2. Points to Ponder
• Don’t silent your phones (switch off)
• No note taking from the screen (you’ll get handout)
• No question during my lecture (you’ll get time after the session)
• No side talking (you’ll get time after the class)
3. Objectives
• To recapitulate and summarize the concepts of ‘Teaching
and Learning’ in front of learned faculty members of CME
and members of MMEd-15 (2018).
• The session will be evaluated by the honorable faculty
members.
4. Effective Teaching and Learning
Teaching – Impart knowledge
Effective teaching must be –
• Stimulating
• Encouraging
• Organized
• Develops positive attitude
• Achieves goal
• Builds self directed learner
28 Aug 2018
Learning – Change in behavior
Effective learning must be –
• Objectives are clearly understood
• Scope of frequent brief practice
• Specific feedback to identify errors
• Reinforcing practice of correct
elements
5. Effective Teaching and Learning
Characteristic of high quality learning:
• Long term knowledge retention
• Perceive relation between old and new knowledge
• Apply knowledge to solve problem
• Communicate knowledge to others
• Wanting to know more (self directed, life long learner)
Contd
Conditions necessary for high quality learning:
• Learner is ready.
• Learner has reason to learn.
• Explicitly relates old and new knowledge.
• Active during learning.
• Environment is adequately supportively to the learner.
6. Effective Delivery of Lecture
Lecture – Formal and time bound presentation of a topic delivered by a speaker, which
stimulates the students to become active learner in their own right.
Skills of lecturing –
• Preparing lecture
• Presenting information
• Explaining
• Generating interest
05 Sep 2018
Steps of preparing lecturing –
• Topic
• Free associate
• Rough structure
• Directed reading
• Structure the lecture
• Check – opening and ending
• Present the lecture
• Reflect and note
Steps of presenting information –
• Sign posts: Signal the direction and
structure
• Frames: Indicate the beginning and ending
of the section of a topic
• Foci: Highlight and emphasize key points
• Links: Join the sections together
7. Effective Delivery of Lecture
Advantages of lecture –
• Saves time & resources
• Enables large amount of information to be presented
• Covers a large group of students
• Presence of teacher (Showmanship)
Disadvantages of lecture –
• Passive students
• Low receptivity
• Doesn’t facilitate problem solving
• Offers hardly any possibility of checking the learning pro
• Doesn’t allow for individual pace of learning
Contd
8. Classroom Management
Definition –
Three basic elements of effective classroom management –
• Well planned physical arrangements (all along)
• Sound class policies (rules, norms, procedures etc.)
• Successful teacher-student relationship
12 Sep 2018
9. Classroom Management
As instructor
• Personal – dress, appearance, gesture, posture etc.
• Presentation – energy, style, etc.
• Presence – voice, vocabulary, non-verbals, pace, communication,
As manager
• Preventions – no surprise, pre-work, objectives, ground rules, agenda, be
available
• Interactions – listen, answer, encourage discussion, invite questions –
boomerang, reflection, paraphrasing
• Response – tactful, disciplined, no excuses, no referring, no threats, be in
control, never loose temper.
Efficiency, Competency, Effectiveness
contd
10. Problem Based Learning
Definition – integrated approach, through simulated and real health
problems, an alternative to traditional teaching-learning
Goals –
1. Enhancing intrinsic motivation
2. Promoting self-directed learning
3. Encouraging clinical reasoning & ability to solve healthcare problems
4. Responding to health needs & expressed demands of the community
5. Facilitating acquisition of essential knowledge
6. Facilitating transferability of concepts & principles
7. Promoting simultaneous acquisition of professional skills
8. Encouraging the ability to work in teams
10 Sep 2018
11. Problem Based Learning
Curriculum arrangement
• Stage I : Introductory problems with emphasis on basic concepts and principles
(knowledge, concepts & principles)
• Stage II : Problems designed around organ system (professional skills relating to patient
care)
• Stage III : Multi-system problems merging with clerkship (community related abilities &
behavioral qualities)
Contd
Elements –
• Problem protocol
• Tutor guide
• Learning module format
Settings –
• Small group (9 – 12 students)
• Students in inner circle
• Teachers in outer circle
• Each session around three days
12. Informing, Persuading, Instructing
Differences between informing, persuading, instructing
12 Sep 2018
Informing Persuading Instructing
Learning Unpredictable Unpredictable Assured
Change Unpredictable Predictable Assured
Effect Short term Mid term Long term
Accountability Nil Nil Learner & instructor both
Selection Receiver is free Receiver is free Prescribed selection
Results Uncertain May be determined Measurable
Communication One way Two way Two way
Performance Not defined Not defined Defined (objective)
Presenter provides
information
In person/ video/ written
report
In person with supporting
materials and reports
By instruction
Receiver Listens/ reads Listens, reads, interacts Interacts with instructor
Feedback None/ only questions (if
live)
Yes (discussion, clarification,
reinforce)
Provided (frequent tests
etc.)
13. Steps of planning a lesson
• Objective
• Purpose
• Pre-requisite learning
• Sequence of contents
• Method of instruction
• Assessment
Lesson Plan: Concept & Construction 26 Aug 2018
Gagne’s events of instruction
• Gaining attention
• Informing the learner of the objectives
• Stimulating recall of pre-requisite learning
• Presenting the stimulus material (content)
• Providing learning guidance
• Eliciting the performance
• Feedback about correctness of performance
• Enhancing retention and transfer
Definition – ??
14. Lesson Plan: Concept & Construction Contd
Advantages of a lesson plan
• Documentation of every session
• Structured planning helps the teacher to conduct the session
effectively
• Aim of the lesson is identified and maintained
• Appropriate instructional method is selected
• Lesson material can be selected & arranged
• Helps the student to understand what they are going to learn
• Learning outcomes can be measured
• Uniformity of the session conduction even when the teacher is
different
• Time management can be done best
15. Educational Objectives 27 Aug 2018
Definition – what the students should be able to do at the end of a learning period
that they couldn’t do beforehand.
Importance
• To inform students concerning
• What they will learn
• Level of performance expected
• To inform educators about what the students are expected to learn, so that
they can –
• Plan the learning experience accordingly
• Assess whether the students have acquired the desired level of competence
• Aware of what is covered in other sessions so as to reinforce learning & avoid
unnecessary duplication
16. Educational Objectives contd
Qualities –
• Relevant
• Univocal
• Feasible
• Logical
• Observable
• Measurable
Elements
• The task – components are
• Act
• Content
• condition
• The criteria
ABCD of writing educational objectives
Audience – learner
Behavior – what is expected from audience
Condition – under which the performance is to occur
Degree – criteria of acceptable performance, how well the performance
must be done
17. Bedside Teaching
Definition – Teaching in the presence of a patient (patient oriented, not disease oriented)
Clinical environment – Community, (Primary, Secondary, Tertiary, Specialized)
healthcare facilities, Long-term care facilities, Office, Clinics, Chambers (each site has its
own merits/ challenges).
09 Sep 20218
Learner objectives – Acquisition of knowledge & understanding, different skills, total
patient management (admission to discharge), personnel management, cost effectiveness,
other attributes (honesty, ethics, dress etc.)
Teacher objectives – Positive attitude to teaching (motivation), role modelling,
integrating basic & clinical sciences, applied problem solving, evaluate learners’
performance & feedback, demonstrate & supervise routine procedures etc.
Key strategies
• Pre-rounds – Preparation, Planning, Orientation.
• Rounds – Introduction, Interaction, Keen observation, Instruction, Summarization.
• Post-rounds – Debriefing, Feedback, Reflection, Preparation.
18. Bedside Teaching
Objectives of bedside teaching
• Base all teaching on clinical data generated by or about the patient.
• Conduct bedside rounds with respect for the patients’ comforts & dignity.
• Critical time for teaching psychomotor skills.
• Provide feedback to learners.
contd
How to do bedside teaching?
• Three circle outcome model.
• Bedside teaching pearls.
• Bedside teaching methodology.
• Five step model.
• Other models (model of best bedside teaching session).
Seven roles of a good clinical teacher
• Medical expert
• Communicator
• Collaborator
• Manager
• Advocate
• Scholar
• Professional
19. Bedside Teaching
Advantages
• Strengthens learning.
• Allows clarification of history & physical findings in presence of students.
• Allows role modelling.
• Helps to develop critical thinking.
contd
Disadvantages
• Time consuming
• Potential patient discomfort
• Requires specific skills & techniques
• Patient related challenges (short hospital stay, too sick, unwilling etc.)
• Lack of teachers incentives & rewards for teaching
• Unfriendly clinical teaching environment (space, equipment etc)
• Work demands (clinical, administrative, research responsibilities)
• Engaging multi-level learners (under/ post graduate students, residents, etc)
20. Motivation
Definition – Process of stimulating people to action to accomplish desired goal.
Process of motivation
03 Sep 20218
Needs
New needs Satisfaction
Action to achieveTensionGoalsFelt needs
Principles
• Principle of participation – employee feel that they are working for their own organization
• Principle of communication – increases employee understanding
• Principle of delegation of authority – employee develop sense of belonging
Performance vs motivation : P = F (A x M x O)
P = Performance
F = Function (unit of production per unit time)
A = Ability (education, experience, training)
M = Motivation
O = Organizational climate
21. Motivation
Theories
• Platonic theory (tri-partite theory of the soul)
• Incentive theory (immediate reward greater & longer effect)
• Drive-reduction theory (strength of biological drive increases, the strength
reduces upon satisfaction of the drive)
• Herzberg’s two-factor theory –
• Hygiene factors (status, job security, salary, fringe benefits etc.)
• Motivators (challenging work, recognition, responsibility) give positive motivation
• Goal-setting theory (individuals have a drive to reach a clearly defined end state)
• Unconscious motivation (there are some behavior is so automatic that the reasons for
it are not available in the individual’s conscious mind)
• Self-actualization (do for other, sacrifice etc.)
contd
22. Motivation
Theories (contd)
• Need hierarchy theory – Abraham Maslow’s theory
• Physiology (hunger, thirst, sleep, etc.)
• Safety (security, shelter, health etc.)
• Belongingness (love, affection, friendship etc.)
• Self-esteem (recognition, respect etc.)
• Self-actualization (do for other, sacrifice etc.)
• Theory X and Theory Y –
• People prefer to be directed, don’t want responsibility, and have little or no ambition
• People have potential, they learn to accept and seek responsibility
contd
Self-esteem
Belonging
Safety
Physiology
Self-actualization
23. Small Group Teaching/ Learning
Definition –
Characteristics
• Active participation
• Purposeful activity
• Face to face contact
Advantages of SGT/ L – Suitable for transferring transferable skills
• Higher cognitive skills: understanding, analytic, problem solving etc.
• Psychomotor skills: patient examination, performing procedures etc.
• Communication skills: listening, working in group, responding etc.
• Attitude: deep approach learning, life-long learning, collaborative learning, team
work, professionalism, leadership etc.
11 Sep 20218
24. Small Group Teaching/ Learning
Disadvantages of SGT/ L
• Can’t cover wide areas of contents.
• Not for large number of students.
• More number of teachers are required.
• Special seating arrangement with special room facilities are required.
• Teachers to have certain managerial qualities.
• Costly.
• Students should be prepared ahead of the class.
• Students should be motivated and committed.
Contd
25. Small Group Teaching/ Learning
Strategies of organizing SGT
• Seating arrangement
• Expectation
• Ground rule
• Safety
• Making the group smaller (pairs, buzz groups, snowballing, pyramids,
cross-over groups, fishbowl, circular questioning, horseshoe group)
• Structuring the group activities – clear plan (lesson plan) with time
allocation for clarity of purpose and task.
Methods of SGT – tutorial, demonstration, case study, simulation, workshop,
presentation, project, role play, brainstorming, step-by-step discussion, problem
based group.
Contd
26. Learning Styles
Outer circle
• Visual (spatial)- Prefer using pictures, images, & spatial understanding.
• Aural (auditory)- Prefer using sound & music.
• Verbal (linguistic)- Prefer using words, both in speech and writing.
• Physical (kinesthetic)- Prefer using body, hands & sense of touch.
• Logical (mathematical)- Prefer using logic, reasoning & systems.
Middle circle
• Social (interpersonal)- Prefer to learn in groups or with other people.
• Solitary (intrapersonal)- Prefer to work alone, self study.
Inner core- (Nemletic styles)
?? Sep 20218
27. Community Based Teaching & Learning
Principles of CBME – Responds to priority health needs, concentration on health
problems prevalent in the community. It is community oriented throughout its duration.
Importance of CBME – Gives the students a sense of social responsibility by enabling
them to obtain a clear understanding of the needs of a local community & the problems it
& the country as whole are facing. Students also understand how health & other factors
that contribute to the community development are interrelated.
03 Sep 2018
Activities of CBL program – Assignment to a family, work in a rural community,
participation in a community survey & in a community oriented program (immunization,
HE to the public etc.), supervised work at a primary care facility (health center,
dispensaries, rural hospitals etc.), GP based learning in a chamber, teaching by specialist
in a setting outside hospital.
28. Community Based Teaching & Learning
Student assessment –
• No standard assessment instrument for CBL program.
• It depends on educational objectives of the program.
• It must be planned from the onset of the program.
• It must be done at the actual place of performance.
• It can be done either during or at the end of the community attachment.
Contd
Constraints –
• Cost
• Security
• Accommodation
• Travel/ transport
• Time
• Logistics
Teachers’ problems –
• GPs have less training to teach.
• Senior hospital teachers have no direct contact with the
community.
• Negative attitudes of hospital based teachers towards
teaching students in the community.
• Coordination between teaching hospital & community is
difficult.
29. Micro Teaching
Definition – Is a teacher training technique for learning teaching skills.
(clearly defined skills, carefully prepared lessons, planned series of 5 – 10 min sessions,
small group of real students, often video taping).
Basic principles –
• Enforcement
• Practice & Drill
• Continuity
• Microscopic supervision
26 Sep 2018
Characteristics – Highly individualized,
one skill at a time, focused on micro
events, less (content, objectives,
student, duration), allows micro-
analysis, immediate feedback.
Steps – plan teach observe re-plan re-teach re-observe…
1. Defining a specific skill.
2. Demonstration of the skill.
3. Feedback.
4. Re-planning, re-teaching & re-evaluation.
Phases –
1. Knowledge acquisition
2. Skill acquisition
3. Transfer
30. Micro Teaching
Merits –
• Helps to acquire hard-to-attain teaching skills
• Can attain proficiency in teaching skills in a phased
manner.
• Immediate feedback makes it more interesting &
reliable.
• Student centered method.
Demerits –
• Time consuming, no emphasis on contents.
• Produces homogenized standard robots.
• A form of play acting in unnatural surroundings.
• Proper practice is essential.
Contd
Strategies –
• Pre-instructional
• Instructional
• Post-instructional
• Feedback
31. Principles of Learning
Activity
Reinforcement
Repetition
06 Sep 2018
Principles emphasized in –
• Learning with understanding
• Organization & structure
• Differences between individual
• Cognitive feedback
• Proposes & goals
• Choice, relevance & responsibility
• Anxiety & emotion
Principles derived from constructivism –
• Learning is an active process
• People learn to learn as they learn
• Reflective activity
• Learning involves language
• Learning is a social activity
• Learning is contextual
• One needs knowledge to learn
• Learning is not instantaneous
• Motivation (key component)
32. Integrated Teaching
Definition – Integration is the organization of teaching matter to
interrelate or unify subjects frequently taught in separate academic
courses or departments.
Types –
• Horizontal – integration between parallel disciplines traditionally
taught on the same phase of the curriculum.
• Vertical – integration between discipline traditionally taught in
different phases of the curriculum.
Advantages & Disadvantages of integration
05 Sep 2018
34. Self Directed Learning
Definition – is a process in which students take the initiative to recognize their
learning needs, put together learning goals, identify human & material resources for
learning, choose & implement appropriate learning strategies and evaluate learning
outcomes.
Mind mapping – writing down a central idea & thinking up new & related ideas which
radiate out from the center.
07 Sep 2018
SQR4 approach for essential reading –
• Scan
• Question
• Read
• Recall
• Review
• Relate
Learning on their own, students
should decide –
• What to learn
• Where to learn
• When to learn
• For how long to learn
• How to learn
35. Self Directed Learning
Principles –
• Students learn & control their own learning (PLP).
• Their specific needs must be recognized & appropriately responded.
• Teacher should act as a manager & support them by proper resources.
Benefits – The benefits are best described in terms of the type of learners it
develops.
• They’re curious & willing to try new things, view problems as challenges,
desire change, & enjoy learning.
• They’re motivated & persistent, independent, self-disciplined, self-
confident, & goal-oriented.
• They’re more effective learners & social beings.
Contd
36. Communication
Definition – is a two way process of exchanging or shaping ideas, feelings
& information, with some effect, using common symbol system.
Characteristics –
• Process – exists in time and changes constantly.
• Symbolic – sender & receiver share a common symbol system.
• Contextual – language, culture, social structure etc. all contribute to a context.
• Purposive – individual differences play a big role in understanding.
• Two way – a specific massage elicits a predictable response.
Components (process) –
sender (source) message (content) Channel (medium) receiver (audience)
feedback (effect)
29 Aug 2018
37. Communication
Functions –
• Information
• Education
• Motivation
• Counseling
• Persuasion
• Entertainment
Social functions –
• Surveillance
• Correlation
• Socialization
• Entertainment
Contd
Types –
• One way (Didactic)
• Two way (Socratic)
• Verbal
• Non-verbal
• Formal
• Informal
• Visual
• Telecommunication
• Internet
• Physical actions (kinesics)
• Space (proxemics)
• Touch (haptics)
• Voice (paralanguage)
• Personal appearance (clothing, …)
• Time (chronemics)
• Objects (room, furniture, …)
38. Communication
Levels –
• Intrapersonal
• Interpersonal
• Group
• Mass or cultural
Barriers –
• Physiological
• Psychological
• Environmental
• Cultural
Listening skills –
• Showing interest
• Concentrating on the
message
• Asking questions to
ensure understanding
Contd
Errors –
Sender – doesn’t possess a clear idea of the message and/ or not able to express it well.
Receiver – doesn’t listen carefully, infers a different meaning, fails to give feedback.
Feedback –
Direct/ indirect
Helping/ toxic
39. Communication Contd
Effective communication –
• A communication is effective when the message is understood and
when it encourages the receiver to think and take action.
• Is the process of sending a message in such a way that the message
received is as close in meaning as possible to the message intended
Principles –
• Clarity
• Brevity
• Simplicity
• Timeliness
• Integrity
• Strategic use of informal
organization
40. Learning Theories
Definition – A process resulting in some modification relatively permanent of the way of
thinking & doing.
05 Sep 2018
Types of learning –
• Imprinting
• Habituation
• Classical conditioning
• Operant conditioning
• Concept learning
• Learning of rules &
principles
Theories –
• Behavior learning (classical conditioning, operant
conditioning)
• Cognitive learning (Information processing,
shcema)
Conditions for successful teaching –
• Appropriate observable behaviors.
• Mastery of basic information.
• Teaching for understanding.
41. Learning Theories
Assumptions of Knowles theory –
• Adults are independent & self directing.
• They are experienced.
• They value learning that integrates with the demands of their daily life.
• They are interested in immediate, problem centered approaches.
• They are more motivated by internal drives.
Knowles principles as guideline on teaching –
• Establish an effective, safe, comfortable learning climate.
• Involve learners in mutual planning of relevant methods & curricular content.
• Involve them in diagnosing their own needs.
• Encourage to formulate their own learning objectives.
• Encourage to identify resources & devise strategies to achieve objectives.
• Support in carrying out their plans.
• Involve in evaluating their own learning.
Contd
43. Concept of learning –
• Quantitative view of learning –
• Knowing more in some vague way.
• Learning by heart.
• Acquiring various facts & skills for use.
• Qualitative view of learning –
• Finding out what something really means.
• Construct a personal philosophy by what is learned.
• Approaches to learning –
• Superficial approach
• Deep approach
• Achieving approach
Contd3P Model of Learning & Teaching
45. Learning Environment
It refers to the diverse physical locations, contexts, and cultures in which
students learn. A good learning environment is interactive and engaging.
Checklist for teaching in clinical settings:
1. Have patients and families given consent for students to be present?
2. Do the staff know that teaching is planned and understand what their
roles will be?
3. Is there adequate space for all participants?
4. How much time is available for teaching?
5. How may the students be made to feel useful (for example, “pre-
clerking” and presenting)?
05 Sep 2018
47. One Minute Preceptor
It is an useful combination of proven teaching skills combined to
produce a method that is very functional. Efficient teaching around a
single patient is possible for teaching micro-skills.
The one minute preceptor method consists of a number of skills that
are employed in a stepwise fashion at the end of the learner’s
presentation.
1. Get a commitment.
2. Prove for supporting evidence.
3. Reinforce what was done well.
4. Give guidance about errors & omissions.
5. Teach a general principle.
6. Conclusion of the encounter.
20 Sep 2018
48. Concept Map
It is the graphic representations that learners draw to depict their
understanding of the meaning of a set of concepts.
Uses –
• Organize & integrate information.
• Assess existing knowledge.
• Gain insights into new & existing knowledge.
• Relate basic science concepts to clinical presentation of the patient.
Process of concept mapping – Identifying important concepts
Establish an order for the concepts Determine the relationships between
individual concepts Look for cross links between concepts Examine the
arrangement or structure of the map.
20 Sep 2018
49. Laboratory Teaching
Uses of laboratory work –
• Observational skills.
• Improving understanding of methods.
• Developing problem-solving skills.
• Nurturing professional attitudes.
Skills of laboratory teaching –
• Explaining and presenting information.
• Questioning, listening & responding.
• Giving direction.
• Teaching demonstrators.
• Helping technicians.
• Preparing a practical/ laboratory manual
26 Sep 2018
Methods –
• Demonstration.
• Exercise.
• Structured inquires.
• Open-ended inquires.
• Project.
Experiments in the laboratory manual
should have –
• Explicit aim & clear instruction.
• Illustration (good quality)
• Question.
• Self-evaluation check list.
• The layout of the manual.