CHAPTER 1: Introduction

Before I started to write this manual I talked to teachers about the problems they faced. They told me about the large numbers of students in each class, the problems of crowding in schools, the poor facilities, and the difficulties of providing food, writing materials and textbooks for students. They also discussed the difficulties caused by lack of time to prepare lessons and examinations. All these difficulties are real and serious. This book cannot put right the cause of these problems by giving the teachers more time or money to spend on supplies, but it will try to show how teachers can use the available resources most effectively.

The teachers also told me about other problems they faced:

"The curriculum we are given is very difficult to interpret. We don't know how much detail to teach."

"The examinations encourage the students to learn facts rather than how to apply the facts."

"The students are good at book learning, but they are weak when they face practical situations."

"The courses are at too high a level."

"The teaching doesn't really train the students how to do the job."

The main aims of this manual are to help teachers to solve these problems. In particular, it will explain how to do four things which are very important in teaching. These are:

- Deciding exactly what the students should learn.
- Choosing and using suitable teaching methods.
- Testing whether students can do the work for which they are being trained.
- Preparing teaching materials and manuals.

1.1 Who is this manual written for?

This manual is written for teachers of primary health care staff. It may be helpful to health care staff who have recently been appointed as teachers. It may also help teachers who have more experience of working with students but who want to learn more about their profession.

The manual will also help people who are involved in planning curricula for health workers or in planning systems of health care. It may also be used by teachers or agencies who are preparing manuals for health workers.

A fourth group who might find the book helpful are students in medical schools and training centres who may later be responsible for training members of the health care team.

1.2 Why has this manual been written?

Teaching is a very skilled job. Yet many teachers have little or no training in how to teach. As a result, they tend to copy the teaching methods which they experienced during their own training. In many cases, they have little opportunity to learn newer, more effective teaching methods.

This book has been written to explain some of the basic points about teaching. It is designed to give teachers information about the variety of teaching methods available to them. Teaching is not simply a question of telling students what they need to learn to do a job. It also includes deciding what students should learn, how they should learn it, and finding out how well they have learned it.

This book has been written in non-technical language as far as possible so that it can be readily understood. It aims to solve some of the problems which teachers face when working with trainee health workers. It is also intended to help those people who are involved in planning courses and manuals for health workers.

1.3 How to use this manual

This manual can be used in either of two ways. It can be used for reference and additional reading - for example, during an educational workshop. Participants may also be asked to do some of the exercises in the book and to discuss the work with other people at the workshop.

The other way of using the manual is to read through it. If you do this, please work on the exercises when you come to them. Write down your answers, either in the space provided or on a separate piece of paper. Try to write down your own ideas before you look at the comments in the manual. In this way you will get much more benefit from the manual, although it will take more time and will need more effort.

A final point. If you read the manual, try to read through it from start to finish rather than looking at the chapters in any other order. This is because many of the ideas in Parts 2, 3 and 4 depend on the explanations given in Part 1. If you prefer to read the book in a different order, the contents page will guide you. If you find that any of the more technical words are unfamiliar, there is a section at the end which defines some of the educational terms.

1.4 How the manual has been written

The manual has been developed rather than written. Early drafts were reviewed at a workshop attended by consultants and representatives of four WHO regions and WHO headquarters. Further draft versions were prepared and field-tested in Kenya and Papua New Guinea. Copies were circulated to many countries and over 100 teachers gave advice on ways of improving these early versions. As a result of this process of development and testing, the first edition was prepared. It included a questionnaire to readers, asking them for their comments on ways in which the book could be improved.

Many comments were received by the author, and were all taken into account during the preparation of the second edition. The advice of readers was extremely important in the re-writing process. It is clearly recognized that this edition is still far from perfect and so continuing advice from teachers and other readers would be most welcome. The author and WHO welcome any comments. Suggestions for specific ways in which this book could be made more helpful to teachers would be especially appreciated.

1.5 A summary of the manual

The manual is arranged in four parts.

Part l deals with the general problem of what students should learn. This is an important issue because complaints are often made that students may know the facts but are not good at applying them. The equipment or drugs which they are trained to use may not be available. In the same way, the skills which they learn may not be related to the real problems of the rural areas.

In Chapter 2 it is suggested that students should be trained to do a specific job rather than to learn a number of academic disciplines. To do this, the job must be defined and related to the health needs of the community. This process is explained in Chapter 3. Chapter 4 looks at the job in more detail so that the teachers can decide exactly what needs to be learned. The technique described for looking at the job is called task analysis.

Part 2 will help you to choose the most suitable teaching methods. Chapter 6 gives a summary of the general ways in which the teacher can help students to learn. Chapters 7, 8 and 9 concentrate on the specific problems of teaching attitudes, skills, and knowledge.

Part 3 will help you to test your students. This section explains the value of testing in helping students to learn and in helping teachers to improve their work. Various assessment methods are explained in Chapter 12, with examples which can be adapted and used with a wide range of students.

Part 4 describes the ways in which teachers can prepare teaching materials and manuals which will help their students to learn. The manuals may also be used for reference by the health workers after they have completed their courses. It is important that teachers can help their students in this way because there are very few manuals available for health workers, and many of those which are available are not appropriate for local conditions.