|Teaching for Better Learning (WHO, 1992, 197 p.)|
|Part 2: How you can help your students learn|
This chapter helps the teacher to plan a teaching session. In doing this it brings together ideas from previous chapters and deals with some specific situations. These situations are: teaching people who cannot read (Section 10.7), teaching people who already have some experience (in-service training) (Section 10.8), and teaching small groups of students (Section 10.9).
10.1 Planning a teaching session - overview
The point of planning a teaching session is to ensure that you use the teaching techniques described in this book in the most effective way. You can make plans in many different ways. One method is suggested here, but you will probably need to adapt this method to meet the needs of your students.
The steps are:
1. Decide on the learning objectives (Section 10.2).
2. Decide how to attract the interest of the students (Section 10.3).
3. Decide on the key points of the session - and their order (Section 10.4).
4. Decide what activities will be done by the students (Section 10.5).
5. Decide how to judge whether students have learned enough (Section 10.6).
10.2 Learning objectives
In practice, teachers are usually given a theme or topic for a teaching session and allocated a certain amount of time. For example, you might be told, "Please teach the students about anaemia. There are three one-hour sessions available". Sometimes more detail is given. This would be helpful but this section assumes that only the minimum details are given.
The first thing you should do is to think about the topic in terms of task analysis.
"What tasks will the students need to do?"
"What resources or equipment are likely to be available?"
" What situations will the students be expected to cope with?"
" What knowledge will they need in order to do the various tasks?" "Are there any attitudes that are especially important?"
Using this method, you should be able to produce a list of learning objectives for the lesson. These may be split into performance objectives (the sub-tasks related to anaemia) and enabling objectives (the knowledge and attitudes necessary to enable the students to do the sub-tasks). Some examples are given below (this list is, of course, incomplete).
Examine patients for clinical signs of anaemia
Know where to look for clinical signs
Know how to recognize the clinical signs
Obtain a medical history from patients
Know which questions to ask
Know which items in a history indicate anaemia
Not - how to take a blood sample or do a haemoglobin test (for this category of health worker)
You should continue this list until you have covered all aspects of the work related to anaemia. The complete list is the list of learning objectives. Note that it is unlikely that this type of health worker will need to know anything about the components of blood. At this stage, you may feel that there is too much or too little detail to be covered in three hours. If so, then you will need to adjust the course. In some cases, you will need to go back to the employers and ask them to reduce the number of tasks or responsibilities related to the job or increase the total time available for training.
10.3 Attracting the interest of students
Now you have to think how to make "anaemia" meaningful and interesting to students. In general, students will find a topic interesting if it is related to their own experience of life (not books or previous lessons) or to the work they expect to be doing.
Therefore a bad way for you to start the session would be:
"Last time we completed the teaching on tetanus. Today we will go on to a new topic, anaemia".
"Last time we finished one aspect of antenatal care - prevention of tetanus. Today we go on to another important part of antenatal care - caring for pregnant women who have anaemia".
Better again would be:
" We are now going on to another aspect of antenatal care - caring for women with anaemia. Many pregnant women have anaemia and it is one of the serious problems of pregnancy. You can do a lot to reduce this problem and these sessions will tell you how".
A better way would be to follow the previous example and then go on to questions such as:
"Have any of you ever had anaemia?"
"Have any of your family had anaemia during pregnancy?"
" What did it feel like when you had anaemia?"
Other topics will need other introductions, but in every session you must try to find the best way of making the subject seem interesting and important to the students.
10.4 Key points
Every session needs to be structured in terms of ideas and topics. One way of doing this is to think of the questions or problems that the session will answer or solve. These questions or problems will, of course, be related to the learning objectives. For a session on anaemia, the questions might be:
A. "How can you tell if a person has anaemia?"
B. "What advice should you give to pregnant women to prevent them becoming anaemic?"
C. "What is anaemia?"
D. "How can it he treated?"
E. "Why is anaemia important?"
When you have listed all the key points or questions, you should then try to put them into a sensible order.
What order would you choose? For example, if you would teach point E first, put the letter E beside number 1, below.
Probably you have put them in the order C, E, A, D, B. However, the various points could also be taught in a different order.
The overall pattern of the session is now established. There will be an introduction designed to gain the students' interest. This will be followed by the main part of the session dealing with the key points in order. Finally there will be a summary.
Often teachers think mainly about what they will do during a session. This is natural, but it is better for teachers to think about what the students will do. As discussed in Section 6.5, students learn very much faster when they are active.
How could "anaemia" be made active?
The starting point is to go back to the objectives. Certainly students will have to practice all of the performance objectives. In this case the students should, as a minimum, look at each other's conjunctival and practice checking for the other clinical signs. Ideally, they should then go on to examine patients. However, they could be asked to do exercises based on case-studies which describe different patients, some of whom have anaemia and some who do not. Role-playing exercises could also be used for the students to practice giving advice to mothers about anaemia.
It is also important to try to make the learning of facts as active as possible. This can be done very simply by setting a short test at the end of the session. Another and possibly better way is to ask the students questions during the session. Do not tell the students everything. Encourage them to think, deduce or guess what the facts are. The less the teacher tells and the more the students work out for themselves the better.
Incidentally, when you ask a question, it is much better to ask all students to write down their answer on a piece of paper than to ask only one student to speak the answer. This gives you a chance to look at all the answers and so judge how well the students are doing. It also makes every student active instead of just one.
10.6 Judging how much students have learned
An integral part of all teaching sessions should be some form of assessment. Teachers should not assume that everything they say has been learned. The activities described above also allow teachers to judge whether the students have achieved a good enough standard.
Ideally, you should only begin teaching a new group of topics when all the students have achieved all the learning objectives related to the previous session. This is rarely achieved in practice. However, the principle is clear and you should try to follow it as closely as possible. You will only know whether you are doing this if you assess what the students have learned.
10.7 Teaching people who cannot read
Many health workers cannot read or find reading and writing very difficult because they have had little or no schooling. The following points may help you to train people with such difficulties.
· Many people who cannot read are just as intelligent and capable of learning as other people. They simply did not have the chance to learn how to read and write when they were children. So they must not be treated as stupid or slow.
· There will be no point in providing these students with written textbooks or written handouts - or writing words on the board.
· The students may find pictures just as difficult to understand as words. However, pictures can be meaningful if they are explained. They can help students to remember what you have said.
· It is especially important to make learning as active as possible. You should draw on the experience and communication skills of the students. Keep asking them what they already know and what they would do in certain situations.
10.8 In-service training
The purpose of in-service training should be to improve the way in which health workers do their work. This is a fundamental point which is often ignored. As a result refresher training is given, which has no impact at all on the way in which the work is done. How can you avoid this problem?
First, you need to think carefully about exactly what improvement in working methods is required. You will need to talk to managers and supervisors. You will also need to go to the field and observe the way in which health workers do their work. In this way you can prepare a list of tasks that should be done differently. Then you should give some thought to the reasons why the tasks are being done badly.
· Is it because the health workers do not know what should be done?
· Is it because they do not have the necessary skills?
· Is it because they are being forced to work in the wrong way?
· Is it because they do not have the right equipment or supplies - or enough time to do the task correctly?
If the reasons are related to a shortage of supplies or other factors outside the control of the health workers, then in-service training for health workers will not improve the situation. Take a different situation. The health workers are giving antibiotics to children with a common cold. You find that they are doing this because the parents insist that their children should be given antibiotics and will make complaints if the children do not get them. To solve this problem, you might need to train the health workers in ways of explaining to the parents why antibiotics would be of no use. Certainly, just telling health workers when to give antibiotics would not have much impact.
This process of analysis will lead to a set of learning objectives. They should be very specific and designed to lead to changes in working methods that are realistic and that will improve the quality of health care. General refresher courses covering a lot of topics, but not dealing with anything in much depth, should not take place.
A final point about in-service training courses concerns the teaching methods. Most of the health workers will be experienced and already have a lot of knowledge and skill. This must be recognized. You should make a point of asking them what they would do to improve situations, rather than telling them. Health workers usually know much more than teachers about how health care can be provided in the field situation.
10.9 Working with groups of students
Much has been said and written about the advantages of smallgroup teaching. There are indeed many potential advantages. Unfortunately these advantages are not always apparent because teachers may not use the methods effectively.
One problem is that small groups are sometimes taught in exactly the same way as large groups. The same sort of lecturing style is used. The only difference is that fewer people hear the lecture. If this happens, very little benefit can be expected.
At the other extreme, some teachers have such confidence in the use of group discussions that they give the group a topic to discuss and leave them to discuss it in their own way. Usually this leads to a very disorganized discussion:
- nobody knows who is right and who is wrong,
- the confident, assertive students talk all the time while the shy students never speak,
- the students do not listen to what other students say,
- topics are changed more or less at random.
Where this happens, very little learning occurs.
In order to avoid these two extremes, you should:
· Have a very clear idea before the session begins concerning the topics to be discussed and the activities that the group will take part in.
· Control the discussion by encouraging the shy people to give their ideas first and by ensuring that all students have some chance to give their views.
· Control the discussion by ensuring that all students keep to the topic being discussed, by pointing out differences (or similarities) between the ideas given by different people, and by ensuring that the discussion is summarized in writing.
· Give feedback to ensure that all students know whether the opinions or ideas given are right or wrong.
· Tell students when they make points that are wrong. This must be done in such a way that they are not discouraged.
· Encourage a group spirit by setting tasks for the students to work on as a group.
If these rules are followed, small groups can learn quickly because all the students are actively involved in thinking and in expressing their ideas.