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Teaching medicine from past to future
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Teaching medicinepastto future Dr.T.V.Rao MD Dr.T.V.Rao MD
What we are trained – we teach • The Classical in which a lecture is divided into broad areas and then subdivided. This is the easiest method of structuring a lecture and, potentially, the most boring. An extension of this method is the iterative classical in which a set procedure is applied to each topic. For example signs, symptoms, diagnoses, management and prognosis may be applied to a set of related diseases. Dr.T.V.Rao MD
Problems in Medical Education: • Too much information, too little time, too many students in crowded rooms, and exams that discourage real learning Dr.T.V.Rao MD
Education is changing from past to future • The old way of learning, was knowing what you should know. Now the way of learning is knowing what you don't know, not feeling bad about it, and knowing how to find out. • BMJ 2003;327:1430-1433 Dr.T.V.Rao MD
Teaching on problem and solving • The Problem Centred in which a problem is outlined and various solutions are offered. Handled well, this method can play on the curiosity or clinical interests of the students. Dr.T.V.Rao MD
The Sequential • In which a problem or question is presented and followed by a chain of reasoning which leads to a solution or conclusion. It is easy to lose the students’ attention when using this method so the use of periodic summaries is recommended Dr.T.V.Rao MD
The Comparative • In which two or more perspectives, methods or models are compared. It is better done visually rather than orally. A common weakness is to assume that the audience knows intimately the perspective or methods under review. If in doubt, first outline each of the perspectives. Dr.T.V.Rao MD
The Thesis • In which an assertion is made and then proved or disproved through a mixture of argument and perhaps speculation. Potentially an interesting approach for students but, like the sequential approach, it can sometimes be difficult to follow. Dr.T.V.Rao MD
What is wrong with our lectures • What's wrong with lectures?” was a key question posed to undergraduate medical education program. • What students disliked was not lectures, but poor • quality lecturing. Students’ dislikes were: • • inaudibility; • • incoherence; • • talking too fast; • • poor use of audio visual aids; • • too much information Dr.T.V.Rao MD
Why thing go wrong in teaching • saying too much too quickly; • • not giving sufficient time to copy diagrams; • • assuming too much knowledge; • • forgetting to provide summaries; • • not indicating asides; • • difficulty in timing a lecture. Dr.T.V.Rao MD
Teachers express their reasons • unresponsive audiences; • • large groups; • • effort and time involved in preparation; • • feelings of failure after a bad lecture; • • lecturing on topics disliked. Dr.T.V.Rao MD
Assess Plan Reflect Teach Dr.T.V.Rao MD
Medical students have their own choices • Science students value logically structured notes more highly than do arts students and arts students value gains in insights and new perspectives more than science and medical students do. Science students see lectures as an entrée into reading. For arts students lectures, ideally, follow reading, and help them to interpret what they have read (Brown & Daines, 1981a and b). Dr.T.V.Rao MD
1- Changes in medical education Medical education has seen major changes over the past decade. Integrated teaching, problem-based learning, community-based learning, core curricula with electives or options and more systematic curriculum planning. The teacher and changes in medical education Dr.T.V.Rao MD
2- Changes in medical education Increasing emphasis is being placed on self-directed study with students expected to take more responsibility for their own learning. The teacher and changes in medical education Dr.T.V.Rao MD
3- Changes in medical education The application of new learning technologies has supported this move. New directions can be identified too in the area of assessment with increased emphasis on performance assessment. The teacher and changes in medical education Dr.T.V.Rao MD
The teacher and changes in medical education 4- An increased emphasis on the students The increasing emphasis on student autonomy in medical education has moved the centre of gravity away from the teacher and closer to the student. Indeed it has become fashionable to talk about learning and learners rather than teaching and the teacher. Dr.T.V.Rao MD
HOW TO MAKE YOUR LECTURES WORK • Connecting learning to the knowledge of the learner facilitates retention and transfer of information. All learning experiences should therefore be appropriate to the level of the learner and relate to the learner's previous experiences. During the learning session, information should be structured in a way that demonstrates the relationship between key ideas. As well, there should be clear linkages between individual sessions to allow for progressive reinforcement of fundamental concepts, while at the same time minimizing unnecessary redundancy. Dr.T.V.Rao MD
“not so much what to teach, but how to teach…” • Sir William Osler, 1899 Dr.T.V.Rao MD
“To act on or influence each other” • Learning is a process that results in some modification, relatively permanent, of the learner's way of thinking, feeling or doing. Learning therefore requires the active construction of new ideas or ways of thinking on the part of the learner Dr.T.V.Rao MD
Effectively communicating your ideas? • Organize your ideas into a logical structure including headings and subheadings. Provide students with your outline at the beginning of the class. Continue to refer to your outline as the class progresses Dr.T.V.Rao MD
Organise your lecture for 60 minutesFirst ~5-10 minutes • Provide your “core idea,” hook students, relate to what they know already, review or link to previous material, provide organizer for the lecture, and note importance of the topic to the students, course and other goals Dr.T.V.Rao MD
Next ~40-45 minutes ( contain the Body of lecture ) • Introduce new concepts, present key terms, explain challenging concepts, link to “real life” situations, provide vivid examples and illustrations, ask questions, respond to answers, build in case studies, break up lecture with activities. Review main points periodically. Dr.T.V.Rao MD
Conclude in 5-10 minutes • Summarize, reiterate the “core idea,” reflect back on organizer, link to additional readings and next class, solicit feedback. Dr.T.V.Rao MD
THE 10 QUALITIES OF EXEMPLARYLECTURERS • 1. Carefully select key information • 2. Clearly state their key objectives • 3. Inform students in advance of topics and • objectives • 4. Structure presentations using a specific • organizer • 5. Provide hand-outs or slides with key information • in advance Dr.T.V.Rao MD
THE 10 QUALITIES OF EXEMPLARYLECTURERS (Cont.) • 6 Pose an intriguing question or problem • 7. Use a wide variety of oral and visual techniques • 8. Present key ideas as opposed to lists of details • 9. Explain clearly using multiple approaches e.g. • narrative, comparisons, examples • 10. Promote interactive learning. Dr.T.V.Rao MD
Your Job as Teacher • ü Initiate the conversation about learning goals • ü Help student make a plan that make sense • ü Make the student be accountable for the goals • he or she has set • ü Give feedback on reaching the goals • ü Have student adjust goals as needed Dr.T.V.Rao MD
Teachers to rememberwe are not robots bring life to your teaching • “Learning is not a spectator sport. Students... must talk about what they are learning , write about it, relate it to past experiences, apply it to their daily lives.” (Chickeringand Gamson, 1987) Dr.T.V.Rao MD
Our teaching should be patient centred • Medical education should be patient canteredAmple content in our day to day practiceFormative Assessment needs to be stressed Dr.T.V.Rao MD
Bring order in your class room from chaos ……… to Dr.T.V.Rao MD
Competent teachers can bring in change from past to future Dr.T.V.Rao MD
“He teaches best who shows his students not what to think, but how to think…” Alan Gregg Dr.T.V.Rao MD
Technology - empowering our students are the medical teachers ready ….. • Adopting technology in education dramatically results in better educational results, progressive college operations, and also smoother and more streamlined academic and administrative workflow Dr.T.V.Rao MD
Medical teachers shouldempower with computers and technology or …….. Dr.T.V.Rao MD
Programme created by Dr.T.V.Rao MD for Medical Professionals, and Medical Educators in the Developing World • Email • doctortvrao@gmail.com Dr.T.V.Rao MD