When India will awake???

By Dr Cuckoo Choudhary, Gastroenterologist,Philadelphia, Pennsylvania

Email	:  cuckoo.choudhary@comcast.net

            "Aanchal mein hai doodh aur aankhon mein paani." I detest this quote now, although I must confess it was one of my favourite ones during school days, likely because it sounded "rich" from a literary perspective, and because I did not understand the meaning well. Regardless, my write up here is not about this quote. It is in some ways related and in other ways different from it.

It was all aunty's fault. Had to be. It began after my brief visit with her during my recent India trip. I vividly remember her precise words, "It is a great responsibility and liability to raise a daughter as opposed to a son, Cuckoo. I never wish for any of my near and dear ones to have a daughter." Okay, I thought. "Was I really listening to an educated woman?"

             Before I could open my mouth, she continued, "For instance, one can sleep at night even if the son comes home late as it really does not matter where he is and what he is doing. On the other hand, if the daughter is late, that is a major problem, because what she does away from home late at might end up becoming your responsibility."

I guess one does not have to be a rocket scientist to figure out the "responsibility" she was referring to. It had nothing to do with crime against women, in either Delhi or elsewhere. I was amazed, ashamed, and dumbfounded. My head started to spin. Why this double standards against female gender in ‘Mera Bharat Mahaan', even in 2012? I always hoped people would worry about both sons and daughters in regards to what they were doing away from home late at night. How come what a son does outside the home with, or to someone else's daughter, does not matter? Are we that selfish and shameless? Or was I just over-reacting?

The conversation left a very sour taste in my mouth, but I could not give it further thought till I boarded my plane back to Philadelphia that night. Her monologue stayed with me throughout my journey back home, and I was very uncomfortable and depressed. No wonder, I thought, discrimination still exists against female children in India to the degree that female feticide is still occurring there. Disgusting. I hated it. I was ashamed to be an Indian. But, how would that help me find a solution? I had a strong urge to do something about it, right that day, right at that moment.

Lo and behold, I come back home and become busy with the mundane, and the not so mundane activities till a few days later when I come across an article on female feticide in a magazine. Auntie's voice resonates in my ears, and it is not very pleasant. I start reading the article which states that in the year1992, 37 million women were reported as ‘missing' in India, and in 2001, the number rose to 44 million. The article made reference to another report published in December 2006 which stated that India had killed about 10 million girls in the last twenty Years. It read, "Ten million girls have been killed by their parents in India in the past 20 years, either before they were born, or immediately after, and a minister referred to it as a "national crisis".
            What absolutely amazed me is that this was happening despite a law in India that bans ultrasounds and other prenatal tests from predicting the sex of the unborn child. "The United Nations says an estimated 2,000 unborn girls are illegally aborted every day in India," the article continued.

I could feel the warmth in my face, my ears turning red and my blood pressure rise as I somehow managed to scramble through the remainder of the article.

I continued to read, "Punjab loses every fourth girl, and was reported as being the leading state in female feticide, followed closely by Rajasthan. Haryana had witnessed a dip in sex ratio as well; 618 girls for 1,000 boys, in all probability as a result of female feticide."

The article also described and commented on other ways in which women were being abused in our country including bridal burning, etc, but to me that was not important. What was vital was that these hideous crimes were still happening, I needed to find out why, and that they needed to stop.

Despite all advances in science, it is still not uncommon to see couples in India offer prayers to God in order to be blessed with a child. Not to say that a baby is not a blessing from God, but for many, if the child happens to be a girl, the blessing soon becomes a curse and the ‘precious gift' is done away with as soon as possible before extending another demand to God, which is that of a ‘male' child. It is also no secret that the yearning for son is deep-rooted in both rural and urban areas, and many prayers and lavish offerings are made in temples in the hope of having a male child.

A look at some facts. Abortion was legalized in India in 1971, mainly to assure that pregnancy can be aborted if it is a result of sexual assault, contraceptive failure, baby having severe congenital malformation, or if the mother is incapable of bearing a healthy child.

Another prenatal test, amniocentesis was introduced in 1975 to detect fetal abnormalities, but it soon began to be used for determining the sex of the baby. However, ultrasound has emerged as the all time winner of the various antenatal tests. Being non-invasive, it has quickly gained popularity within the masses, is now available even in some of the most remote rural areas in India, and is being used widely for sex determination, in many instances with the intention of aborting the fetus if it turns out to be a female.

We revere our 'mothers', worship Goddesses Lakshmi, Saraswati, Parvati, Durga, and Kali, claim they represent wealth, intelligence, strength and power and then offer prayers for a boy child, or worse still, want to abort a girl child! This is absolutely hypocritical, and instead of hanging our heads in shame, we proclaim "East or West, India is best"! Dear readers please do not get me wrong. I love India too, but we have to acknowledge its problems and fix them so that it can indeed become the best.

Feticide and infanticide are not the only issues with a girl child in India. At every stage of life, right from birth to adulthood, and even death, she is often discriminated against and neglected. Why? The reasons are numerous. The status of women in India, which, like elsewhere in the world is determined by their level of education, health, economic role in the society, professional presence, and decision-making powers at home, remains substantially lower than that of their male counterparts, even today. It is distressing that the image of women that Ramayana and Manusmriti have painted in our minds remains unchanged. Most Indians still see an ideal woman as being obedient and submissive, and always needing the care of a male: first father, then husband, and then her son.

If you look at Islam, it still permits polygamy and gives women fewer rights than men.

In all major religions practiced in India, a son is often seen as an "asset' since it is thought that he can earn money and support the family, whereas a daughter a liability since she is "married off to another family", and therefore does not contribute financially or otherwise to the care of her parents. So, then why should an average person in India not desire only sons? After all, what is the benefit of having a child who is of no use to parents in their old age? Why have daughters at all? Top that off with the stress of assimilating dowry for a daughter's wedding, which still exists in many parts of India, and the problem is quadrupled.

Enough complaining, I thought. How can this be fixed? How can we abolish the dowry system, improve the status of women in India, and thereby make female feticide a thing of the past?

Although rigid enforcement of laws will undoubtedly play a key role in this that is not the only solution to this problem. Our society at large needs to change their sickening attitude. We have landed in a sad state of affairs due to the Indian patriarchal society, male chauvinism, and our marriage system. These are the important root causes and they need to change education, and economic empowerment of women is imperative.

In addition, there is a dire need to give women power at varied levels, beginning at the level of the Panchayat to all the way up. I contemplated some, and then decided to discuss this with my colleagues, who had varied opinions, none of which I perceived as being helpful.

I was astonished when I realized that most held women responsible for feticides and felt only women could change this. Some thought that a woman should refuse abortion when asked to undergo one by her family. Yes, it is true that it is the women's body that is being subjected to feticide, and she should definitely resist abortion, but then she would be alone, without family support, and we all know that is not easy.

Societal pressures cannot be dealt with easily by educated, independent people, leave alone the not so educated, and dependent, young, pregnant, women. Why most of my friends were missing the point was beyond my comprehension. Many sophisticated people opined that young women should refuse marriage if dowry is involved. Although it may sound an excellent idea to many, I just could not consume all of this. Why can these well-read people not understand that if one girl refuses to marry because of dowry, the groom's side will find another bride to be, and so on, and so forth. So, I reflected, contemplated, and deliberated some more on the subject and concluded that, the change in the status of women can come about only when both men and women, preferably both young and old realize the problem, think as if it were their own, and try to fix it. We have to realize that this is everyone's crisis, and not just of those that have daughters and sisters. Women have remained nice, submissive, and lady like for too long and it is about time they changed their image, at least in some ways, so that they are not victimized. This reminds me of a poem written by the great Shri Ramdhari Singh Dinkar. Let me share a few lines with you:

Atyachaar sahan karne ka kufal yahee hota hai
Paurush ka atank manuj, komal hokar khota hai!

If my readers are wondering who I am writing this piece for, let me tell you that this is for all of us. I know that some will look at the heading of this article, let out a chuckle or two, and not proceed further. I discern, however, there will be at least four categories of people reading it. Of all those that read this, most will laugh or ignore it completely. Next in line will be the crowd that will read the article with interest, and then forget about it the moment they are done. The third group will take me seriously, may be even amend the way they think about women now, and God forbid, if they ever had plans of being involved in dowry or proceeding with female feticide, this article may deter them from doing that. And last, but not the least will be the most important category, obviously in minority, comprising of those that will actually do something to revolutionize the status of women in India. To them, I express my gratitude in advance.

Dear readers, it is about time we did something to bring about a change. Here we are, after sixty-five years of independence from British rule, and forty three years since man first landed on moon, still struggling with things such as dowry and female feticide. This is an embarrassment, is not going to change automatically with time, and something radical needs to be done. We have to change the image of woman from "abla" as specified in the opening quote by the famous poet Shri Maithili Sharan Gupta to "sabla" and much more.

So, in the end, meeting and talking to aunty was not such a waste of my time, as I initially thought. "A blessing in disguise", shall we say?

My Note: No doubt about Dr Cuckoo’s concern that Indians need a change in their psyche. One theory rather say hypothesis, I would like to share here that female feticides happen to those women who are well literate. From my own knowledge I would like to share that low literate/illiterate mothers of Bihar, Orissa, Uttar Pradesh with 4-5 daughters still struggle to be blessed with a son...Feticide a term they still do not know. Many well educated wives are fascinated about a son.  The well educated Indian women can go at any stretch to have a male fetus in their wombs. A woman kills a woman... We have to change these women of 21st century first of all...I am 200% against feticide of any kind and I must advise a lady to remain barren rather to go for a feticide...Dr Cuckoo’s thoughts are well reflected through these words. I hope she would keep up advocating against gender discrimination...

“Medical Education: Teaching Skills for Aspiring Medical College Faculty”

“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.

“Medical Education: Teaching Skills for Aspiring Medical College Faculty”

“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.