Methods of teaching by Rabaa .pdf presentation

Teaching method

1. METHODS OF
TEACHING
By dr. rabaa
Emrcogonline sessions

2. LECTURES

3. There are many circumstances in which this is a suitable
method of teaching. However, there are potential
drawbacks.
◦Participation by learners is minimal
◦there is a risk that the lecturer can appear patronizing and ulterior motives may be suspected.
◦The lecture has been described as ‘a process by which the notes of a teacher become the notes of the
student without passing through the minds of either’.
◦it is recognisedthat students actually retain very little of the information imparted
◦On the other hand,
◦a lecture is a useful method of teaching learners when they are at a comparatively early stage in their
career and when the lecturer is a world authority on a subject with a limited amount of time

4. Tips to produce the best possible lecture include the following:
• Ensure that the topic is best learned by the trainee through the lecture format and
would not be better delivered by one of the techniques outlined below.
• Resist the temptation to put in ‘everything’ and overfill the available time.
• Ensure that it meets the trainees 'learning objectives by making yourself aware of the
curriculum
• Summarize before you finish.
• Provide the students with some self-assessment questions to ensure their
understanding.
• Provide some additional resources for those you hope you have stimulated to learn
further!

5. PROBLEM-BASED
LEARNING

6. An example would be a
case involving the organisationof a
multiprofessionalteaching session for a small
group of midwives and medical students on the
subject of termination of pregnancy for fetal
abnormality.
Over a 2-week period the learners
have three 1 or 2-hour sessions with a facilitator.
The role of the teacher in
this situation is to
•facilitate the trainees’
learning: to ensure
everyonetakes part, to
guide the discussion if
importantareas are
being neglected and to
keep the discussion
focused. Resources such
as clinics, ultrasound
sessions, the library and
the internet are provided
for use in private study
time.

7. THE 1-MINUTE
PRECEPTOR
This is a five-step process that can
be carried out
in minutes

8. This is an example of a teachingmethod that demands a good
rapport between the teacher and the learner(s). The teacher
must makethe learner feel secure and allow the voicing of
opinions, whether they are correct or incorrect.
The five steps are:
•commitment
•justification
•application
•positive reinforcement
•correction of mistakes.
Application of the 1-minute preceptor model
of teaching would involve asking a group of
learners who have just seen the woman what
would be the differential diagnosis
This is thestep of ‘commitment’ on the
learners’ part. It isimportant to note that
the teacher does notpresent his or her own
views before the learnershave an
opportunity for expression

9. The secondstep, of justification, involves
asking the learners
to provide evidence from the woman’s history
and relevant examination findings to support the
differential diagnosis they have identified.
As thelearners present their evidence the clinical teacher
must either affirm or reject what is said.
Mostclinicians would find the first two stepsstraight forward
The third step involves
•illustration of how the learning from the woman
with antepartum hemorrhage can be applied to
other women with obstetric hemorrhage.
•Thiscould include a discussion on how the volume
of blood loss can be estimated or measured.
•Theteacher could elaborate on how the blood loss
in postpartum hemorrhage is usually revealed
unless there is a broad ligament hematoma,
whereas in antepartum hemorrhage due to
abruption there may be a large amount of
concealed retroplacental blood loss.
•Anotherfundamental point to cover would be the
adagethat ‘painless antepartum hemorrhage is
due toplacenta previa until proved otherwise’.

10. The fourth step is
to reinforce what the learners
did correctly. This increases their confidence: an
important consequence of learning.
The fifth step
is the correction of mistakes, which should be
specific and not vague.
The value of the method lies in the use of all five
steps, not a ‘buffet’ selection of some of them

11. DIRECTLY OBSERVED
PROCEDURES WITH
FEEDBACK

12. The teacher observes the learner carrying out a task.This could be the insertion of an indwelling urinarycatheter,
intrauterine contraceptive device orvaginal pessary. If the learner fails, three steps areintegral to this method of
teaching
First, theteacher must observe, preferably record thefindings, and make a judgement
The second stepis to inform the learner of the opinion that has beenformed and to demonstrate how the
procedureshould have been done.In basic terms the learnermust be told that the performance was either
adequate or inadequate.
However, the methodof teaching is incomplete without the third step,which is to advise the learner exactly
where theywent wrong to the point of an inadequate score.The learner must be offered an analysis of the
mistake(s)

13. BRAINSTORMING

14. This is a spontaneous group discussion to produceideas and ways of solving a problem. The clinicalteacher may use this
method to promote clinicaland critical thinking in trainees who are at arelatively early stage in their career.
The teachermay start by introducing an idea or clinicalquestion such as the
measurement of cervical
length by transvaginal ultrasound as a valid
screening tool for detecting women at risk of
preterm labour.
Brainstorming would encompass the
pathophysiology of preterm labour; theanatomy of
the cervix; changes in the cervix prior
to the onset of labour; the reliability of ultrasound
and how it compares with vaginal examination in
terms of accuracy, acceptability and feasibility; the
concept of screening; how a simple study may be
designed; and how preterm labourcan be
prevented if an at-risk group is defined

15. SCHEMA ACTIVATION

16. A schema is a representation of a plan in the formof a model.
From a philosophical perspective aschema is a conception of what is common toall members of a class.
For instance,
it is quitereasonable for a clinical teacher to expect specialist trainees in year 1 to understand the anatomy of thevagina
and cervix.
These learners would have beentaught the basic anatomy in medical school.
Theteacher would activate recall of basic facts andconcepts prior to enhancing learning.
An examplewould be the task of providing a tutorial tospecialist trainees in years 1 and 2 on themanagement of
genitourinary prolapse. Theclinical teacher would initially apply schemaactivation to revise the learners’ knowledge of
pelvic floor anatomy which had been taught yearsbefore but the knowledge of which is essential toall the learners in
the group.

17. SCHEMA REFINEMENT

18. This is a useful method for teaching more advanced
learners. In this technique the learners are
encouraged to apply basic concepts, clarify their
understanding and solve clinical problems.
One
example would be the use of a tutorial on the
anatomy, physiology and endocrinology
appropriate to amenorrhoeafollowed by a series
of clinical cases which could include postchemotherapyamenorrhoea, Turner syndrome,
hyperprolactinaemiaand complete androgen
insensitivity syndrome. The learners recall what
they have experienced in the tutorial and attempt to
solve clinical problems.

19. SNOWBALLING

20. The discussion may be very basic and unstructured
at first. However, it soon becomes obvious that the
knowledge base of the learners is high and the
discussion is allowed to snowball —increase in
intensity and importance.
One example would be the task of teaching ethics
to a group of 12 embryologists for 2 hours. The
teacher is unsure of their current understanding of
the subject. They may start by getting the students,
in groups, to discuss the terms of the Abortion Act
1967 ,basing further teaching on the knowledge
displayed by the students.
Some clinical teaching methods have been
employed by teachers throughout their clinical
lifetime without their being aware that they had
a formal name!

21. SIMPLIFIED PROCEDURAL
HIERARCHY

22. A hierarchy is a system in which members are
ranked according to relative authority
simplified procedural hierarchy is a
demonstration by the teacher to the learner
or learners
There is no demand for assessment,
evaluation or feedback
The learner is simply shown how to do
something. For example, a teacher has been asked
to instruct junior trainees on how to carry out
diagnostic laparoscopy. The teacher initially shows
the trainees how to assemble the laparoscopic
equipment.

23. COMPLEX PROCEDURAL
HIERARCHY

24. In this technique a hierarchy is involved which
develops over several encounters and over a
significant time span.
In one example a consultant asks a trainee to assistin the operation of total abdominal hysterectomy.
After several such operations, during which theeducational experience of the trainee consists of
observing surgical techniques, there is a rapportbetween the consultant and the trainee. The
consultant would then ask the trainee to describethe operation in order to ascertain that they have
grasped the steps, techniques and use ofinstruments that are vital to a safely conducted
operation. The consultant then assists the traineein the procedure. After several operations with
ongoing assessment, evaluation and feedback, theconsultant and trainee would be in a position to
judge progress. The safety of patients is ofparamount consideration. If the trainee is capable
of carrying out uncomplicated abdominalhysterectomy independently, the next step is to task
the trainee to carry out the operation while assistedby another trainee. The consultant would be
immediately available.