- Email: [email protected]
Secrets of a Successful Lecture
Wilderness and Environmental Medicine, 10, 185-188 (1999)
THE WILDERNESS INSTRUCTOR
Secrets of a Successful Lecture STEVE DONELAN
Good lecturers are able to focus on their students and teach interactively because they are well prepared. Preparing a lecture is done in three steps: • Doing research. • Teaching the topic to yourself. • Doing mental rehearsals as you write a lesson plan. In the classroom, a lesson plan helps you find your way to your teaching goals by the shortest route. But more important, if you have gone through the planning process, you will have the plan in your mind as well as on paper. Then if the lesson bogs down, you can find an alternative route to your teaching goals. Your preparation may be abbreviated, depending on how many times you have taught the topic, but it is important to follow each step. Research may include reviewing old texts, reading new articles, consulting experts, and checking Web sites. For topics that you know well, you may not have to gather much new information, but you still need to organize what you know and decide how much of it the students need to know. This is especially important for instructors with advanced medical training and experience who are teaching lay people. After gathering or reviewing information, you need to teach the topic to yourself. Ask yourself questions: How does this work? Why does this happen? Why do we do it this way? What are the connections, for instance, between mechanism of injury and damage, or between damage and changes in vital signs? For example, can you explain why a floating segment of the rib cage (flail chest) is sucked in when the patient inhales, and pushed out when the patient exhales? If you answer that it is because of the difference in pressure between the air in the lung and in the atmosphere, can you explain why air pressure in the lungs decreases when you inhale? Or why the lungs normally expand when you expand the chest cavity? Too often we think that we understand a topic because we have read about it and what we read seemed to make Direct correspondence to PO Box 1227, Berkeley CA 94701 (e-mail: [email protected]).
sense. Then students start asking simple questions that we can't answer or can't put into terms that make sense to them. To avoid this situation, ask yourself the questions first, and figure out the answers before you go into the classroom. Teaching a topic to yourself should start you thinking about how the lesson is going to work. But different people learn in different ways, at different paces, and from different starting points. So you need to do a mental rehearsal. Teach the class in your mind, visualize how it will go, and try to anticipate how your students will respond based on what you know about them. Remember, however, that you are the director of the play you are rehearsing, not the star. Think of the students' part of the classroom as the stage, and of yourself as guiding them through a play. When you bridge from lecture to skills practice, the students should be ready to step into their roles as rescuers and perform realistically. As you do mental rehearsals, you should be writing your lesson plan. Begin with your teaching goals. What should the students be able to do after completing the lesson? Use only active verbs such as recognize, list, describe, distinguish, explain, and demonstrate, because these verbs refer to behavior that you can observe and verify. For example, if you are preparing a lesson on hypothermia, by the end of the lesson students should be able to do the following: • Recognize the signs and symptoms of hypothermia. • Distinguish between early and late signs. • Describe mechanisms of both accidental and immersion hypothermia • Explain how the vital systems respond to cold. • List hypothermia risk factors. • Describe ways to prevent hypothermia. • Demonstrate treatment for both mild and profound hypothermia. As you write your lesson plan, keep asking yourself how each part of the lesson will help students reach the teaching goals. Anything that does not help them reach those goals should probably not be in the lesson. Once you've listed your teaching goals, ask what topics you need to include to enable students to reach those
186 goals. Which are your key concepts, and which are subordinate to them? What can be abridged or left out if you run short of time? Then decide the sequence in which to present the key concepts, which depends partially on your teaching style. In teaching a lesson on hypothermia, for example, you could begin with the signs and symptoms, perhaps by staging a short, rehearsed scenario, then bridge to the physics and physiology by asking how these signs and symptoms are produced. Or you could begin with the physics (heat loss mechanisms), bridge to the physiology (how the vital systems respond to decreasing body temperature), and then ask what signs and symptoms these responses may produce. Some topics may presuppose topics from a previous lesson, in which case you should bridge back and possibly review. For example, recognizing signs and symptoms presupposes assessment skills, and response of the vital systems to cold presupposes that students can explain how the vital systems work. Wherever you begin the lesson, your first move is to get the students' attention. A short, dramatic scenario or a visual aid can do so. Another way is to involve the students by asking a question, preferably one that brings out a surprising fact or statistic. This can also have the advantage of bridging from students' personal experience to the lesson, which will make the topic more real to them. For example, you might ask, at what temperature range do most cases of hypothermia occur? If you give students some choices, many will pick the lowest, whereas the answer is between 32° and 50°P' Then ask why, and from the students' answers bridge into your first key concept, which could be the physics of heat loss or signs and symptoms of hypothermia. For many centuries, lecture meant to read aloud, because before printing made books cheap, the function of the lecturer was usually to read and comment on the one precious copy of the textbook chained to the lectern. But the root meaning of the word is "to gather or assemble," which more accurately describes what a modem lecturer should do. Lecturers present what they have assembled (concepts, facts, procedures), but can use a variety of techniques to involve students in the lesson. Perhaps the most important of these techniques is the leading question: a question that leads students toward the next step, but lets them take the step. If you lead students on skillfully, they should begin anticipating you, not just following you, rehearsing in their minds how they would find problems, figuring out what was going on, and deciding what they would do. In other words, when you lecture, you should be teaching students how to think, both by setting an example and by involving them in the lesson. For example, a
Donelan
series of leading questions on hypothermia might begin with heat production: how and where the body produces heat, what it needs (fuel, oxygen, water), then move on to heat distribution (role of the circulatory system), and finally the mechanisms of heat loss. From there, you can bridge to prevention (hydration, energy food, clothing) or to what happens if you lose too much heat. Using leading questions effectively is an art. Your questions should point toward the answers but be challenging enough so that students must work out the answers for themselves. After asking a question, pause and look around. If students seem baffled, ask a follow-up question. For example, if no one responds to the question of how the body produces heat, ask how we produce heat in the kitchen or in an overnight camp. Once students understand the concept of burning fuel, they can move on to more specific questions. Make sure that the whole class is with you as you move toward your teaching goals. Rather than focusing on the students who are the quickest to answer questions, scan the room and make eye contact with all the students frequently. Instructors who really focus on the students soon learn to read their body language, even in response to rhetorical questions. For example, they learn to distinguish signs of enlightenment from the vague, reflexive nod of the student who doesn't get it but doesn't want to hold up the class. Medical terms are usually very descriptive. Unfortunately, they are in Greek and Latin, which few instructors or students know well. But once you break the terms down into their components and show students where the components come from-that is, the etymology of the words-the terms become transparent. W. S. Haubrich's Medical Meanings: A Glossary of Word Origins (Harcourt Brace Jovanovich, 1984) is a valuable resource. You can then reinforce students' grasp of terminology by pointing out common words built from the same Greek and Latin components. For example, the first part of the word pneumothorax is also found in the words pneumatic and pneumonia, and thorax means "chest," so by putting the two together, we get "air in the chest." Once demystified, medical terms tend to be very concrete, and often visual, and so should the rest of your lecture vocabulary be. Remember that images are stronger than abstractions, and words that evoke images can help students to see concepts. Your grammar should also be clear and direct. Never use the passive voice (eg, "The patient is intubated"), because it conditions students to think of themselves as spectators rather than participants. Using the active voice helps students picture themselves responding to emergencies.
Secrets of Successful Lecture
After deciding what topics will be in the lesson and how you're going to teach it, your next step is to estimate how much time it will take. The times for some activities, such as videos, staged scenarios, and quizzes, are known or easy to estimate. To estimate the time needed for each part of your lecture, however, you need to look at your outline and ask questions such as how many of the concepts are new to the class and how many steps it will take to work through each concept. For teaching about injuries and medical emergencies, timelines depend mainly on three factors: how common a problem is, how important it is, and how complex it is. Hypothermia, for example, rates high by all three criteria. It is very common, it frequently kills people, and it is complex, involving some physics as well as physiology. Moreover, instructors cannot afford to skimp on the explanation of hypothermia for two reasons. First, hypothermia may not be obvious in the early stages, when it is easiest to treat; and second, students are not likely to remember the bewildering variety of signs and symptoms, or be able to distinguish them from other things, unless they can figure out what is going on. A good way to put timelines in the lesson plan is to write the time when each activity or lecture topic should start in the left margin. Then you can tell at a glance whether you are on schedule. Once you know what you want to teach and how to teach it, think about how to set up the room so as to encourage the kinds of activities and interactions that will make the class work. For example, a traditional academic lecture has all the students in rows facing the instructor, which puts the instructor in a dominant position and tends to lock students into a passive learning role. They cannot easily make eye contact with each other or interact with anyone except the instructor. Seating students in a hollow square or circle opens up the class and lets students address the whole class when responding to a question or making a comment. Lesson plans should be outlines, not solid paragraphs. Lay them out with headings, subheads, and indentations to show the structure of the topics, with plenty of space for adding notes and references. Each topic should have a main concept and one or more levels of subordinate concepts. For example, the main concept of shock could be that if anything prevents enough oxygen from getting to the cells in the vital organs, those cells begin to die. Subordinate to that concept are how vital systems can compensate and how they may begin to fail. Next could come signs and symptoms of compensation and organ failure, which may vary depending on the cause. The last concept would be how to support the vital systems and prevent organ failure.
187
Begin each topic with your teaching goals. What should students be able to recognize, describe, explain, distinguish, and demonstrate after that part of the lesson? Then decide what teaching methods will best get students to those goals. For example, a lesson on cardiac risk factors can be drawn mostly from students' own experience, so it could be taught by discussion or brainstorming. But you will have to show and explain the anatomy and physiology of the heart to most students. Finally, ask yourself what you will need to teach the lesson. List teaching equipment such as chalk or markers, slide projector, overhead projector, video player, props, and things to show students. It is wise to include key phrases, leading questions, and facts or figures that you might otherwise forget in your lesson plan. Resist the temptation, however, to write down everything. A lesson plan should be a guide to keep you on track as you teach interactively, not a book that you read aloud. Today's students have their own copies of the books. When students are reading a book, they can pause, go back, browse forward, or check other references. They can make connections and put things together at their leisure. In a lecture, however, you need to help students make the connections by bridging and summarizing. If you don't keep showing them the big picture, they will see only the flickering foreground of your lecture against the blurring memory of what you have already said. Bridging back is especially important when your topic presupposes something already taught. One way to do it is with a brief oral quiz. Another way is with a brief summary, which enables students to flash forward through the topics they have already learned and pause to fill any gaps. Visual aids such as board writing or flip charts automatically provide bridges back to more recent topics. If legible and well organized, they can also show students the emerging pattern of concepts and connections. Bridging forward is equally important. Students need to be reminded not only of where they have been and where they are, but also of where they are going and why. Perhaps the most important bridge is from lecture to skills practice. Students need to know not only what skills they are going to practice and how, but also why. Knowing the reasons improves skills learning and retention and helps students work out solutions to problems even if they forget the procedures they were shown. For example, if they know that the purpose of traction splinting is to prevent spasrning muscles from driving broken bone ends any further into the soft tissues, then the construction and sequence of the splint will make sense, no matter what device they are using. When a course is full of information and complex
188
ideas, lecturing is an essential teaching method. Lecturing well requires preparation: doing research, teaching yourself, and going through a mental rehearsal. This process yields a lesson plan, which enables you to focus on
Donelan
the students and teach interactively. Good, interactive lectures become mental rehearsals for the students, which prepare them to practice emergency care skills more effectively.
THE WILDERNESS INSTRUCTOR
Secrets of a Successful Lecture STEVE DONELAN
Good lecturers are able to focus on their students and teach interactively because they are well prepared. Preparing a lecture is done in three steps: • Doing research. • Teaching the topic to yourself. • Doing mental rehearsals as you write a lesson plan. In the classroom, a lesson plan helps you find your way to your teaching goals by the shortest route. But more important, if you have gone through the planning process, you will have the plan in your mind as well as on paper. Then if the lesson bogs down, you can find an alternative route to your teaching goals. Your preparation may be abbreviated, depending on how many times you have taught the topic, but it is important to follow each step. Research may include reviewing old texts, reading new articles, consulting experts, and checking Web sites. For topics that you know well, you may not have to gather much new information, but you still need to organize what you know and decide how much of it the students need to know. This is especially important for instructors with advanced medical training and experience who are teaching lay people. After gathering or reviewing information, you need to teach the topic to yourself. Ask yourself questions: How does this work? Why does this happen? Why do we do it this way? What are the connections, for instance, between mechanism of injury and damage, or between damage and changes in vital signs? For example, can you explain why a floating segment of the rib cage (flail chest) is sucked in when the patient inhales, and pushed out when the patient exhales? If you answer that it is because of the difference in pressure between the air in the lung and in the atmosphere, can you explain why air pressure in the lungs decreases when you inhale? Or why the lungs normally expand when you expand the chest cavity? Too often we think that we understand a topic because we have read about it and what we read seemed to make Direct correspondence to PO Box 1227, Berkeley CA 94701 (e-mail: [email protected]).
sense. Then students start asking simple questions that we can't answer or can't put into terms that make sense to them. To avoid this situation, ask yourself the questions first, and figure out the answers before you go into the classroom. Teaching a topic to yourself should start you thinking about how the lesson is going to work. But different people learn in different ways, at different paces, and from different starting points. So you need to do a mental rehearsal. Teach the class in your mind, visualize how it will go, and try to anticipate how your students will respond based on what you know about them. Remember, however, that you are the director of the play you are rehearsing, not the star. Think of the students' part of the classroom as the stage, and of yourself as guiding them through a play. When you bridge from lecture to skills practice, the students should be ready to step into their roles as rescuers and perform realistically. As you do mental rehearsals, you should be writing your lesson plan. Begin with your teaching goals. What should the students be able to do after completing the lesson? Use only active verbs such as recognize, list, describe, distinguish, explain, and demonstrate, because these verbs refer to behavior that you can observe and verify. For example, if you are preparing a lesson on hypothermia, by the end of the lesson students should be able to do the following: • Recognize the signs and symptoms of hypothermia. • Distinguish between early and late signs. • Describe mechanisms of both accidental and immersion hypothermia • Explain how the vital systems respond to cold. • List hypothermia risk factors. • Describe ways to prevent hypothermia. • Demonstrate treatment for both mild and profound hypothermia. As you write your lesson plan, keep asking yourself how each part of the lesson will help students reach the teaching goals. Anything that does not help them reach those goals should probably not be in the lesson. Once you've listed your teaching goals, ask what topics you need to include to enable students to reach those
186 goals. Which are your key concepts, and which are subordinate to them? What can be abridged or left out if you run short of time? Then decide the sequence in which to present the key concepts, which depends partially on your teaching style. In teaching a lesson on hypothermia, for example, you could begin with the signs and symptoms, perhaps by staging a short, rehearsed scenario, then bridge to the physics and physiology by asking how these signs and symptoms are produced. Or you could begin with the physics (heat loss mechanisms), bridge to the physiology (how the vital systems respond to decreasing body temperature), and then ask what signs and symptoms these responses may produce. Some topics may presuppose topics from a previous lesson, in which case you should bridge back and possibly review. For example, recognizing signs and symptoms presupposes assessment skills, and response of the vital systems to cold presupposes that students can explain how the vital systems work. Wherever you begin the lesson, your first move is to get the students' attention. A short, dramatic scenario or a visual aid can do so. Another way is to involve the students by asking a question, preferably one that brings out a surprising fact or statistic. This can also have the advantage of bridging from students' personal experience to the lesson, which will make the topic more real to them. For example, you might ask, at what temperature range do most cases of hypothermia occur? If you give students some choices, many will pick the lowest, whereas the answer is between 32° and 50°P' Then ask why, and from the students' answers bridge into your first key concept, which could be the physics of heat loss or signs and symptoms of hypothermia. For many centuries, lecture meant to read aloud, because before printing made books cheap, the function of the lecturer was usually to read and comment on the one precious copy of the textbook chained to the lectern. But the root meaning of the word is "to gather or assemble," which more accurately describes what a modem lecturer should do. Lecturers present what they have assembled (concepts, facts, procedures), but can use a variety of techniques to involve students in the lesson. Perhaps the most important of these techniques is the leading question: a question that leads students toward the next step, but lets them take the step. If you lead students on skillfully, they should begin anticipating you, not just following you, rehearsing in their minds how they would find problems, figuring out what was going on, and deciding what they would do. In other words, when you lecture, you should be teaching students how to think, both by setting an example and by involving them in the lesson. For example, a
Donelan
series of leading questions on hypothermia might begin with heat production: how and where the body produces heat, what it needs (fuel, oxygen, water), then move on to heat distribution (role of the circulatory system), and finally the mechanisms of heat loss. From there, you can bridge to prevention (hydration, energy food, clothing) or to what happens if you lose too much heat. Using leading questions effectively is an art. Your questions should point toward the answers but be challenging enough so that students must work out the answers for themselves. After asking a question, pause and look around. If students seem baffled, ask a follow-up question. For example, if no one responds to the question of how the body produces heat, ask how we produce heat in the kitchen or in an overnight camp. Once students understand the concept of burning fuel, they can move on to more specific questions. Make sure that the whole class is with you as you move toward your teaching goals. Rather than focusing on the students who are the quickest to answer questions, scan the room and make eye contact with all the students frequently. Instructors who really focus on the students soon learn to read their body language, even in response to rhetorical questions. For example, they learn to distinguish signs of enlightenment from the vague, reflexive nod of the student who doesn't get it but doesn't want to hold up the class. Medical terms are usually very descriptive. Unfortunately, they are in Greek and Latin, which few instructors or students know well. But once you break the terms down into their components and show students where the components come from-that is, the etymology of the words-the terms become transparent. W. S. Haubrich's Medical Meanings: A Glossary of Word Origins (Harcourt Brace Jovanovich, 1984) is a valuable resource. You can then reinforce students' grasp of terminology by pointing out common words built from the same Greek and Latin components. For example, the first part of the word pneumothorax is also found in the words pneumatic and pneumonia, and thorax means "chest," so by putting the two together, we get "air in the chest." Once demystified, medical terms tend to be very concrete, and often visual, and so should the rest of your lecture vocabulary be. Remember that images are stronger than abstractions, and words that evoke images can help students to see concepts. Your grammar should also be clear and direct. Never use the passive voice (eg, "The patient is intubated"), because it conditions students to think of themselves as spectators rather than participants. Using the active voice helps students picture themselves responding to emergencies.
Secrets of Successful Lecture
After deciding what topics will be in the lesson and how you're going to teach it, your next step is to estimate how much time it will take. The times for some activities, such as videos, staged scenarios, and quizzes, are known or easy to estimate. To estimate the time needed for each part of your lecture, however, you need to look at your outline and ask questions such as how many of the concepts are new to the class and how many steps it will take to work through each concept. For teaching about injuries and medical emergencies, timelines depend mainly on three factors: how common a problem is, how important it is, and how complex it is. Hypothermia, for example, rates high by all three criteria. It is very common, it frequently kills people, and it is complex, involving some physics as well as physiology. Moreover, instructors cannot afford to skimp on the explanation of hypothermia for two reasons. First, hypothermia may not be obvious in the early stages, when it is easiest to treat; and second, students are not likely to remember the bewildering variety of signs and symptoms, or be able to distinguish them from other things, unless they can figure out what is going on. A good way to put timelines in the lesson plan is to write the time when each activity or lecture topic should start in the left margin. Then you can tell at a glance whether you are on schedule. Once you know what you want to teach and how to teach it, think about how to set up the room so as to encourage the kinds of activities and interactions that will make the class work. For example, a traditional academic lecture has all the students in rows facing the instructor, which puts the instructor in a dominant position and tends to lock students into a passive learning role. They cannot easily make eye contact with each other or interact with anyone except the instructor. Seating students in a hollow square or circle opens up the class and lets students address the whole class when responding to a question or making a comment. Lesson plans should be outlines, not solid paragraphs. Lay them out with headings, subheads, and indentations to show the structure of the topics, with plenty of space for adding notes and references. Each topic should have a main concept and one or more levels of subordinate concepts. For example, the main concept of shock could be that if anything prevents enough oxygen from getting to the cells in the vital organs, those cells begin to die. Subordinate to that concept are how vital systems can compensate and how they may begin to fail. Next could come signs and symptoms of compensation and organ failure, which may vary depending on the cause. The last concept would be how to support the vital systems and prevent organ failure.
187
Begin each topic with your teaching goals. What should students be able to recognize, describe, explain, distinguish, and demonstrate after that part of the lesson? Then decide what teaching methods will best get students to those goals. For example, a lesson on cardiac risk factors can be drawn mostly from students' own experience, so it could be taught by discussion or brainstorming. But you will have to show and explain the anatomy and physiology of the heart to most students. Finally, ask yourself what you will need to teach the lesson. List teaching equipment such as chalk or markers, slide projector, overhead projector, video player, props, and things to show students. It is wise to include key phrases, leading questions, and facts or figures that you might otherwise forget in your lesson plan. Resist the temptation, however, to write down everything. A lesson plan should be a guide to keep you on track as you teach interactively, not a book that you read aloud. Today's students have their own copies of the books. When students are reading a book, they can pause, go back, browse forward, or check other references. They can make connections and put things together at their leisure. In a lecture, however, you need to help students make the connections by bridging and summarizing. If you don't keep showing them the big picture, they will see only the flickering foreground of your lecture against the blurring memory of what you have already said. Bridging back is especially important when your topic presupposes something already taught. One way to do it is with a brief oral quiz. Another way is with a brief summary, which enables students to flash forward through the topics they have already learned and pause to fill any gaps. Visual aids such as board writing or flip charts automatically provide bridges back to more recent topics. If legible and well organized, they can also show students the emerging pattern of concepts and connections. Bridging forward is equally important. Students need to be reminded not only of where they have been and where they are, but also of where they are going and why. Perhaps the most important bridge is from lecture to skills practice. Students need to know not only what skills they are going to practice and how, but also why. Knowing the reasons improves skills learning and retention and helps students work out solutions to problems even if they forget the procedures they were shown. For example, if they know that the purpose of traction splinting is to prevent spasrning muscles from driving broken bone ends any further into the soft tissues, then the construction and sequence of the splint will make sense, no matter what device they are using. When a course is full of information and complex
188
ideas, lecturing is an essential teaching method. Lecturing well requires preparation: doing research, teaching yourself, and going through a mental rehearsal. This process yields a lesson plan, which enables you to focus on
Donelan
the students and teach interactively. Good, interactive lectures become mental rehearsals for the students, which prepare them to practice emergency care skills more effectively.