“Medical Education: Teaching Skills for Aspiring Medical College Faculty”
Dr Prabir Ranajan Moharana & Dr Nirmal Chandra Sahani
Teaching technology is currently the most neglected part in professional institutions like medical colleges in India. Even it is a real challenge for physicians with high professional qualifications to impart teaching and training to medical students in an effective manner.So teaching technology plays a complementary role in enriching professional knowledge and improves the teaching quality, hence an effective intervention in medical education.
“Teaching is Communication”. An efficient teacher is an effective communicator. One develops such skills of communication by virtue of his/ her in depth knowledge in the subject, interest, age and experience.(1) How ever training of teachers on teaching skills make the process faster by creating interest in medical teaching. Class room teaching, bed side clinical classes, seminars and demonstrations in laboratories though traditional, generate ample of scopes to build up confidence and gather practical experience. It is worth discussing on various teaching skills and the tips therein to guide the medical college teachers.
Teaching Skills:
There are many types of teaching skills to be practiced and used by a teacher to make teaching effective. Some of the important and convenient skills are as followings.(2)
(i) The skill of Introducing a Lesson: ‘Morning shows the day’. The introduction of a lesson should be mind catching and objective oriented in order to draw the students’ attention to a lesson which is the first step in a teaching session. A teacher may use previous knowledge of students, examples, questioning, narrating, storytelling, role playing, audio-visual aids for introducing a lesson. Mind receives new knowledge if there is continuity with the relevant previous knowledge.
(ii) The skill of Questioning: A teacher asks questions to students in a classroom to establish two way communication. A question should be well structured, very precise (devoid of unnecessary extra words), specific (not vague and elicits a clear answer) and relevant (teaching related). While asking a question the teacher should speak out in an audible and clear voice. The teacher should neither be too hurried nor too slow while asking a question. A question should be put in general to the class so that all the students get alert and attend to it. A brief pause is given to them to assimilate and then the teacher may point towards a particular student to make the desired response.
The level of questions stimulates highest level of thinking among the students and helps them in developing creative and reasoning abilities. Classroom questions can be of three levels eg. Lower order (recalling concepts, facts, definitions already learnt), Middle order (stimulating understanding and explaining) and higher order (inducing ability of reasoning, analysis, evaluation and creativity).
(iii) The skill of Reinforcement: Strengthening the inbuilt force of a student to respond and to learn is called reinforcement. The stimuli which induce pleasant experience are called positive reinforcement and negative reinforcement contribute unpleasant experiences. Positive reinforces may be verbal, in the form of praise words like ‘good’ ‘yes’, ‘correct’, ‘right’, ‘very good’, ‘excellent’, ‘carry on’, ‘think again’. Positive reinforces may be non-verbal in the form of gestures expressing satisfaction, in the form of ‘smiling’, ‘nodding’. Sometimes to encourage the students a teacher may use extra-verbal reinforces like ‘Wow’, ‘Aaah’, ‘Hmm’ etc. Sometimes the teacher may use negative verbal reinforces in the form of discouraging words like ‘no’, ‘it is wrong’ etc. Non-verbal reinforces may be gestures in the form of ‘frowning’, ‘looking angrily’ and ‘staring’. Negative reinforces are used to eliminate undesirable response or behaviors from students.
A teacher must take utmost care to provide reinforcement when it is due. Repeated and over-use of reinforcement are also not desirable from a teacher.
(iv) The skill of Probing: Probing is the skill of going deep into students’ responses and subject matter to elicit the ‘correct response’ from the ‘no response’, ‘wrong response’, ‘partially correct response’ or ‘incomplete response’. The components of this skill comprise of ‘prompting’, ‘seeking further information (asking what else?)’, ‘redirecting’, ‘increasing critical awareness’.
(v)The skill of Explaining with Examples: A teacher should master to explore the message hidden in between lines of a text. A good teacher uses inter related facts about a concept/phenomenon. The teacher must have in-depth understanding on a subject matter. Explanation should be descriptive and it should answer to ‘who’, ‘what’, ‘why’, ‘how’, ‘when’ and ‘whom’ aspects of a lesson. It should contain simple examples. The examples should be related to subject matter and contain appropriate vocabulary. Examples should be continuous and interesting to arouse curiosity among students.
(vi)The skill of Stimulus Variation: Stimulus is an external force or an act by the teacher which breaks the monotony/equilibrium of a classroom teaching. Stimulus variation is a set of teaching behaviors/acts to bring desirable changes in order to secure and sustain students’ attention towards classroom teaching. The components of this skill include- movement of the teacher in the class, gesture and eye-to-eye contact towards students, modulation in the volume and speed of speech by the teacher, focusing to a particular idea/formula, one-to-one interaction style, pausing of 3-4 seconds by the teacher, aural-visual switching (changing from lecture to visual aid and vice versa) etc. During eye-to-eye contact a teacher should cover every student in every row in a classroom so that an inattentive student could be picked up and the control of the teacher over the class will be established. Continuous use of the same stimuli by a teacher produces dullness, fatigue and inattention among students towards lesson and consequently undue request from them to stop the teaching.
(vii)The skill of using Black Board: Blackboard/Chalkboard is most widely used as a teaching device for classroom teaching. Skillful use of blackboard makes teaching very effective. A teacher must take care of legibility of handwriting, neatness of blackboard, grammatical and vocabulary correctness of words, appropriateness of written work etc. A teacher must write salient points and summary in brief with distinct letters of proper shape, size, slant and space. Blackboard writing becomes effective when a student can follow the whole lesson at a single glance. For the purpose of focusing the teacher may use colored chalk, avoid noise produced from friction of chalk, stand on one side of board and should never come in between students and the board.
(viii)The skill of using Audio-Visual Aids: There are a variety of audio-visual aids available for the teaching like LCD Projector, TV, film, radio, tape recorder, models, charts, specimens, role play, field visits for demonstration. An enthusiastic teacher should choose an appropriate aid and imagine how a particular aid can enhance the learning.
(ix)The skill of recognizing Attending Behavior: An intelligent teacher can diagnose whether the students are attending or not attending the lesson. Sometimes they seem to be attentive. Of course they remain physically present in a classroom but they are not psychologically involved in the lesson. To break this ice the teacher may give directions (making student to stand up to repeat the statement that he/she made which leads to physical participation from student), ask questions, accept idea of the student. The teacher may follow ‘skill of silence’ and ‘non verbal cues’. ‘Skill of silence’ means a teacher takes a pause and allows the student to think and respond. Non verbal cues include a smile, a frown, a quizzical/ thoughtful look, nodding and bodily movement from one place to another in the classroom. These skills are in concordance with stimulus variation.
(x) The skill of Closing a Lesson: The closure of a lesson should be in such a way that the students could configure the whole lesson into a meaningful cognition. Therefore the closure may be achieved at the end of major teaching points or at the end of complete lesson. The lesson must have a ‘take home message’ at the end.
Teaching Devices:
Teaching devices add quality to teaching. These include different types of teaching aids and teaching methods which are used by a teacher to make teaching interesting, free of hurdles, simple, easier, time and energy saving.
(i) Intangible Teaching Devices- Oral communication, Questioning, Assignments and Home work.
(ii) Audio teaching devices- Tape recorder.
(iii) Visual Teaching Devices- Chalk Board, Over Head Projector and LCD Projector with opaque screen, Teaching Slides, Film Strips.
(iv)Audio-visual Teaching Devices- Motion pictures in the form of films, educational television show and video conference.
(v) Models- Three dimensional models of plastic, newborn dummy, cadaver specimens, X-ray plates, wooden or thermo cole models etc.
Teaching Practice produces an Effective Teacher:
Repeated microteaching sessions and adoption of different teaching skills help young teachers to develop their efficiency under the direct supervision of an experienced senior teacher. Utmost care on the part of senior faculty members and sincere attempts by young ones should be carried out to know faults, shortcomings, omissions and commissions during the act of teaching.
Microteaching is a specific “teacher training technique” (not a teaching technique) for young teachers where the complexities of a normal classroom teaching are reduced. In a given micro-teaching session, the teaching skills to be practiced must be decided in advance. A young teacher takes up a short lesson limiting the content to a single concept of 5-20 minutes’ duration to a small group of 5-10 students. Such a session may be video tapped and played back. It should be constructively criticized by the supervisors/senior faculty members and other participating young teachers. The concerned teacher can re-teach the lesson after viewing himself and integrating the criticism to ensure a good performance. In this process the young teacher can evaluate himself/herself during the micro teaching session and thus improve his/her teaching skills. Bed side clinical demonstrations for undergraduate students in clinical wards are suitable examples of the microteaching.
Microteaching as a new experiment and a highly individualized training device in the field of teacher education will definitely produce effective teachers. It also helps those teachers who have reached their professional plateau and are enjoying reputation for their skill of teaching and do not want to improve their skills further. It is a fact that they do not find a way to experiment with new skills of teaching and improve in their skills. Microteaching helps them to overcome their weakness.
Medical Council of India desires the incorporation of “Integrated Medical Teaching” currently into medical curriculum to make teaching-learning activities more coordinated. Horizontal integration of all the departments is adopted to teach a particular topic/disease to medical students at the same time. For example, for teaching of ‘Diabetes mellitus’ the faculties from Biochemistry, Pathology, Community Medicine and Internal Medicine are involved in the same time to teach glucose metabolism, patho-physiology, prevention & control of the disease and management of the patients respectively. This type of integration in medical teaching coordinates the teaching learning activities to ensure development of the skills among medical students to investigate, analyze and to perceive the patient as a whole. Integrated teaching offers integrated thinking to medical students to learn with a holistic rather than fragmented learning. (3)
In every specialty of medical science, senior residents/tutor and students during their post graduation should be trained in skills of teaching technology to develop interest for medical teaching. The senior experienced faculties are also expected to guide them with feed back to boost up enthusiasm and improve their teaching skill. Even the in service medical college teachers need updating on modern day skills keeping pace with changes there in.
