Whew! Classes are over, summer is beginning, the students are off on a well-deserved vacation, and so are you!

It’s time to relax, kick back,have an umbrella drink, perhaps mow the lawn occasionally, right?hammock


What I’d like to suggest that now is the time to plan your next course.whatThat’s right—while the course is fresh in your mind, and the foibles, and successes are shining bright, it’s time to plan.
And I have an idea about your planning. It comes from Dr. Maryellen Weimer in her blog Faculty Focus.

Let’s use Bookends. 

Book-ending as a pedagogical and course design strategy is relatively simple. Add structure and “tie things together” to your course by building a thread throughout. You introduce the thread in the first class, continue it as much (or as little) in your course as you like, and then bring it to closure with an activity similar to the first class, at the end of the course in the last class.

Bookends are a common technique in writing professions, such as screenwriting, storytelling, and even essay writing and I think it has particular relevance for us in health sciences education. Think of the cases we use, especially in medical education, to ask students to apply their foundational knowledge to the “stories” of patients. Those cases have a thread, and are bookended, aren’t they?

Let’s see how it could work in your course…

Activity 1: First and Last Day Worksheet:

From MaryEllen Weimer: On the first day of class, give students a worksheet that they fill out (either in class or online). In MEdTech, you could use an online quiz to do this. Use prompts like these: “What do you know about INSERT YOUR COURSE TITLE? Or “What do you know about…INSERT KEY CONCEPT? What reasons justify making this a required class? Are there skills that will you be needing as a professional that you hope to develop in this course?”

Pass out the same sheet on the last day, give students time to complete it, and then return the one they filled out the first day. Have a brief discussion about the differences and similarities of the two sheets. We did something similar in the former Professional Foundations Course at Queen’s where Dr. Ruth Wilson introduced students to the Intrinsic Roles of a physician, and then asked them to look back a year later to see what they’d learned, as part of their Portfolio assignment on what they’d learned about the intrinsic roles.

Activity 2: First and Last Day Problem:

Also from Dr. Weimer: Pass out a problem set on the first day. Give bonus points for answers and for work that shows the student spent some time searching for the solution. Calm students’ fears by indicating that they’ll see these problems throughout the course. Pass out the same problem set on the last day and watch for smiles.

Activity 3: Meet Mr. Ms. Lavigne…

…or Mr. Gonzales or…. whoever you’d like to “star in your bookend case. Ms. Lavigne is a patient whose case is introduced in the first class. cases 2Checking in with Ms. Lavigne happens throughout the course. It could be that, after a lecture on infection or infection control, or hospital acquired infections, Ms. Lavigne has had this complication in her case. Or after a learning event about safe opioid prescription, and opioid addiction, Ms. Lavigne has to be treated. We don’t want to overload Ms. Lavigne G with every condition in the book—it becomes a bit of a joke, if she’s not treated with respect, relevance and as someone encountering real-life issues. But Ms. Lavigne’s case can also be the wrap up of the course in order to ask the students, “What have you learned?”. You can follow Dr. Sue Moffatt’s example at Queen’s with the case of Mr. McCade, and have an integrated case that bookends three different body systems such as Cardiovascular, Respiratory and Renal across a whole term.

Activity 5: Graphic Representations:

Create an algorithm or some other graphic representation of your course. Fill in the first few blanks. Leave the others blank and ask students to track their learning by filling it in through your the course. Reviewing these in small groups makes for interesting learning in itself, especially when compared to your own vision of the course.  Or you can ask students to create a “concept map” of what they learned, based on the outline you provided on the first day.  Pulmonary Hypertension.cmap

Activity 6: What is working? What is not?

Introduce your students to informal evaluation of the course on the first day. Ask them to record (on an electronic survey, on a recipe card, or giving feedback to a class representative) what they have learned this week, what is confusing them (muddiest point), whatever questions you have for them. Start this early, and do it periodically as check-in’s throughout the course, and wrap up with final evaluations.   checklist-on-a-paper-with-a-pencil_318-64499In between, show students how you are responding to their concerns, especially muddiest points. (In our school, where faculty don’t always have a chance to come back to the class, they can email, or use our MEdTech Discussion Board).


So, what do you think of bookends?


Can you make them work for your course? You can always check in with our Educational Development Team to run ideas by us.

And of course, you can now get back to that well-deserved break!


Have a wonderful summer, and many thanks to all the wonderful teachers and students who made the academic year of 2015/16 at Queen’s UGME such a success!

Resources:  Two of the ideas are from Dr. Maryellen Weimer’s blog article, The last class session:  How to make it count, April 13, 2016. http://www.facultyfocus.com/articles/teaching-professor-blog/the-last-class-session-how-to-make-it-count/