my business whether I repair the gauze
or not.'
Now I realize that I approached him in the wrong way, but I went on to
explain how mosquitos breed where there is still water and how mosquitos transmit
malaria.
'What do you mean transmit? - they aren't radio stations.
Anyway
mosquitos can't cause malaria.'
I ended up by my calling him ignorant and he
was very cross-and refused to mend the gauze.
It was a disaster."
The former student went on "When I thought about it, I realized that we had
been told in lectures all about malaria and the life-cycle of mosquitos, but we
had not had any practice in explaining these ideas to ordinary people.
In the
exams we had to talk to examiners - but they are quite different from these
people who live near the harbour."
B didn't know whether to be insulted or whether to try to improve his
teaching as a result of this conversation.
In the end he decided that he did
have something to learn and that he would have to reconsider the whole plan of
the part of the course that he taught.
This case indicates some of the things that can go wrong with a course even though students and colleagues may think it is taught well.
Preparing the
right plan is the most essential step.
The plan is based on assumptions that
every teacher makes — either consciously or unconsciously.
The following form
may help you clarify your own assumptions.
17
COURSE ON
.
.
.
Teaching assumptions:
That I have to prepare students for the following major professional
tasks:
- That in my course students will learn the following competencies needed
in courses that follow:
- That students will have learned the following before commencing the
course:
That students will be able to devote _______ hours a week to learning in
this, course.
- That the following resources will be available to me:
Your assumptions may be accurate, or they may in some instances be false.
It may be worth while checking how accurate they are.
B had made some assumptions that were incomplete - for example he had
assumed that his students needed to "know about the life-cycle of the mosquito",
but he didn't realize that they would also have to explain this to ordinary
people.
Consequently he didn't give the students an opportunity to practise
explaining - he didn't even tell the students how to explain.
These false assumptions can be reduced if teachers plan their courses
thoroughly.
Overleaf is a checklist of things that teachers can do when
preparing for a course.
It is for you to decide your own standards and whether
each, item is relevant to you in your situation.
18 -
2.1
DECIDING WHAT STUDENTS
SHOULD LEARN
This aspect of planning is at the heart of good teaching.
Some teachers
will be designing a course starting from a blank sheet of paper.
Others will
need to work out how a given syllabus will be put into practice.
In making these decisions do you:
Find out where the students will be employed and what jobs they will be
doing (both now and in the future)?
This can be done by:
- reading the national health plan, looking at job descriptions, reading
professional manuals
- talking with supervisors, former students, practising health workers, to
find out exactly what they are doing and what the students need to learn
- observing field conditions to identify what resources are really
available
- observing workers in their jobs to identify what kinds of problem they
need to solve, what judgements they make, what skills they use (including
communication and decision-making skills).
Find out how your part of the course is related to the other parts?
This can be done by:
- listing the knowledge and skills that you assume students will have
before starting your part of the course
- finding out whether they have been taught - and whether they have been
learnt by all students
- asking what other teachers expect students to learn during the part of
the course that you teach.
- 19
2.2
PUTTING THE CONTENT IN A SUITABLE SEQUENCE
When the content has been decided you should arrange the ideas and skills
in the order in which they will be taught,
Have you arranged them so that:
the teaching relates new experience to what has been recently learnt?
unfamiliar ideas are presented after the more familiar ones?
simpler ideas or skills are learnt before more complex ideas and skills?
2.3
ALLOCATING TIME
When you are planning the amount of time that the students will spend on
each part of the course, do you:
estimate how much time will be required for the students to achieve
competence in each of the objectives (including time needed for practising
skills)?
compare the times needed for each of the parts with the total time
available - then adjust what is to be learnt in line with the
priorities?
take account of competing demands for students’ time (e.g., other courses,
travelling, etc.)?
take account of the time when other resources (such as laboratories or
health centres) will be available?
use past experience of the amount of time taken by students on previous
courses to achieve similar objectives?
2.4
DECIDING ON LEARNING ACTIVITIES/TEACHING METHODS
Do you think about the kinds of experience that students will need during
the course so that they can practise the patterns of thinking and the practical
and communication skills that they will use in their job?
20 In particular, do you:
I-J
plan to use teaching methods that involve the students in activity rather than allowing them to be passive?
□
plan to use activities that involve the students in working in the field,
with patients or members of the public?
□
plan activities that are sequenced in order of increasing complexity
(e.g., if the task were to identify a particular parasite, a sequence
might be to identify it from: a written description - a diagram - a
photograph - the actual parasite)?
choose methods that give plenty of opportunity for students to apply
factual learning in problem-solving situations?
plan to use a wide variety of methods?
□
plan methods that are consistent with the available time, space and
equipment ?
plan to use methods that you are comfortable with - and that the students
are able to adapt to?
2.5
CHOOSING PROCEDURES TO ASSESS STUDENTS AND EVALUATE THE COURSE
When you plan the procedures to assess students and to evaluate the course
you need to consider how you will obtain information about the students'
abilities, when you will do this, and what you will do with that information.
So when you look at your plan you should ask yourself whether you:
□
decide which are the really important student competencies to assess
(i.e., which are the skills in communication and decision-making that are
crucial to the students’ ability to provide appropriate health care)
□
choose methods that are most suitable for assessing the kinds of
competencies that you want to observe (an essay or multiple-choice
question is not a good way of finding out whether or how well a student
weighs a baby, digs a pit latrine or operates a defibrillator)
□
choose methods that are consistent with the existing rules of the
institution and are practical in view of the available manpower and
other facilities and resources
- 21
plan how the information from the assessments will help students to
learn and help teachers to improve their teaching
plan how to assess your own teaching and the course as a whole - both
during the progress of the course and after it ends
know what the students are like (this involves knowing what they already
have learnt and knowing something of their general experience before the
course, how hard they can be expected to work, how well they are motivated,
and what they hope to achieve)
Such information can be obtained by:
- interviewing some of the students
- using pre-course questionnaires or asking students to prepare a
statement
- using opportunities for informal discussion.
□
select priorities for what has to be learnt (there never seems to be
enough time for students to learn everything that might be useful - so
some things have to be left out)
state what students will learn in terms of what they will be able to do
(i.e., the tasks they will perform, the kinds of decisions they will make)
□
select the content that will be needed (this can be done by analysing the
the tasks to determine what students should know in order to perform their
tasks).
For a detailed description of "task analysis", see Chapter 4 in
Abbatt, F. R. Teaching for better learning, 1980 (available, on request, from
Division of Health. Manpower Development, World Health Organization,
1211 Geneva 27),
- 22
2.6
IDENTIFYING RESOURCES,
OPPORTUNITIES, AND CONSTRAINTS
Although this issue is mentioned last it should take place throughout the
planning process.
It is not worth while to decide to use sophisticated
audiovisual equipment that cannot be made available.
Equally, there is little
point in finding out whether particular equipment is available if you are
unlikely to need it.
On the whole you should start with the educational goals,
choosing methods that will most effectively achieve these goals, then modifying
the methods to suit the resources.
However, you should identify the resources available and use this knowledge
to explore opportunities that have not previously been fully exploited.
To decide how fully you have identified resources, you should ask yourself
whether you have found out about:
facilities - rooms (their size, how many seats, whether the seats can be
moved, whether the room can be darkened for films or slides,
when the laboratories, wards, health centres, outpatient
department are available to students]
□
□
equipment
- microscopes, audiovisual equipment such as models, slide
projectors
people
- patients, people in the community, health service personnel,
other students who might take a part in the learning process,
laboratory and technical personnel
support
- the administrative and secretarial facilities, technical and
laboratory services, educational support services
timetable
- the time available (both the total amount and the way it is
divided up)
possible modifications of the plans to make use of the appropriate
resources available (especially the resources of the community) and to be
consistent with any constraints.
23 INFORMING THE STUDENTS ABOUT THE PLAN
2.7
Did you:
|
tell students what they are expected to achieve in this course?
i
|
incorporate students' expectation of the course in your plan Ce.g., include
in the course issues or activities that are of special interest to
students)?
|
i
discuss with students the methods, learning activities and resources used
in the course?
|
j
find out whether they understand the plan and accept the directions you
proposed?
u
3.
COMMUNICATION
Dr C joined our teaching staff after a brief but very successful career in a
district hospital.
There was no doubt that he knew his subject matter but when
he began teaching his students almost revolted.
They said that Dr C was talking
way over their heads.
As one student put it "Dr C knows his material but not
his students".
Dr C was naturally concerned.
He could have thought that the
students were not trying hard enough, but being enthusiastic about his new job he
decided to find out what he could do to change the situation.
In reviewing his teaching, Dr C was aware that he didn't quite know how to
translate his ideas about what students should learn into appropriate educational
activities.
He then proceeded to find out more about what his students had
learnt in earlier courses.
He decided to encourage more participation by assigning study problems
before each tutorial so that students could prepare themselves for discussion.
He then organized his presentations around the study problems and was pleased
to find out that students were more involved and that he in turn had opportunities
to find out what they did not understand.
3.1
TELLING AND EXPLAINING
Telling and explaining are central to much of teaching and the extent to
which students learn is clearly affected by how well facts are told and areas of
uncertainty explained.
However, it should not be assumed that the telling and
explaining can be done only by the teacher.
Other students, books, manuals, and
self-learning programmes are all important methods.
Nor are telling and
explaining limited to facts; all the practical, communication, and decision
making skills, as well as attitudes, will usually need some explanation.
You can check, whether you:
identify the major points of an argument or the crucial aspects of a
procedure and give them emphasis.
organize the main ideas into an order that is logical and can be followed
by the students
show the relevance of the facts or arguments or skills to the students so
that they wi.ll want to learn
provide many and appropriate examples and illustrations to make clear what
is meant by general statements and concepts
25 -
use printed materials [books, manuals, hand-outs) or other self-learning
materials [e.g,, tape-slide programmes, films) to provide the information
or explanation when these are available and appropriate
give students a chance to react to explanations and to assimilate the
ideas.
This can be done by pausing, asking questions that involve
students in applying the information to a new situation.
3.2
HELPING STUDENTS EXCHANGE IDEAS
Much learning takes place when students have to clarify their own thinking
in order to explain to other students.
Students may also learn better when
listening to other students making the explanation.
So an important part of
the communication task is to help students to exchange ideas.
You can gain some idea of whether you are doing this well by asking whether
you:
choose appropriate issues for discussion.
if it:
An issue will be appropriate
- involves judgement and application of facts rather than just memory of
facts
- allows students to use their own experience
- is of interest and importance to students.
stimulate rather than close discussion.
This can be done by reflecting
back questions for students to answer, rather than acting as the source of
all information
focus discussion.
This means summarizing points of disagreement,
specifying where disagreement occurs, and keeping discussion to the point
give all students opportunities to contribute.
This will involve
discouraging the people who talk too much [possibly including yourself)
and providing for those students who talk less - for example, by inviting
them to talk about their own experiences, giving them opportunities to
express, their opinion on specific issues, or leading them through the
steps of an argument.
26
3.3
PROVOKING STUDENTS TO THINK
An essential stage in learning is to use facts and ideas, to explore their
implications in different situations.
If this thinking about the facts and
concepts does not take place then the amount learnt will be very much reduced.
Another reason for stimulating thinking is that the provision of health care
is not a blind routine of following procedures.
All the time, the health worker
(at every level) is considering evidence, applying factual knowledge to new
situations, and making decisions.
For all of these reasons it is vital for teachers to provoke the students to
think.
You can assess whether you do this by deciding whether you:
ask. questions that require students to apply knowledge in new situations
□
provide case studies, patient management problems, or simulation exercises
for students to work through, either individually or in small groups
ask students to apply principles to a context with which they are
familiar ("How would you control mosquitos in your village or town?” or
"How could people adapt their diet in your village or town so that they
increase their intake of protein?")
ask students to test advantages and disadvantages of a proposed course of
action (e.g., what are the pros and cons of referring an expectant mother
to hospital for the delivery of her third child?
Details of the mother's
weight, nutrition, family circumstance, distance from hospital, quality of
health care available in both the hospital and at home, should be provided)
pause, wait for questions, respond warmly to questions, enjoy the debate.
You can assess your effectiveness in provoking thought by observing the
response of students.
Are they eager to ask questions and to take part in
exercises and debate?
Or do they tend to remain passive, lethargic, uninvolved?
- 27
3.4
THE VARIED TEACHING TECHNIQUES
Variety makes learning more
Variety is desirable in its own right,
It is important to fit the method
interesting.
But there are other reasons,
Further, different methods of
of teaching to what students need to learn,
teaching are needed to fit different styles of learning.
The overall principle is to involve the students in active participation in
a variety of ways.
Do you us.e the following techniques- in your teaching?
Role-play - to stimulate thinking, to help students become more sensitive
to feelings and to help students practise communication skills
Field projects - to allow collection, analysis, and presentation of data
Exercises, case studies, and patient management problems - to give
practice in applying principles and facts to specific situations
Self-learning programmes and textbooks - to stimulate independent
learning skills, which will be necessary throughout every health worker's
career in his continuing education
Use different locations for learning - health centres, the community,
patients' homes, laboratories, wards, outpatient departments
Allow different students to learn the same competencies in different ways
(e.g., some might attend a lecture while others use reference books,
tape-slide programmes!.
3.5
FIND OUT WHETHER STUDENTS HAVE LEARNT
As one teacher told us "
my presentation seemed quite clear and useful.
I felt enthusiastic and the students seemed to be responding.
To use some eoctra
time I had I asked them to discuss in small groups how they would apply the idea
in the dispensary.
Half an hour later I realized that, as far as the students
were concerned, my initial presentation was at best incomplete and at worst a
source of confusion.
I had to start again, but T am glad I detected this
confusion in good time".
28
The checklist below suggests some of the things that you can do to find out
how much your students have learnt.
Do you:
stop regularly to invite questions?
ask questions regularly and ask everyone in the class to write down the
answer?
ask questions and provide alternative answers?
Then ask the students to
select one of the alternatives and indicate their choice by a show of
hands or b.y using different coloured pieces of paper?
talk informally with students and ask them what they have learnt during a
session?
set assignments and carefully study the students' work to identify areas
of misunderstanding?
study examination performances so that areas of difficulty can be
explained and so that teaching on future courses can be improved?
use tests of practical decision-making and communication skills fairly
frequently so that feedback can be obtained and used?
- 29
4.
PROVIDING RESOURCES
Providing resources is another way of communicating with students and of
helping them to learn.
A separate chapter is devoted to it so that this aspect
of communication is given particular emphasis.
Providing resources is very
important in teaching health care,
pt would be impossible to think of an
effective training for any aspect of health care that did not involve a
substantial element of integration with the health care services.
And so the
providers of health care become one of the major resources to be used in training
programmes.
All teachers have access to some resources.
Some have many resources to
choose from; others are less fortunate.
The concern of this book is not to
change the resources that exist, but to help you decide whether you are making
the best use of these opportunities.
It will depend on identifying the various
resources, adapting or selecting from these resources, and then using them to
maximum effect.
The guiding criterion for use is similar to the criterion for
choice of teaching methods: do the resources provide opportunities for learning
and practising important competencies?
4.1
SELECTION,
PREPARATION,
AND ADAPTATION OF RESOURCES
D taught medical assistants in a country where there never seemed to
be enough money to purchase materials.
Consequently, he had to depend
very much on his own initiative.
He found from a friend in another college
a place where he could obtain posters and slides very cheaply.
In spite of
the delays in postage and at customs, the materials did arrive eventually.
He found that some parts of the materials weren’t suitable for his students,
but he was able to adapt them by leaving out some parts and changing others.
D also formed a good friendship with the staff of the nearby health
centre and was able to arrange for his students to spend some time in the
health centre - an arrangement that worked well because when the students
got more experience they were able to do some of the work of the health
centre and so free the staff to do a bit more teaching.
The students were
able to join in the work of surveying the local communities’ health needs a job that the health centre staff were meant to do, but to which they had
never been able to devote enough time.
D had been able to adapt and use the resources that were available to
him.
The checklist overleaf gives some questions that will help you find
out how well you are making use of the resources available to you.
- 30 -
Do you:
I
|
know what resources (people, facilities, equipment) are available?
This.
knowledge comes -from talking with colleagues in your institution about the
resources, they us.e, contacting the health services locally to find out who
would be willing to help, and contacting aid agencies and educational
groups to find out whether they have any useful materials.
□o you use such resources as
- people
- health workers, community workers, patients, teachers from
other institutions, students helping each other?
- materials
- hand-outs, journal articles, manuals and library books,
lecture notes, films, tape-slide programmes; equipment
used in laboratories, clinics; audiovisual equipment?
- facilities
health centres, hospitals, dispensaries, laboratories?
select or adapt resources that are appropriate for the learning
objectives?
select or adapt resources that are consistent with the local situation
and the students' abilities?
(Textbooks from other countries may deal
with different kinds of disease or assume different areas of
responsibility for a particular category of health worker.
Levels of
language may be inappropriate, especially when students are reading a
language that is not their mother tongue,)
us.e resources that complement the other aspects of the teaching?
(If
you use a film to explain a particular idea, you probably will not want
to explain the same idea in a lecture.)
use hand-outs and references to pages in manuals to free students from
some of the need to write notes. - and free the teacher from the need to
cover some topics?
use written materials, (e.g., hand-outs) where specific information
(e.g., the name and dosage of a drug) must be recorded accurately?
4.2
INVOLVING HEALTH SERVICE PERSONNEL IN TEACHING
Health service personnel are often involved in the training of many types of
health worker.
They can pass on their own immediate experience of providing
health care, and they can often arrange for students to obtain direct experiences
31
of working with patients and working in the field.
This is clearly valuable
for students since it allows them to see the reality of the service conditions
and so provide a guide to what they will need to learn.
It is also valuable to
the service personnel since the contact with students offers some variety in
their routine and may prove to be a stimulus to the service personnel to continue
their own education.
However, this potential value may not be fully realized unless the teacher
organizes the experiences suitably.
The checklist gives some guidance on
whether you are doing this.
Do you :
.
|
involve the health service personnel in planning what learning activities
should take place?
I
identify what the students should learn while they work with the health
service personnel?
explain to both the health service personnel and the students what
learning experiences are planned and what should be learnt from them?
|
|
provide full information to the health service personnel about what the
students will already know, and about who the students are?
!
j
monitor the effectiveness of the experiences with health service personnel
and provide feedback to both students and health service personnel?
4.3
ARRANGING ACCESS TO MATERIALS
When you have adapted and selected the materials and resources, they must
be made available.
In one institution, students on a 12-week course were able
to use tape-slide programmes during only one week of the course.
In another,
the library was open only during the time when almost all the students were in
lectures or laboratories or wards.
When the library hours were changed so that
the library was open when students did not have other scheduled commitments, the
library books were used very much more.
When arranging access to resources do you:
i
make sure that the resources are available at a time and place such that
students can use them?
- 32 -
check that the students are able to use the resources available?
(Do
they know how to -find a particular book in the library or use any
audiovisual equipment?)
check that the people controlling resources (including wards, libraries,
etc.) are available at the time when students may need help?
check that students know what resources are available, what they can
learn by using them, and how they relate to the rest of the course?
check how much each of the resources is actually used - and identify and
correct causes of under-utilization?
33 -
5.
COUNSELLING
If counselling is successful, students will feel comfortable in approaching
the teacher for advice about educational and personal matters.
The teacher's
relationship with them will be one of mutual respect and support.
Personal
crises associated with the course will be kept to a minimum.
Counselling can be thought of as taking place in three modes.
A checklist
to help you discover how well you perform each of these parts of the counselling
task is given below.
5.1
SHOW THAT YOU CARE:
LISTEN AND ATTEMPT TO UNDERSTAND
Do you:
|
set a time and place when you will be available to meet students
individually?
notice students who appear to have learning difficulties or personal
problems that affect their ability to learn?
|
|
show that you are interested when a student talks to you about his
difficulties?
|
|
help the student to clarify the essential nature of the problem?
This
may be done by rephrasing the problem, or asking questions such as
"Do you mean . . . ?"
|
avoid gestures and tones of voice that indicate an aggressive, critical,
or harsh response to the problem?
|
|
avoid seeing the problem from your own point of view in the light of your
own values and beliefs?
i
|
avoid interrupting - allow the student to be silent while he decides what
to tell you?
;
|
when you don't understand some point, explain that you don't understand
rather than try to hide your confusion?
34
HELP STUDENTS TO IDENTIFY THEIR OPTIONS AND IDENTIFY THEIR
OWN DECISIONS
5.2
Do you:
I
i
encourage the student to state what he sees as the alternative ways of
coping with the problem?
|
i
help the student to work, out the costs and benefits and the risks of each
alternative course of action?
I
|
help the student to analyse the present status of the problem and to
define the outcome of the proposed course of action?
i
j
avoid taking the decisions for the student?
□
remain patient?
PROVIDE ADVICE AND INFORMATION TO HELP STUDENTS
5.3
Do you:
|
j
refer the student to other people or agencies who might be able to help?
- 35
6.
ASSESSMENT
The central purpose of assessment is to monitor student learning.
This is
done in order to guide students' learning, modify teaching methods, or decide
whether the student is competent to move on to the next part of the course or to
qualify as a health worker.
For some learning objectives, it is harder to decide whether students have
reached the required standard than for others.
For example, if the objectives
are not very precise, they will lead to difficulties in assessment.
Other
objectives may present difficulties, even though they are precisely stated,
simply because they are intrinsically difficult to measure.
For instance, it is
easier to find out whether the student can list the signs and symptoms of
measles than to assess his ability to persuade mothers to bring their children
for immunization.
Yet, the latter task may be an essential aspect of the health
worker's job.
Therefore, teachers may be tempted to assess those things that are easy to
measure rather than those things that are important to measure.
For example,
it would be totally useless to try to assess the students' ability to diagnose
diseases common in their country by asking multiple-choice questions that test
only their recall of information.
Teachers should appreciate the impact of tests on students' learning;
changing the examination system has a much more profound effect on learning than
changing the rest of the curriculum.
In general, assessment will be successful if:
- it measures what it is supposed to measure accurately (i.e., possesses
high validity)
- it measures precisely (i.e., possesses high reliability)
— it measures in an efficient manner in terms of the cost of its
administration and scoring
- it serves the purpose for which, it is used, e.g., if it is used to
identify learning deficiencies it should provide sufficient information
to plan a remedial programme.
The following checklists will help you to assess your own performance in
assessing students.
36
DESIGN ASSESSMENTS THAT MEASURE HOW MUCH STUDENTS HAVE LEARNT
6 .1
Do you:
I
decide what the information from the assessment will be used for (e.g.,
guiding students’ learning, improving teaching methods, deciding whether
students pass or fail)?
|
decide on the important objectives or competencies that you want to assess
before deciding on the assessment methods?
|
use assessment methods that measure the type of skill or competence that
you have decided is important?
(Writing essays is a poor way of assessing
how well students can communicate with patients; observation using a
checklist would be better, though it would be more time-consuming.)
□
use methods that minimize subjective judgements by the assessor (e.g., use
checklists to guide observations, use multiple-choice questions rather than
essays to assess ability to recall facts)?
|
use a variety of methods and people in assessment so that judgements may
be based on a broad base of evidence?
i
|
j
□
6.2
assess frequently enough to sample adequately the whole range of
competencies that are important?
USE ASSESSMENT TO GUIDE STUDENTS'
LEARNING
Examinations and tests influence what students try to learn.
The results
of examinations and tests can be used to guide students about where they need
to put in more effort and where they have reached a satisfactory standard.
Hence teachers can use assessment to guide student learning.
In order to achieve this, do you:
i
|
(This
provide students with detailed information from all assessments?
may be in the form of written comments, a filled-in checklist, or a
An
detailed analysis of performance on multiple-choice questions.
overall score or impression would be inadequate.)
study the students' performance in an assessment to identify areas of
common weakness or misunderstanding?
(The results of this study must be
passed on to the students.)
- 37
I
I
provide opportunities for students to discuss the feedback with a view to
identifying learning activities that will correct the weaknesses?
i
conduct the assessments sufficiently early in the course and sufficiently
frequently to allow students to put right their weaknesses?
USE THE ASSESSMENT TO GAIN FEEDBACK IN ORDER TO MODIFY TEACHING
6.3
The results of examinations and tests have implications for the teacher.
If a high proportion of students experience difficulty in a particular area, the
teacher may wish to:
- examine the reasons
- provide further teaching in this area
- modify the teaching approach in future courses.
When using assessment to guide your teaching do you:
analyse the performance of students to identify areas of common
difficulty or uncertainty or incompetence?
discuss with students why they found the area or skill or competency
difficult to learn?
|
|
review the way in which you taught each of the areas identified above
(with a view to improving the way you teach it next time)?
provide further teaching to overcome any learning difficulties?
use assessment early enough in the course so that there is time for
remedial teaching?
6.4
USE THE ASSESSMENT TO DECIDE WHETHER STUDENTS ARE COMPETENT
TO PROVIDE HEALTH CARE
Often assessments are used to determine whether students are competent to
practise as doctors, nurses, medical assistants.
Clearly this decision should
be based on comparing the standard of the individual student's performance with
some clear criterion of the necessary performance.
Yet in practice this is
difficult.
This is because of the complexity of setting criteria for the whole
range of activities in which, health care personnel are necessarily involved.
38 Nevertheless, it is important to identify standards in those tasks that are
assessed.
The standards should be related to what is acceptable as adequate
health care - rather than comparison with the performance of other students.
When deciding whether students should pass or fail:
do you attempt to define standards of adequate performance?
|
’
do you set criteria (standards] for the individual competencies that are
assessed?
□
are you confident that students who pass are really competent to provide
health care?
Are you also sure that the ones, who fail are not competent?
ENCOURAGE STUDENTS TO USE SELF-ASSESSMENT AND PEER ASSESSMENT
6.5
There are two main benefits from encouraging students to assess themselves
and to assess each other.
These are that:
- the self and peer assessments will help learning
- the attitude and skills required in assessing their own performance are
essential throughout their career.
Self-assessment is the basis for
continuing education and the further development of competence.
Do you:
!
1
encourage students to think ahout and define the standards that they wish
to achieve?
|
|
ask students to assess their own performance in detail?
(This may be
after they have completed some field work or work with patients.
It may
be after completion of a written assignment.
The aim is not so much for
the students to give an overall rating such as "quite good"; rather it is
for them to decide in detail which aspects are good, which aspects need
improvement, even how the performance could have been bettered.)
i
|
provide opportunities for students to assess each other’s work?
I
J
provide support materials (such as guidelines or checklists] that will
help the students to carry out assessments of themselves or each other?
- 39
7.
CONTINUING SELF-EDUCATION
Teachers should constantly upgrade and update their knowledge of the
subject they teach, because involvement in personal learning is a necessary
condition for being an effective teacher.
It is equally important for teachers
of health workers to be aware of developments in health services, particularly
in areas in which their students will be employed.
The preparation of this
book reflects our belief that teachers should also continue to develop their
skill as teachers.
Use the following checklist to explore what you are doing in your own selfeducation .
KNOW THE SUBJECT MATTER THAT IS TAUGHT
7.1
Do you:
read publications in your area of teaching, including manuals, textbooks
and reports?
visit other educational institutions to observe how the subject you are
concerned with, is taught?
■
|
|
discuss the subject matter with colleagues who have similar expertise?
I
:
attend workshops, seminars, and lectures in your subject and related areas?
□
make sure that you know where to find additional information about
developments in your subject and the way it is being taught?
7 . 2
KNOW THE WAY IN WHICH HEALTH CARE IS PROVIDED LOCALLY
Knowing the setting in which students will work and the jobs they will
perform enables teachers to help students learn relevant skills.
Conditions in
the field change constantly, new procedures are adopted and the roles of health
workers change.
It is important that teachers adapt to these changes.
Do you:
!
|
visit health, facilities in communities where your students will work?
|
|
review health, service organization and management including national health
plans and other policies concerning manpower development?
- 40 -
|
observe and discuss current practices and probable developments with
health practitioners?
modify your teaching to emphasize present conditions and to enable
students to practise current procedures?
foresee probable future developments in health care and modify your
teaching accordingly?
BE A CONTINUOUS LEARNER YOURSELF
7.3
Students often learn more from what the teacher does than from what the
teacher tells them they should learn.
The teacher’s behaviour and attitudes
provide an important learning model.
To convey to students that learning is a
never-ending process, the teacher must be a continuous learner himself.
Do you:
acknowledge gaps in your knowledge?
|
set targets for your own professional development?
□
consult others who may contribute to your knowledge?
|
attend continuing education activities?
|
make notes of new ideas and developments you may come across?
believe that you can always learn more?
- 41 8.
FINDING OUT FROM OTHERS
The previous six chapters have been concerned largely with questions that
you can ask yourself about your own teaching.
This chapter is about seeking
advice from others.
The first two sections concern general ways of involving
students and teaching colleagues.
Section 8,3 introduces a method of using
recordings to review your teaching.
8.1
FEEDBACK FROM STUDENTS
Since students are the consumers of teaching and it is the quality of their
learning that determines your success as a teacher, you may wish to ask for their
help in this assessment.
In business circles, some say that the customer is
always right.
In education, this may not always be true.
Popular teachers
are not necessarily the ones from whom the students learn most, but student
opinion taken in perspective is very useful.
You should not hesitate to ask for
clarification from students if you feel uncertain about what they are telling
you or what they seem to prefer.
There are two other reasons for seeking feedback from students.
One is
that by asking for students’ opinions you are demonstrating that listening to
the opinions of others is desirable.
Hopefully this will encourage the
students to be equally responsive to criticism in their careers.
The second
reason is that the process of seeking advice places some responsibility on
students for the quality of their learning experiences.
When seeking student help keep the following suggestions in mind:
- In asking for feedback, be as simple and concrete as possible.
If
students are going to be able to respond to your questions in a
constructive way, they must understand exactly what you want to know and
why.
- Choose questions about teaching over which you have personal control,
e.,
i,
that you could modify if you wish to (e.g., don’t ask a class of
200 students whether small group discussion would be more useful if
resources to provide it are not available).
- Do not ask questions if you do not trust the students' judgement (e.g.,
if you believe they are not qualified to judge your scholarship, don't
ask for an opinion),
- Avoid leading questions that suggest the right answer or that project
what you expect students to answer.
- 42
8.2
FEEDBACK FROM COLLEAGUES
Observations made by colleagues can draw attention to issues that have
escaped you.
The detail of such observational analysis will depend on the
needs and the qualifications of the observers.
At the very least, their
observations should reveal what you have actually done and how the students seem
to have reacted.
In selecting an observer, bear the following suggestions in mind:
- The major consideration is to choose someone you trust, who is capable of
viewing and reporting dispassionately what has been observed.
It is
essential that both you and the observer feel comfortable about
discussing openly any weaknesses that might be identified.
- It is also important to seek someone whom you regard as a good trainer
and from whom you feel you can learn.
Find someone who is willing to
devote the necessary time to helping you.
One good arrangement is for
two teachers to observe each other and to provide reciprocal feedback on
a regular basis.
The more clearly you define what you are trying to
achieve, what you are concerned about, and what type of feedback you
would like, the easier it will be for the observer to help you.
8.3
REVIEWING TEACHING ON VIDEO-TAPE
An excellent method (which is available to only a small proportion of
teachers) to become aware of how you teach and to identify areas for improvement
is to look at yourself on a video-tape recording.
A recording can convey to
you information that others may be reluctant to provide, as well as enabling you
to find out for yourself about your good and bad points.
Seeing yourself as
others see you may make you uncomfortable but can be most helpful and rewarding.
In reviewing the recording you can stop the replay at points where you made
decisions or where some particular aspect of your behaviour appeared to be
significant.
Many things go through your mind while you teach.
The recording
permits you to slow down the process and look at important things at your own
pace.
It may be useful to invite other teachers or students to join you in
reviewing a recording of your teaching.
- 43 The technique of video-tape recalling is especially useful in clinical
teaching where the teacher is often required to deyote attention simultaneously
to the patient, to the students, and to other things that happen in the clinic.
In looking at the recording, teachers may find, for example, that they talked
more than they thought they did, that they did not allow students to ask
questions or practise skills, or that they have failed to diagnose students'
learning difficulties.
If video-tape facilities are not available in your institution, you may be
able to use a simple tape recording instead.
While you will not get as much
information in this way, the recording can be very useful for reviewing the
verbal exchanges in your teaching.
- 44 9.
EVALUATION INSTRUMENTS
The previous chapter explained in general terms the value of consulting
colleagues and students to obtain feedback.
This chapter provides ten selected
instruments that will make this feedback more specific and purposeful.
The
instruments include questionnaires and guidelines for interviewing and observing.
You may find that some of the instruments can be used immediately, without
any amendment.
Because of this they have been printed on separate pages so that
you may photocopy them if you have access to this equipment.
However, you
should also regard the instruments as a source of ideas.
Adapt them; rewrite
them; develop new instruments according to your needs and your interests.
The instruments are arranged in an approximate order, ranging from an
overall view of the course as a whole to more specific instruments that deal only
with one aspect of a session.
Obviously, only a small sample of all the
possible instruments can be included here - so omission of an instrument for
assessing some aspect of a course does not imply that this aspect is unimportant.
INSTRUMENT NO. 1:
COURSE EVALUATION QUESTIONNAIRE (Page 48)
This questionnaire to be filled in by students can be used as a review of
the course as a whole, or some part of it.
It combines closed questions, where
students are asked to tick the appropriate space, with open questions, where
students provide comments.
This allows both a quick method of recording the
opinions of the class as a whole and creative suggestions for ways in which
improvements can be made.
INSTRUMENT NO. 2:
TEACHING SKILLS QUESTIONNAIRE (Page 50)
For students or colleagues - or yourself (when viewing a video-tape or
listening to a tape recording).
This questionnaire provides a way of checking whether specific components of
a teaching technique are well done.
It can be used after just one session, or
after a series of sessions.
It should, of course, be completed only for sessions
taught by the same teacher.
You may wish to change the specific components.
at the bottom an overall question such as:
You may also wish to add
- 45
The overall effectiveness of the teaching was
EXCELLENT
GOOD
SATISFACTORY
POOR
VERY POOR
(Please record your opinion by marking a cross on the line)
INSTRUMENT NO. 3;
STUDENT FEEDBACK ON COMMUNICATION (Page 51)
This instrument is included to emphasize that much valuable help can be
obtained by talking with students.
By discussing these issues openly with
students, greater appreciation of the nature of both students' and teachers'
problems may be obtained.
INSTRUMENT NO. 4:
CLARITY OF THE COURSE PLAN (Page 52)
This questionnaire is included to reinforce the idea that students should
be aware of the overall plan of a course or series of teaching sessions.
This
questionnaire enables you to find out whether the plan was clear to the students
and their initial reaction to it.
This may lead you to explain some aspects of
the plan again or possibly change the plan in some respects.
INSTRUMENT NO. 5:
ANALYSING USE OF QUESTIONS (Page 53)
This instrument is of a quite different nature since it concentrates solely
on one small (but very important) skill - asking questions.
This instrument should normally be used during small group teaching (which
may take place in a ward or health centre).
An observer (who will usually be a
colleague, but may be a student) should sit outside the group and just record
what happens.
In order to make the record, the observer should:
1.
note the teacher's first question in the left-hand column;
2.
decide whether the kind of answer implied by the question would be broad
or narrow.
A narrow answer would be "yes" or "no" or a fact, e.g,, the
name of a drug, disease, or bone,
A broad answer would involve
discussion, statement of opinion;
- 46
3.
decide whether the question required the student to remember something that
had already been learnt (recall) or work out a solution to a new problem or
speculate on the consequence of some action (thought);
4.
decide whether the question is clearly or ambiguously expressed;
5.
decide whether the manner of asking the question was "threatening",
"neutral" or "encouraging" to the learner.
Completing this may take some time so it will be impossible to do the
analysis for every question.
Instead, take the first question after completing
one line of the form.
The essence is that the questions in the session must be
sampled.
INSTRUMENT NO. 6:
FOCUS ON STUDENT BEHAVIOUR (Page 54)
This instrument should also be completed by an observer, who may be either
a colleague or a student.
This instrument is included as an example of one way of observing what the
students do, rather than what the teacher does.
It should be completed at the end of a session, when the observer makes an
estimate of what was "typically" happening during the session.
He should then
note down the proportion or percentage who were usually attentive (for example),
usually not attentive and so on.
This rather imprecise process can be made a
little sharper by repeating the observation every 15 minutes and recording what
was happening at the specific time.
The aim is not to make precisely reproducible observations.
to give an indication to the teacher of the students’ state.
INSTRUMENT NO. 7:
Rather it is
FEEDBACK ON FIELD ATTACHMENT (Page 55)
This instrument can be used to promote contact between teachers and health
service personnel in the field.
It may be modified quite simply to suit
alternative situations where the teacher is working with, other personnel.
INSTRUMENT NO. 8:
FEEDBACK ON HAND-OUTS AND READING MATERIAL
(Page 56)
This questionnaire can be used to provide a framework for your colleagues
to comment on written resource material.
It can easily be adapted or extended
to he used for other teaching materials.
- 47 INSTRUMENT NO. 9.;
REVIEWING TEACHER COUNSELLING (Page 57)
Teachers may see themselves in one way; students may see them rather
differently.
This checklist allows students to express their view of the
teacher.
It is of course the students’ view, rather than the teacher’s that
is crucial to the success of counselling.
INSTRUMENT NO. 10;
FEEDBACK FROM OTHERS (Page 58)
Feedback, from others encourages you to reflect on all the information that
you have received from the various sources,
It provides a framework for
determining your own priorities.
- 48 INSTRUMENT NO. 1
COURSE WVATHATTAW ATTT? C TTn™ * T nr-
Please tick, the appropriate space
Comments.
1.
The amount of preparation/
reading (prior to each
class] expected of me was:
2.
The overall workload
(assignments] was:
3.
The amount of practical
experience in proportion
to the theory taught was:
4.
The intellectual effort
needed to complete the
work was:
5.
The amount of material
covered was:
6.
The information I
received on what was
expected of me was:
7.
The amount of feedback I
received on my personal
progress throughout the
course was:
8.
List the major strengths of this course (in terms of what was most helpful
to your learning].
9.
List the main weaknesses of this course (in terms of what was least helpful
to your learning}.
- 49
INSTRUMENT NO. 1 continued
10.
Describe the major strengths of the chief instructor in this course
(in terms of what was most helpful to ypur learning),
11.
Describe the main weaknesses of the chief instructor in this course
(in terms of what was least helpful to your learning).
12.
Was the teaching style used by the instructorCs) suited to the subject
matter and the method(s) employed?
Please elaborate.
13.
Other comments:
14.
If this course was an elective one, what was your main reason for choosing
it?
15.
What advice would you give to a friend intending to enrol in this course
next year?
- 50
INSTRUMENT NO. 2
TEACHING SKILLS QUESTIONNAIRE
Please tick the appropriate space
During the session/course the teacher
was able to:
1.
explain clearly
2.
simplify complex issues
3.
summarize issues before moving on
4.
provide examples
5.
demonstrate/illustrate
6.
pose thought-provoking questions
7.
arouse interest/curiosity
8.
inspire and motivate
9.
encourage participation
10.
encourage students to share
ideas and experiences
11.
lead a discussion
12.
relate issues to the real world
13.
provide stimulating materials
14.
provide relevant materials
15.
adapt teaching and language to
level of students’ ability
16.
detect confusion and misconception
17.
detect when students were bored
18.
distinguish between central and
peripheral issues
19.
listen to students
sympathetically
51
INSTRUMENT NO. 3
STUDENT FEEDBACK ON COMMUNICATION
To obtain detailed information about the quality of communication, you could
interview a randomly selected group of students (say, 6-8 students].
The kind of questions you could raise with them include:
- Was the material interesting?
- Were the presentations clear?
- Did the teacher react appropriately to signs of confusion?
- Could the students follow the courses with a reasonable amount of effort?
- Did the students have opportunities to discuss; to seek clarification;
to ask questions; to raise issues; to provide feedback?
- Were the discussions among students useful?
facilitate the discussions when needed?
Did the teacher
52
INSTRUMENT NO. 4
CLARITY OF THE COURSE PLAN
To he completed by students after reading the course outline
A - I understand very well
B - I understand with few exceptions
C - I am somewhat confused
D - I can't make any sense out of this
E - Not applicable to this plan
Please circle the appropriate response
What I am expected to achieve in this class
A
B
C
□
E
What assignments I am required to complete
A
B
c
0
E
What resources are available to me
A
B
c
D
E
How imy achievements; will be assessed
A
B
c
D
E
Other important organization procedures
(e.g., timetable, locations)
Specify:
A
B
C
D
E
My overall reaction to the directions and procedures proposed for this course is:
A
B
C
D
E
Very
enthusiastic
Positive
Not
sure
Somewhat
negative
Very
negative
Comments (your comments are especially important if your feeling about this
course is not positive)
INSTRUMENT NO. 5
ANALYSING USE OF QUESTIONS
To be completed by an observer during a teaching session
Questions
Narrow
Broad
Recall
Thought
Confused
Clear
Threatening
Neutral
Encouraging
1.
2.
3.
4.
5.
6.
7.
6.
9.
10.
Put a tick in appropriate columns.
1.
Note question briefly in first column.
3.
Record in the last column any general comment on the question asked.
2.
Comments
- 54
INSTRUMENT NO. 6
FOCUS ON STUDENT BEHAVIOUR
To he observed by a nominated student or a colleague
Please indicate the proportion of students who fit each of the categories
below and add comments in the space provided.
1.
Understanding the aim of the session
Understand
2.
Puzzled
Indifferent
Enthusiasm to participate in the learning activities
Motivated
3.
Bored
Indifferent
Attention in class
Attentive
Not attentive
Not observable
Satisfaction with answers to the question
4
Satisfied
5.
Not satisfied
Not applicable
Reaction to each other's contribution to discussion
Welcome
6.
Bored
Indifferent
Freedom to ask questions
Free
Other comments:
Discouraged
Not observable
55
INSTRUMENT NQ. 7
FEEDBACK ON FIELD ATTA
To be completed by supervisors of students
in attachment for field/practical learning
Please tick the appropriate response
I had a chance to discuss with the course
coordinator my role as. a supervisor.
I find the trainee well prepared for the
attachment (background information and
expectations).
I believe that the trainee had a chance
to observe our typical work situation
(cases, problems).
I think that the trainee understands better
the opportunities and constraints
involved in our work.
I think that the trainee made the optimal
use of the opportunities for learning we
offered him.
I think that the trainee has made
satisfactory progress and accomplished
the aims of the attachment.
Comments:
If you disagree with any of the statements made above, please offer your
reasons.
Also, if you think that some aspects of the attachment were
especially useful, we would like to know about them (use an extra page if
there is not enough space below).
Would you recommend continuation of this scheme?
YES/NO/NOT SURE
Are you willing to help us again next year?
YES/ND/NOT SURE
- 56 INSTRUMENT NO. 8
FEEDBACK ON HAND-OUTS AND READING MATERIAL
To be completed by colleagues after review of materials
A - Agree
B - Agree with few- reservations
C - I don't think so
D - I am not sure (not sufficient information]
E - Not applicable to this material
Please circle the appropriate response
Which purposes do you think this material serves?
To indicate what students are expected to learn
A
To help learn new vocabulary
ABODE
To provide information not included in the
teacher's presentation
ABODE
To provide a guide or structure to the lecture
ABODE
To assist (e.g., economize] note-taking by students
ABODE
To summarize content discussed in lecture
ABODE
To provide guidelines for preparation of
assignments or examinations
ABODE
To provide stimulation for further reading
and thinking about the topic
ABODE
Comments:
B
C
0
E
- 57
INSTRUMENT NO. 9
REVIEWING TEACHER COUNSELLING
To be completed by studants
SD -• Strongly disagree
D - Disagree
U
Uncertain
A - Agree
SA - Strongly agree
Please circle the appropriate response
This teacher . . .
sees students individually when they request an
opportunity to discuss personal matters
SD
D
U
A
SA
SD
D
U
A
SA
SD
D
U
A
SA
- views students as individuals
SD
D
u
A
SA
- becomes acquainted with students
SD
D
u
A
SA
- is ready to help where possible
SD
D
u
A
SA
- limits, his/her contact with students to class sessions
SD
D
u
A
SA
SD
D
u
A
SA
- is fair and discreet in dealing with students
SD
D
u
A
SA
- encourages students to make their own decisions
SD
D
u
A
SA
- is biased and intolerant to different values
SD
D
u
A
SA
SD
D
u
A
SA
- is sensitive to students' feelings about the course
- helps students to identify their problems and to
find resources for solving them
- answers questions without making the students feel
they are bothering him/her
- humiliates or embarrasses students who disagree
with him/her
58
INSTRUMENT NO. 10
FEEDBACK FROM OTHERS
Having considered the variety of methods to obtain feedback, you may wish
to attempt to recall feedback you have received in the past from your colleagues,
students and others.
Please note critical comments as. well as- compliments made
about your performance.
Are the comments consistent?
What do they tell you
about yourself as a teacher?
Note the feedback that you have received
e.g., I have been told that T often seem impatient when
supervising students who take medical history
from patients.
What kinds of things do people tell me I do very well?
What weak points were identified by others?
Which comments are consistent with my perceptions?
- 59
RECOMMENDED READING
The following books and periodicals are useful references about teaching
and learning in health care.
Abbatt, F. R. (1980) Teaching for better learning (available, on request, from
Division of Health Manpower Development, World Health Organization,
1211 Geneva 27)
An excellent guide for teachers of primary health care staff.
The book
addresses the following issues;
(a) what should your students learn,
(b) how you can help your students learn, (c) finding out whether your
students have learnt and (d) preparing teaching materials.
Cox, K. R. & Ewan, C. E., ed. (1982) The medical teacher.
Livingstone
Edinburgh, Churchill
A practical guide for medical teachers in all aspects of teaching and
assessment.
This book provides suggestions on how to do various things
in medical education with useful examples and references.
Ford, C. W. & Morgan, M. K., ed. (1976) Teaching in the health profession.
St Louis, Mosby
This book contains useful papers on all aspects of planning, conducting
and assessing educational programmes.
Guilbert, J. J. (1981) Educational handbook for health personnel, revised edition.
Geneva, World Health Organization (WHO Offset Publication No. 35)
This is a very popular book, which covers all aspects of educational
planning.
The book includes a practical guide to planning educational
objectives, teaching and learning activities, evaluation and assessment.
Kemp, J. E. (1971) Instructional design.
Belmont, CA, Lear Siegler
A simple and practical guide to planning instructional units and to
developing courses.
McKeachie, W. J. (1965) Teaching tips, 6th ed., Lexington, MA, Heath & Comp.
A classic on teaching with many good ideas for beginners and experienced
teachers.
The book includes chapters on lectures, discussion groups,
laboratory teaching, audiovisual techniques, and many other issues of
concern to teachers.
Segall, A. J. et al. (19.75) Systematic course design for the health fields.
New York., Wiley
This book is intended as a basic text for courses on curriculum design in
the health fields and as a guide to course design by teachers.
The book.
contains guidelines for each step, discussion of problems in implementation,
and suggestions concerning methods to facilitate the application of this
model.
WHO publications may be obtained, direct or through booksellers, from
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C/1/82
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The uneven quality of the education offered to many health workers is a
serious obstacle to the attainment of an acceptable level of health in most
countries, but the authors contend that it is not insurmountable. Any teacher
should be able to improve his or her performance by applying well defined
techniques of self-assessment and being willing to learn and adapt to new
ideas.
Planning, communicating, providing resources, counselling, assessment,
and continuing, self-education are essential functions for any teacher. Separate
chapters discuss each of these six functions in detail in relation to the teaching
of health subjects. Checklists are provided in each chapter so that teachers can
tell how effectively they are helping their students to learn. The last chapter
provides a number of evaluation instruments by which teachers may obtain
feedback on their professional performance from their teaching colleagues or
from their stiidents.
This book is not about educational theory but about the everyday practice
of teaching. It has been written specifically for teachers of health workers by
two experienced teachers of teachers. Its basic concepts, however, and the
tec niques it describes are applicable with a little modification to teachers in
a branches of learning. The book is based on a draft that was tested and
co™mented uPon by teachers in a variety of countries and cultural settings,
and the needs of developing countries have guided both the content and the
form of presentation.
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