Strategies for ‘Great Teaching’ in Evidence-Based Medicine

January 21, 2019

‘If I had to distill great teaching down to one element, it would be practice, practice and practice.’

Carl Heneghan

A 2014 review by the Sutton Trust tells us that effective teachers have in-depth knowledge of the subjects they teach, use effective questioning and assessment, employ a classroom that continually demands more and reflect on and develop their teaching practice within an environment and culture of continual learning.

A simple definition of what defines great teaching is it should lead to improved student achievement. Beyond all of these strategies, great teaching also relies on what and how teachers teach, and the culture of the professional learning environment that their learning occurs in.

Teachers who are engaged in active professional learning, and reflection on their teaching, take on greater responsibility for student learning. And as they take on this greater responsibility, they evolve their knowledge and the impact they have; setting up a cycle of feeling more effective, and ultimately being more effective (see Teacher professional learning and development by Helen Timperley).

To engage in effective professional learning requires us, as teachers of EBP, to continually develop our skills and collect evidence on the effectiveness of our teaching, reflecting on what works and what doesn’t. To achieve this, you might want to consider a combination of:

  1. Classroom observations by peers, external evaluators
  2. Self-evaluation and reflection
  3. Assessment of gains in student achievement
  4. Student evaluation and ratings
  5. Critical discussion and reflection with peers of what works and what doesn’t.

Timperley’s review suggests reflection can be made even more straightforward by seeking to answer three vital questions: “Where am I going?”, “How am I doing?”, and “Where to next? You may want to try answering these with one of your colleagues to improve your teaching.

Let’s also be clear; there is no plateau for great teaching: that is unless you choose to let there be one. Do teachers improve over the first 3 to 5-years and then plateau? As is often quoted (see page 5). Studies conflict as teacher’s ability to boost achievement has been shown to increase for at least ten years – if not longer.

To continue to build your skills in effective teaching in EBM here are five of my strategies that you may want to take on board:

  1. Build a bank of learning materials – as said earlier keep what works, discard what doesn’t
  2. Use well-chosen questions that engage and challenge learners
  3. Use real-world examples – if you aren’t finding questions you have asked and tried to answer you will find it difficult to teach about finding evidence to answer questions faced in actual practice
  4. Create a structure in your teaching – much of evidence-based practice requires a deep understanding of research methods and the complexity of applying the evidence to actual practice – creating structures such as PICO enables question answering to become much more straightforward, which leads me to my final point.
  5. Keep it simple.

In addition, a hierarchy of effective teaching and learning to acquire competence in EBM suggests that at the top is interactive and clinically integrated activities; followed by interactive but classroom-based activities and at the bottom is didactic, classroom or standalone teaching. I’d keep this in mind when planning your lessons.

If I had to distill great teaching down to one element, it would be practice, practice and practice. That’s why I hope to see you sometime on the Teaching Evidence-Based Medicine course in Oxford.

Read more

> Why is teaching EBM so damn hard?

 

Competing interests

Carl has received expenses and fees for his media work. He holds grant funding from the NIHR, the NIHR School of Primary Care Research, The NIHR Oxford BRC and the WHO. He is Director of CEBM and Programmes in EBHC. He attends the Teaching EBM course to reflect on his practice, and he is Editor in Chief of BMJ EBM.

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