CHAPTER 4: Task analysis

Figure

This chapter explains how teachers can look at each of the tasks in more detail to find out exactly what needs to be learned.

A story

Mr W. a teacher in a college of health sciences, was asked to teach a group of trainee nursing orderlies about weighing babies in an MCH clinic. He carefully planned a series of lectures about child development and told the students about nutrition and malnutrition. He explained why babies should be weighed regularly and he brought scales into the classroom and demonstrated, using a doll, how to weigh a baby At the end of the course the students took an examination in which they wrote short notes on questions such as " What are the major causes of ma/nutrition?" and "List three reasons for weighing babies regularly". The students ail answered the questions quite well and Mr W was pleased with their performance

However, when the nursing orderlies started to work in the MCH clinics there was chaos They did not know how to organize the queue of mothers and children because the teacher had not told them They had great difficulty picking up and weighing the babies, because they had only seen the teacher weigh a doll. They did not know how to record the weights on a growth chart, because they had never used graphs and did not understand them.

What went wrong? Even though the task was specified (weighing babies), Mr W had not thought in detail about how the students would do the task - he had not done a task analysis.

This chapter describes how to do a task analysis. Task analysis will help teachers to make sure that their students learn exactly how to do each of the tasks in their job.

4.1 What is task analysis?

Task analysis involves looking at some part of a person's job (a task) and writing down exactly what is done. This description is then analysed to find out what students need to learn in order to do the task well.

Task analysis can be done in great detail by professional teams who may take years to do a full task analysis. However, it can also be done in much less detail and much more quickly by teachers. This less detailed approach will still be extremely useful and will be described in this chapter.

4.2 An example of a task analysis

If Mr W had analysed the task of weighing babies in an MCH clinic, he might have produced something like the example overleaf.

This task analysis was done for a specific category of health worker in one country. Health workers may do the task in a different way in other countries. Some may not use the weighing

Task analysis form trousers or may not examine the baby at all when it is weighed. Some may carry out a thorough examination. The example is intended to show how to write down a task analysis. It is not meant to be a perfect model for weighing babies in every country.

Category of Worker Nursing orderly
Task Weighing a baby in MCH clinic

Sub-Tasks	Knowledge	Attitudes
Actions (A) Decisions (D) Communications (C)
1 Ask the mother to dress the baby in weighing trousers (C)		Friendliness to mothers
2 Check and adjust the zero point on the scale (A and D)	Location of the zero adjuster	Concern for accuracy
3 Place the baby on the scale (A)		Gentleness and caring
4. Read the scale (D)	The need to look at the scale from straight in front	Concern for accuracy
5 Help the mother take off the weighing trousers (A)
6. Examine the baby for physical signs of abnormalities (mainly D)	Which signs to look for	Thoroughness
7. Record the weight on the growth chart (mainly D)	How to read and plot graphs	Accuracy
8. Decide what comment to make to the mother (D)	Criteria for malnutrition, weaning methods, locally available foods
9. Make a comment (C)	Ways of communicating effectively	Sympathy for the problems faced by mothers

What does this example show? First, the task - weighing a baby - involves much more than simply putting a baby on a weighing scale and making a note of its weight. A task analysis can show the whole range of skills involved in doing a task.

Second, the task analysis shows which facts and attitudes need to be learned by the students in order to do the task. This also helps teachers to decide which facts must be learned and which are less important.

The rest of this chapter explains how teachers can prepare a completed task analysis like the example shown, and how they can make use of it. No teacher has enough time to do a full task analysis for every task that he or she teaches. However, it will certainly be useful for teachers to do at least two or three task analyses in full. This will help them to think more in task analysis terms and so make their teaching more practical and more purposeful.

4.3 The stages in doing a task analysis

Select the task for analysis	Section 4.4
Select the sources of information	Section 4.5
Collect the information	Section 4.6
List the sub-tasks	Section 4.7
Decide on the knowledge and the attitudes needed	Section 4.8
Check the task analysis table	Section 4.9

The diagram shows the stages which are described in turn in Sections 4.4 to 4.9.

4.4 Selecting the task

The first stage is to select the task for analysis. In this book two examples are used. One is "weighing a baby" and the other is "persuading an unwilling mother to take her child for immunization". These are both tasks.

The situation analysis leads to a list of tasks. Ideally, a task analysis should be done for each of these tasks. In practice, this takes too much time, so just a few tasks should be chosen to start with. It does not really matter which tasks are chosen, but it might be sensible to start with tasks that are familiar or are carried out frequently by health workers.

4.5 Selecting the sources of information

When you have decided on the tasks that you wish to analyse, you should decide how you will find out about the way the tasks are done. To do this you should choose one, or preferably several, of the sources listed below:

Sources of information for task analysis

A Yourself
B Manuals and textbooks
C Observation of health workers
D Discussion with teachers, administrators and advisers
E Discussion with health workers

Suppose you wished to analyse the task of giving intramuscular injections. If you had a lot of experience of this task, you might use that experience as the main source of information. You could compare your description of the task with that given in a textbook or manual. You could also check that your analysis was accurate by watching several health workers giving intramuscular injections.

The advantages and disadvantages of each source of information are given below.

A Yourself

You are likely to have some experience of the tasks to be analysed. Therefore you should use it. You are certainly the most convenient source of information.

But remember:

you may not have enough experience or the right experience. Have you been working under the same conditions as your trainees will be working under? Have you been working with the same kind of patients? Is your method of doing the task really the best?

Even if you are able to answer "yes" to these questions, you should always check your analysis with at least one of the other sources.

B Manuals and textbooks

Many of the tasks carried out by health workers are described in medical textbooks, teaching manuals and guidelines issued by the ministry of health or WHO. A task analysis can therefore be prepared, based on one or preferably several sources of reference.

But remember:

the manuals or textbooks may be intended for trainees at a different level of the health system, in which case the skills will be described in too little or too much detail. Furthermore, they may have been written for different countries or different circumstances.

The tasks will not be described in the form of task analyses and so you will always have to change the format and add your own experience. For example, you may have identified the task of "monitoring the growth and development of children". A textbook will probably give all the background information but it is unlikely to say exactly what health workers in your country should do. It might also describe the normal changes in body weight and the need for a suitable diet. You would have to rewrite these details as a series of tasks such as weighing and recording the weight of children, or examining them for signs of malnutrition.

C Observation of health workers

In this method you would choose health workers who are regarded by their colleagues as being good at their job. You then watch the workers doing the task to be analysed, noting down everything that they do or say. At the end of the task you will probably need to ask the workers to explain why certain actions were done and what would have happened if the circumstances had been slightly different. Ideally, you should watch the same person doing similar tasks several times, and also see other people doing the same task. In practice, this may take too much time.

If you have seen two or three people doing the task in the same way, then this is enough.

But remember:

competent workers will be especially careful to do a good job while you are watching. They may take unnecessary precautions. On the other hand, workers may be generally very competent but may not be very good at the particular task you are watching. A further problem is that there may be unusual circumstances when you are watching - for example, the patient may be particularly uncooperative. So what you see may not be typical.

A further difficulty is that you might not be able to identify all the different stages of the task or the events may take place too quickly to record them all. For example, if you watch a midwife delivering a baby, you will probably see her place her hand on the baby's head as the head comes out. In this case, you will have to ask the midwife why she does this, in what direction she is pressing and how hard she presses.

D Discussion with teachers' administrators and advisers

It will often be helpful to talk about the task with teachers, doctors, nurses, training advisers or officials from the ministry of health.

When talking to one of these experts, do not ask them what they would teach. Instead, use a role-playing method.

For example, you could start by saying - "Imagine that you are a health worker working in the field. Suppose that I come to you and tell you that I have been coughing a lot. What is the first thing you would do?"

The expert might tell you " Well, I would start by taking a history."

This is much too vague, so you would need to follow this up by asking, " Yes, but what would you actually say to me?"

The expert might then reply " When did your cough start?"... and so on.

In this way you can piece together the specific actions, decisions and communications involved in the task.

But remember:

the experts may not realize what conditions are really like in the field. They may have a good understanding of the overall job of a health worker but may not be good at actually doing it.

E Discussion with health workers

In this method you would select a worker or a group of workers who are generally regarded as being good at their job. You would then discuss a specific task with them in the same way as described above, i.e. using role-playing and talking through specific case histories.

This method has the advantage that you will be told what is practical and realistic in the field. You will also hear about other people's experiences.

But remember: the workers may not be using the best techniques because they may have been trained some time ago. They may also have developed poor habits after training.

From the previous sections you will realize that each source has advantages and disadvantages. Ideally, several different sources should be used, as suggested overleaf.

4.6 Collecting the information

The next stage is to collect the information from the sources which you have decided to use.

Use your own experience

Note down how you think the task is done. This will be useful in putting your own experience on paper and will help you to organize your thoughts. It may also make you realize that there are some details which you are uncertain about.

Consult the manuals

Use them to fill in any gaps in your own experience and compare what you think is correct with the textbooks or manuals.

Discussion

Discuss any differences between your opinion and what is written in the manuals or textbooks with experts or health workers. This will help you to decide what actions are involved in the task.

Observation

Check your task analysis by watching the good workers doing the job. Make sure that the sequence of actions you have noted down is the one used by the workers. You should not include actions which they are not trained to do or for which they do not have equipment.

Collecting the information simply means writing down the various stages (the sub-tasks) of the task. While you are writing these down, it is a good idea to ask the following questions.

· How is the sub-task done? Are there any special points to note about the technique?

· What is the reason for doing the sub-task? For example, when weighing a baby, the nurse orderlies should examine the baby to detect early signs of malnutrition. This will allow preventive treatment to be provided before the condition becomes serious.

· What might go wrong? What would happen if the sub-task was poorly done? For example, mothers might be discouraged from bringing children to the clinic if they are treated rudely or have to wait for a long time.

All these points should be noted down. They will be put in order in the following stages.

4.7 Listing the sub-tasks

At this stage you should draw up an organized list of sub-tasks using the notes you have taken. You can write this list on a task analysis form such as the one shown below.

Task analysis form

Category of Worker	Nursing orderly
Task	Weighing a baby in MCH clinic
Sub-Tasks Actions (A) Decisions (D) Communications (C)	Knowledge	Attitudes
1. Ask the mother to dress the baby in weighing trousers (C)
2. Check and adjust the zero point on the scale (A/D)
3. Place the baby on the scale (A)
4. Read the scale (D)
5. Help the mother take off the weighing trousers (A)
6. Examine the baby for physical signs of

The sub-tasks are the things that happen:

· the actions
· the communications
· the decisions.

You should record these on the form in the order in which they occur. So for the task of "weighing a baby" you should have a form like the example shown.

The sub-tasks are the skills that students should learn. They are the learning objectives of the course, but they are not the only learning objectives. Other learning objectives are described in the next section.

4.8 Deciding on knowledge and attitudes

The sub-tasks are the key to successful teaching. If students are able to do each of the sub-tasks successfully then the course will have been successful.

So why bother to do a further stage?

The reason is that some of the sub-tasks require knowledge or attitudes that must be taught. For example, health workers must know what a graph is in order to "record the baby's weight on a growth chart". The health workers must also learn about correct attitudes towards mothers before they can "ask the mother to undress the child". Otherwise they may be rude or bossy and do the sub-task in an unsatisfactory way.

The sub-tasks are the performance objectives for the course. Knowledge and attitudes are also important to enable the health workers to do the sub-tasks. These are the enabling objectives for the course.

How can you decide what the enabling objectives should be?

To make this decision, you need to consider questions such as "Why might a student do this sub-task poorly?" or "What rules or facts must the student know before making that decision?"

For example, consider the sub-task "decide what comment to make to the mother" (after weighing the baby). Here the health worker has to decide whether the baby is growing properly or is at risk of malnutrition. This decision requires knowledge of normal weights for babies of different ages and clinical signs of malnutrition. These topics must be taught and are the enabling objectives for this subtask.

Consider the sub-task "make a comment" (after weighing the baby). Here the health worker may need to give the mother some nutritional advice. This involves knowledge of feeding practices, weaning foods, foods available locally, etc. The health worker will also have to give this advice in the right way and try to support the mother. This requires sympathy for the difficulties that mothers face - an attitude.

In this way, you can list the knowledge and attitudes needed for each of the sub-tasks on the task analysis form. When completed, it should look something like the form on page 22. Note that some tasks do not require specific knowledge or attitudes. Do not feel that you have to put something in every space on the form.

4.9 Checking the task analysis table

The task analysis table is now complete. However, it should not be used until it has been checked.

If you have used yourself, books or discussion as the sources of information, you must check that what you have written describes what health workers actually do. The only way to check this is to observe health workers doing the task in the field.

Remember also that health workers may be using old methods or may not have been trained how to do the task in the best way. So check with experts about the best way of doing the task.

You may find that the best way of doing the task is not realistic because the health worker does not have enough time, resources or training. In these cases teachers have to decide whether to train their students in the best method or to limit the training to what is realistic now. Task analysis does not help in making this decision but it does help in making the differences clearer.

4.10 Using the task analysis table

The value of the task analysis is that it gives teachers a very clear statement of the objectives for the course. These objectives have been worked out from the job description and from watching experienced health workers doing the job. So they must be relevant in helping the trainee health workers to learn.

Task analysis Relevant objectives

What is the advantage of having relevant objectives?

The objectives tell teachers exactly what the students must learn. So they help teachers to make sure that all the necessary content is included in the curriculum. They also help them to decide which details can be left out.

Task analysis Relevant content

The objectives are also useful in assessing the students. The subtasks or tasks should be used as the examination questions whenever this is possible. For example, the best way to test whether students can do the task of "weighing a baby" would be to ask them to run a session at a clinic where babies are weighed. While this is the ideal test there may be difficulties in organizing it. So teachers could ask students to do some of the sub-tasks instead. For example, the students could be asked to record a baby's weight on a chart or decide what advice to give a mother whose 12-month-old baby weighed 7 kg.

Task analysis Relevant assessment

The final point is that a task analysis is the first stage in choosing teaching methods. If students are learning facts or knowledge, lectures may be a good way of teaching them. However, if they are learning a skill, they must be able to practice the skill - lectures will not be of much use. So when teachers think about whether students must learn skills, attitudes or knowledge they need to think about teaching methods.

Task analysis Choice of teaching method

4.11 How can teachers find time for task analysis?

Teachers are very busy and very few will have time to analyse more than one or two tasks. So here are some practical suggestions.

· Do one or two task analyses as described in this chapter. Use several sources of information and check the results in the field. This will take quite a lot of time, but it will be time well spent.

· Think in terms of task analysis. For example, when planning a lesson decide which facts must be learned and which are less important. If the fact would appear in the "knowledge" column of the task analysis form, it should be taught. If not, it should probably be left out.

· Teach your students to do task analysis. This is one of the best ways of learning how to do a task. When one group of students have analysed a few tasks, they will be able to teach other groups. (This must be supervised of course).

4.12 A less straightforward task

"Weighing a baby" is a fairly straightforward task. It can be analysed by watching health workers, most of whom follow the same sequence of steps or sub-tasks. Other examples of straightforward tasks are "giving an intramuscular injection" and "building a pit latrine".

Other tasks are much less precise, however, and different workers will follow different methods. For example, consider the task "persuade a mother to breast-feed her baby". This is much more vague. There are many ways of doing this task. None of them is guaranteed to work every time and each health worker will need to develop his or her own method.

So is it worth analysing this kind of task? The answer is definitely "yes", because students have to learn how to do these less precise tasks. The minimum responsibility for teachers is to teach the students one way of doing the task, even if there are several possible ways.

It is also important to do the task analysis because it will often show that the student needs a lot of practice in communication skills and that attitudes are extremely important. While task analysis will not show the only way to do the task - nor even possibly the best way - it will show a way that is acceptable and that includes the basic skills, knowledge and attitudes that the students must learn.

Look at the example below which analyses how a health worker might do the following task: "persuade an unwilling mother, in a remote area, to take her child for immunization".

Example

Task: To persuade an unwilling mother, in a remote area, to take her child for immunization

Sub-tasks Actions (A) Decisions (D) Communications (C)	Knowledge	Attitudes
1. Greet the mother (A)	Friendliness, lack of prejudice
2 Find out reasons for refusal (C)	Common reasons for refusal (cultural, procedure, prejudice due to reported experience)	Sympathy, patience
3. Explain why immunization is beneficial to the child	Reasons for immunization, effects, simple facts about illnesses prevented by immunization
4. Explain importance to community of protection of all at-risk children (C)	How disease may spread, simple facts about immunity, epidemics in community	Confidence in ability to help
5 If successful, arrange clinic appointment for mother (A)	Fully conversant with immunization programme (dates, times, place)	Sympathy, friendliness
6. If unsuccessful, seek an appropriate decision- maker (A)	Decision-maker in local culture (husband, grand mother, council elder)	Tact
7. Repeat 3 and 4 (C)

While this task may be performed in different ways, the example given does show some important points which are likely to apply to all countries.

1. The task involves little knowledge of "medical topics" such as types of vaccine or mechanisms of immunization.

2. There is a great emphasis on communication skills - i.e. the ability to talk, explain, persuade, and listen to people.

3. The learning experiences which will help students to learn the relevant skills knowledge and attitudes are practice in talking and listening, in preparing information material, and in writing reports.

4.13 Summary

1. Task analysis is a method for describing exactly how parts of a job (tasks) are done.

2. Teachers should use task analysis in:

· stating the objectives of a course
· deciding on the content of courses
· choosing questions for examinations and tests
· choosing teaching methods.

3. Teachers should analyse at least one or two tasks in full. They should consider teaching their students how to do task analysis.