A Sampling and Overview of Instructional Methods Below is a sampling of instructional (i.e., teaching/learning) methods in which students have opportunities to become involved in the instructional process as ways to engage them, toward developing critical thinking and problem solving skills. Each of the instructional methods can be implemented and used in a variety of ways and can also be combined, using 2 or 3 simultaneously. For example, large group teaching does not just mean lecturing to a large group of students. These methods will not be successful in and of themselves. Toward the success of each, there are numerous additional effective teaching strategies that must come into play and be implemented in harmony with the methods (e.g., the use of questions; how the methods are combined and presented to the learners; how visuals, including media, are used; pacing; how the online or blended learning is designed, keeping in mind objectives, and presented; orientation to the teaching and learning situation; learning climate; negotiation; leadership). One also needs to exercise the skillful ability to move through the evolving process of teaching and learning moments, and the learning domains of any give learning/teaching situation; as well as understand the interplay of learning objectives, domains of learning, teaching methods, and teaching settings (e.g., classrooms, clinical venues, laboratories). Also of critical importance is the interaction of the teacher and learners. “Teaching is not only the art of thinking and speaking. It is also the art of listening and understanding. Nor by listening is meant just the act of keeping still. Keeping still is a technique; listening is an art.” 1 Barnes, L.B., Christensen, C.R., & Hansen, A.J. Teaching and the case method (3rd ed). 1995. Boston, MA: Harvard Business School Press, p. 16.
Instructional Methods Brief Description Use Examples Case Based “A successful case…involves many characteristics of active Can be used in large or small group teaching, in learning: students‐teacher interaction, collaboration, problem conjunction or sequentially, with many of the solving, reflection, and extensive discussion. Within a case…, instructional methods described in this document, students develop group‐interaction skills, respond to ideas and such as large group teaching, small group teaching, contributions of classmates, and apply career and life discussion. experiences. Another value….is its potential for involving students in discussion that call for higher–order… reasoning, such as analyzing situations, forming judgments, and evaluating solutions.” “A case sets up a problem to be solved or a question to be answered.” 1 Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 A Sampling and Overview of Instructional Methods Team Based “Team–based learning” is an instructional strategy that is designed to a) support the development of high performance learning teams and b) provide opportunities for these teams to engage in significant learning tasks.”2 Problem Based “A method characterized by the use of patient problems as a context for students to learning problem‐solving skills and acquire knowledge about the basic and clinical sciences.”3 “One objective…is to provide an environment for active and self‐
directed learning.”4 One example: Thinking Aloud Pair Problem Solving (TAPPS). “Students in pairs talk aloud as one student attempts to solve a problem, while the other listens and tries to clarify what is being said. Thinking aloud works because it makes students aware of their thought processes as they solve problems; it also helps them quickly see when they make errors or run into blind spots. Problems solvers must…talk about how they are thinking about solving it.” The job of the listeners [is] to” ask questions without solving the problem.” We often do not know what we think until we try to say it. “Talking with other is...an integral part of learning.”5 “A structured, systematic instructional strategy in which small groups of students work together towards a common goal”.6 Goals are “to enhance students’ learning and develop…skills like decision making, conflict management, and communication.” 7 Problem Solving Exercises Cooperative Group Projects/Work Large Group Teaching Small Group Teaching Classroom large group setting with usually more than 12. Active learning can be encouraged in a) individual or pairs… in a large lecture or b) groups of students in a large group. 8 “Putting…students in a class into small groups for the purpose of promoting more active and more effective learning.” 2 As there can be sub‐groups within groups, it is hard to define small group. There is no magical number…. A lecturer used to This instructional strategy is a way of using small groups. It can be used for small group teaching & learning within larger groups, in conjunction or sequentially with many of the instructional methods described in this document, such as cooperative group work, small group teaching, large group teaching, problem solving exercises. A small group instructional strategy. It can be used in large or small group teaching, in conjunction or sequentially with many of the instructional methods described in this document such as small group teaching, problem solving exercises, simulation. Can be used in large or small group teaching, in conjunction or sequentially with many of the instructional methods described in this document, such as small group teaching, peer assisted learning. 2 A small group instructional strategy. It can be used in large or small group teaching, in conjunction or sequentially with many of the instructional methods described in this document, such as peer assisted learning, discussion, small group teaching. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as case based, problem based, team based, simulation, teaching and learning with Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 A Sampling and Overview of Instructional Methods Lecture Discussion Role Play taking 400 in a lecture would define 50 as a small group. In a discussion, where participation is assessed some students may not speak up in a group that begins to be get bigger than 10 participants and in addition [faculty] would find it hard to assess participation by individual students in groups with numbers greater than this.8 “A formal presentation in a classroom [type] of setting.”9 “Probably the most frequently abused method”10 Can include an interactive lecture. technology, microskills/one‐minute preceptor, experiential learning, peer assisted learning, tutorials. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as case based, problem based, team based, classroom assessment, teaching in the conference room, teaching and learning with technology. “An…effort by a group of 2 or more to share views and engage in Can be used in large or small group teaching, in mutual and reciprocal critique. Purposes: 1. To help participants conjunction, or sequentially with many of the reach a more critically informed understanding about the topic(s) instructional methods described below, such as case under consideration; 2. To enhance participants’ self‐awareness based, problem based, team based, simulation, and their capacity for self‐critique; 3. To foster an appreciation teaching and learning with technology, experiential among participants for the diversity of opinion that… emerges learning, providing feedback, inter‐professional, when viewpoints are exchanged openly and honestly….” 11 student presentations, teaching in the conference “…fundamental premises: 1. A discussion class is a partnership in room, learning portfolios. which students and instructor share the responsibilities and power of teaching, and the privilege of learning together; 2. A . discussion group must evolve from a collection of individuals into a learning community with shared values and common goals; 3. …the discussion leader can help them [students] gain command of the course material; 4. Discussion teaching requires…the ability to manage content and process. 12 Can be used in conjunction, or sequentially, with “… More or less unstructured situations in which students’ behaviors are improvised to fit in with their conceptions of roles many of the instructional methods described in this document such as providing feedback, simulation, to which they have been assigned. The individuals portraying specific roles improvise their responses to the situation. No lines large group teaching, small group teaching. “To give students practice in using what they’ve learned; to are learned.”13 Students are assigned “roles in a true‐to‐life, illustrate principles from, the course content; to problematic social or interpersonal situation that they act out, develop insight into human relations problems; to improvising the script. Students learn experientially by provide a concrete basis for discussion; to develop identifying with the roles they play and observe.”6 “Role plays, Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 3 A Sampling and Overview of Instructional Methods Teaching & Learning with Technology (e.g., online, blended, spectrum of technologies) Variations on Journal Clubs Classroom Assessment Peer Teaching/Peer Assisted Learning simulations, and games can be used to help students experience ‘stressful, unfamiliar, complex, or controversial situations’ by creating circumstances that are momentarily real, thereby letting students develop and practice [necessary skills]….”14 Different technologies have different characteristics that can be exploited to enhance particular kinds of learning, but... ...the determinant of success or failure appears to be the quality of the learning design itself, rather than the vehicle. Certain basic
knowledge and skills are required for online instruction and that
teaching goals must lead the use of technology. Faculty need to design learning that can incorporate appropriate technologies to meet the needs of individual learners and course or curricular goals. Selection of appropriate technologies is defined by such factors as desired learning outcomes, student needs, learning styles, and approaches to learning. The purpose of journal club is to provide critical appraisals of articles that impact the clinical practice of critical care and to foster the development of skills necessary for the practice of evidence‐based medicine.15 Participants review a specified number of articles on a weekly or monthly basis. an awareness of one’s own and others’ feelings.”13 Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as discussion, small group teaching, problem based learning, lecture, tutorials, peer assisted learning, providing feedback, simulation, learning portfolios. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document. Articles can be chosen by the learner or faculty based on specific criteria, such as discussion, small group teaching, teaching and learning with technology, peer assisted learning. “An approach designed to help teachers find out what students Can be used in conjunction, or sequentially, with are learning in the classroom and how well they are learning it.” It many of the instructional methods described in this is learner‐centered, teacher‐directed, mutually beneficial, document, such as lecture, large group teaching, formative, context‐specific, [and] ongoing….”16 small group teaching, experiential learning, teaching and learning with technology. Can be used in conjunction, or sequentially, with “Increasingly recognized as important alternatives to more many of the instructional methods described in this common forms of small‐group work.”10 “Cognitively it provides document, such as small group teaching, tutorials, an opportunity for elaboration – putting material into one’s own discussion, teaching with technology, rounds, words – as well as a chance to begin to learn the language of the variations on journal clubs, simulation, experiential discipline. The task of the …student is to question, explain, learning, inter‐professional. express opinions, admit confusion, and reveal misconceptions; but at the same time the student must listen to peers, respond to their questions, question their opinions, and share information or concepts that will clear up their confusion. Accomplishing these Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 4 A Sampling and Overview of Instructional Methods Inter‐professional Student Presentations Simulation Experiential Learning tasks requires interpersonal as well as cognitive skills – being able to give feedback in nonthreatening, supportive ways, maintaining a focus on group goals, developing orderly task‐
oriented procedures, and developing and sustaining mutual tasks.”13 Can be used in conjunction, or sequentially, with “Inter‐professional education occurs when students from the many of the instructional methods described in this health professions and related disciplines learn together about document, such as simulation, discussion, the concepts of health care and the provision of health care observational learning, rounds, bedside teaching. services toward improving the effectiveness and the quality of health care. Although effective inter‐professional education may occur in different ways, it generally involves…collaboration, respectful communication, reflection, application of knowledge and skills…. [It] occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care.”17 “When used effectively, [they] can be an excellent way to develop Can be used in conjunction, or sequentially, with interaction among students and professors. It is crucial that the many of the instructional methods described in this student making a presentation offers an argument… or topic, document, such as discussions, large group teaching, which can be treated as a subject of discussion…, as opposed to a small group teaching. Making effective classroom merely informative presentation.”18 "The one who does the presentations of their work. Students can use a peer evaluation form to rate peers on specific criteria. talking does the learning."16 “A…method in which learners practice tasks and processes in life‐ Can be used in conjunction, or sequentially, with like [face‐to‐face] circumstances, with feedback from observers many of the instructional methods described in this [and] peers…to assist improvement in skills; an interactive document, such as experiential learning, role play, approach to teaching and learning which provides experiences peer assisted learning, problem based, small group that reproduce real situations. Simulation offers opportunities to teaching, teaching and learning with technology, observe learners’ performance in a realistic but risk‐free, inter‐professional. controlled environment.”19 Can have simulation as human enactment as well. “…involves reflective thought, and influences subsequent actions Can be used in conjunction, or sequentially, with many of the instructional methods described in this and personal development.” As described by Kolb experiential document, such as simulation, role play, providing learning consists of four related components: concrete feedback, bedside teaching. experience, reflective observation, abstract conceptualization, and active experimentation. An adaptation of Kolb’s model of experiential learning by Dunn...adds a fifth point to the cycle, that Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 5 A Sampling and Overview of Instructional Methods Rounds Teaching in the Conference Toom Bedside Teaching Providing Feedback Learning by Observation/Observational of ‘planning for implementation’‐ examination of what will be done differently in the next implementation.” 20 “Thus, in Dunn’s model, the learner moves from a concrete experience (an event), to reflection (what happened), to abstract conceptualization (what was learned), to planning for implementation (what will be done differently), to active experimentation (what is done differently), and back to the concrete experience, thus completing the experiential and feedback loops.”20 Attending rounds: “the daily teaching/working sessions conducted by attending physicians.” Work rounds: “the daily review of patients overseen by the service resident.”21 Grand rounds: “A ‘gold standard’ presentation” that is primarily in lecture format, but can also be interactive. “Teaching rounds and morning report…are types of teaching which combine the group discussion method used in classrooms and the apprenticeship method used in the application environment.”21 “The conference room, the hallways, and the bedside are the three locations where most teaching during rounds occurs.”21 Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as providing feedback, microskills/one‐minute preceptor, observational learning. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as discussion, small group teaching. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as microskills/one‐minute preceptor, observational learning, experiential learning. A critical component of clinical teaching, although the prevalence of
this activity has decreased over the past two decades, especially
during attending rounds. Bedside teaching often occurs on work
rounds, during which resident are often the leaders in these teaching
encounters.22 Residents can either model or observe history taking
skills and review pertinent findings with their team. Bedside teaching
also provides a perfect setting in which residents can model skills in
professionalism and respect; students often observe their residents
carefully in these settings and observe many details of the approach
used by their resident in treating and interacting with the patient.22
Can be used in conjunction, or sequentially, with “An essential component of teaching…. an objective, informed, non‐evaluative appraisal of the goals of improvement of…skills.”23 many of the instructional methods described in this document, such as simulation, experiential learning, “Its instructional value is long recognized.”24 microskills/one‐minute preceptor. “The whole art of medicine is in observation.”25 “Observational… Can be used in conjunction, or sequentially, with learning is pivotal for “developing [students’] clinical competence many of the instructional methods described in this Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 6 A Sampling and Overview of Instructional Methods Learning Microskills/One‐Minute Preceptor Tutorials and for their future teaching roles.”26 “The process involves a behavior model (role model)...and a learner who assimilates and adapts the behavior that the model demonstrates. A teacher who deliberately uses modeling may combine it with guided practice, in which the students repeats the observed behavior and receives suggestions for improvement from the teacher. Finally with experience the learner may incorporate aspects of the teacher’s role by developing skill in self‐monitoring, self‐evaluation, self‐
motivation, and self‐control.”26 “A five‐step model of clinical teaching that utilizes simple, discrete teaching behavior or ‘microskills’.”27 They “facilitate the instructional process by enabling teachers to effectively assess, instruct, and give feedback efficiently.”26 document, such as rounds, bedside teaching, simulation, role play, problem solving exercises. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as bedside teaching, rounds, discussion, observational learning, experiential learning. “…most useful in situations with only a few minutes available for teaching (e.g., work rounds, ambulatory teaching).”26 Designed to keep the encounter to 5‐minutes or less. “…the preceptor is better able to diagnose…the learner’s understanding of the case, make a targeted teaching point, and provide positive and corrective feedback.”28 Preceptor gains insight into the decision‐making process and learner understanding of the case. Can be used in conjunction, or sequentially, with many of the instructional methods described in this document, such as peer assisted learning, lecture, large group teaching, small group teaching, discussion. “…usually linked with a series of lectures and its role is to complement the lecture. The tutorial specifically has been noted for its value in complementing knowledge in lectures, expanding on the concepts considered in lectures, encouraging student reflection, developing students' communication skills, encouraging active life‐long learning.”8 Professional Learning Plans A collection of samples of a student’s work [across a defined Can be used in conjunction, or sequentially, with and Learning Portfolios period of time] that you and s/he have the option of assembling many of the instructional methods described in this together. These samples may be the student’s best work, the document, such as discussion, teaching with widest variety of…good work, and/or the ‘history’ of one or more technology. major pieces of work….” They “encourage constructive dialogue between students and instructor.” 6 Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 7 A Sampling and Overview of Instructional Methods References 1. Meyers, C. & Jones, T.B. (1993). Promoting active learning. San Francisco: Jossey‐Bass. 2. Michaelsen, L.K., Knight, A.B., & Fink L.D. (Eds.) (2004). Team‐Based Learning. Sterling, VA: Stylus Publishing, Inc. 3. Albanese, M.A. & Mitchell, S. (1993). Problem­based learning: A review of literature on its outcomes and implementation issues. Academic Medicine, 68(1), 52‐
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25. Sir William Osler in Edwards, J.C., Friedland, J.A. & Bing‐You, R (Eds). (2002). Residents’ Teaching Skills, New York: Springer Publishing Co. 26. Edwards, J.C., Friedland, J.A. & Bing‐You, R (Eds). (2002). Residents’ Teaching Skills. New York: Springer Publishing Co., 27. Neher, J.O., Gordon, K.C., Meyer, B., Stevens, N. (1992). A five‐step “microskills’ model of clinical teaching. Journal of the American Board of Family Practice, 5, 419‐424. 28. Aagaard, E., Teherani, A, & Irby, D.M. Effectiveness of the one‐minute preceptor model for diagnosing the patient and the learner: Proof of concept. Academic Medicine, 79(1), 2004, 42‐49. Prepared by Susan J. Pasquale, PhD, UMMS, Offices of Medical Education & Faculty Affairs March 12, 2009 8