Month: September 2021
Honing skills for writing learning objectives
Many people – from award-winning educators to rookies and everyone in between – find writing learning objectives a challenge. The typical advice of write out who will do what under what conditions is vague, so it’s often not very helpful.
“General” learning objectives – from our UGME Competency Framework, aka the Red Book* – are already assigned to your course, and possibly to your session by your course director. (The Red Book’s 7th edition is forthcoming; the link will be updated automatically).
The key task for instructors is to take these general objectives and annotate them with specific objectives for their sessions, including what level of learning, such as comprehension, application or analysis. (This is from something called “Bloom’s Taxonomy”, if you’re interested in the research behind this).
A natural starting point is: What do you want your learners to take away from your session? (Or, if you’re creating an independent learning plan, as in the case of the new Scholar block in Clerkship: “ What do I want to accomplish in this block?”)
Frequently the response is:
- “I want them to know….” / “I want to know…”
- “I want them to understand….” / “I want to understand…”
- “I want them to be able to…” / “I want to be able to…”
Once you’ve wrestled something like this into sentences, I realize it’s disheartening to have someone like me come along and say, “Uh, no, that’s not up to scratch.”
What’s wrong with “know” and “understand”? Isn’t that exactly what we’d like learners to walk away with – knowledge, understanding, skills? Absolutely. The challenge with these so-called “bad objective verbs” is that we can’t measure them through assessment. How do we know they know?
That’s the starting point for writing a better learning objective. If you want to assess that learners know something, how will you assess that?
For example, while we can’t readily assess if a learner “understands” a concept, we can assess whether they can “define”, “describe”, “analyze”, or “summarize” material.
Here’s my “secret” that I use all the time to write learning objectives – I can’t memorize anything to save my life, so I rely on what I informally call my Verb Cheat Sheet. The one I’ve used for many years was published by Washington Hospital Centre, Office of Continuing Medical Education. It list cognitive domains (levels) and suggests verbs for each one. There are many such lists available on the Internet if you search “learning objectives” (here’s another one that’s more colourful than my basic chart, below).
Well-written learning objectives can help learners focus on what material they need to learn and what level of mastery is expected. Well-written objectives can assist instructors in creating assessment questions by reminding you of the skills you want students to demonstrate.
Here’s my quick three step method to annotating your assigned objectives on your Elentra Learning Event page with your learning-event specific objectives:
- Start with writing your know or understand statements: what do you want learners to know or understand after your session?
- Think about what level of understanding you want students to demonstrate and how you would measure that (scan the verb chart for ideas)
- Write a declarative sentence of your expectation of students’ abilities following your session. In your draft, start it off with “The learner will”. For example: The learner will identify the bones of the hand on a reference diagram. Your objective would be: “Identify the bones of the hand on a reference diagram.”
As a fourth step, feel free to email your draft objectives to me at email@example.com for review and assistance (if needed). I’m happy to help.
Table excerpted from Washington Hospital Center, Office of Continuing Medical Education’s “Behavioral Verbs for Writing Objectives in the Cognitive, Affective and Psychomotor Domains” (no date).
* The “Red Book” got its name because for the first edition (we’re now on the fourth), the card stock used for the cover was red. Over time, everyone started calling it the “Red Book”.
A version of this post was originally available in 2017… but writing learning objectives is an ongoing challenge for all!
Kingston and its Students: A Tempestuous but Enduring Symbiosis
With tongue firmly in cheek, a friend recently remarked that “Town-Gown” relations seem somewhat strained in our community these days. A remarkable example of impish understatement if one was ever uttered. Indeed, the usual energy and sense of renewal that accompanies the return of students each September has been muted if not completely submerged under layers of pandemic-related anxiety and efforts intended to mitigate them. The juxtaposition of such efforts with images of unrestrained street parties, fenced off beach areas and rising local COVID case counts has been, for many, rather jarring and unsettling.
Amid all this, I recently received a letter from a local physician that cut through that gloom like a glimmer of sunshine on a stormy day. Dr. Stephen Yates, a longstanding Family Physician in our community, wrote to Dr. Philpott and myself about his experiences working in vaccination clinics alongside volunteer medical students. In Dr. Yates own words (provided in part and abridged with his permission):
I am writing to you both after a very busy 6 months working as the Clinical Lead at several community covid19 Mass Immunization Clinics that have run from March to August this year. Those MIC’s put Kingston on the “Vaccine Map” of Canada as one the very highest vaccine rates in a Canadian community.
We could not have accomplished this extremely successful vaccine roll out without volunteers and the Queen’s Medical School Students stepped up to the plate and helped us out. When the medical school academic year ended numerous 1st and 2nd year students, with a few 3rd and 4th year, and even a few students entering the school this year, came forward to donate their time.
To try and name all the students who took part will leave many students out by mistake but suffice it to say…all the students were an absolute delight to get to know and to work with.
Whether organizing student volunteers, helping with vaccine draws, functioning as principal vaccinators, organizing recipient stand by lists for extra vaccines, calling literally hundreds of recipients in for shots, reviewing side effects or even managing vaccine hesitancy, your students were exemplary and were key to helping this community get through the pandemic.
The community of Kingston owes a great debt of gratitude to your medical students!
Very best regards,
Dr Stephen Yates, MD, CCFP, FCFP
Kingston and its student population. A raucous, tempestuous, never-fully-resolved, but also never-boring relationship. A marriage, it would seem, doomed to constant struggle, never to achieve either complete happiness or peaceful separation. To the cynical or those hopelessly frustrated by all this, the idiom “can’t live with them, can’t live without them” might seem appropriately applied, by either party. But, like any relationship experiencing difficulty, causes are deep, complex and worthy of some thoughtful reflection. Like many, I encountered our city initially as a student, have embraced it as adopted home, raised a family here, have seen numerous family members attend as students, and now live both sides of the “Town-Gown” dichotomy. And so, some observations, respectfully offered.
Firstly, it must be said, Kingston would not be Kingston without its students. This is not simply an economic or political reality. The student population brings energy, purpose and, on a regular cycle, youthful renewal to one of the oldest communities in our country. The city of Kingston, for many generations of students, has provided a supportive environment and wonderful example of community life. It has been an incubator of citizens who learn what it means to be part of and to care for their “home”. Its productivity or place in Canadian society will never be measured in terms of manufactured goods or agricultural productivity. Its true “product” are the young people whose lives are, in ways great and small, shaped by their lived experience among us.
For most students, their time in Kingston is their first experience living, to some extent at least, on their own. They are going through a very challenging phase of life during which most struggle with understanding and developing their own interests, strengths, values, and purpose in life. For most of them, the time they spend in Kingston will be the most transformational of their lives.
That transformation doesn’t occur entirely or even mostly in the classrooms of Queen’s, RMC or St. Lawrence College. It also happens in the streets, shops, restaurants, waterfront, trails, lakes, and rivers of our community. It happens through interactions with their fellow students and faculty they encounter to be sure, but also within the community in which they must function, independent of the influences and supports of home. Those encounters, as we’ve observed recently, can be ill-advised and troublesome. Judgement may be lacking, consequences may not be understood or ignored, actions may be impulsively taken, untempered by experience. This is not to say that actions should be free of consequences. In fact, it would be a disservice not to maintain standards based on the best interests of the greater community. But those responses should be directed at the actions not the individuals, motivated by a desire to correct not condemn, and tempered with the understanding that most of us will have no difficulty recalling similar lapses of judgement if challenged to cast the first stone.
Symbiosis is a biologic term that might have relevance here. It implies a mutually beneficial relationship between different people or groups. Hummingbirds, for example, have a symbiotic relationship with wildflowers. The birds are feeding on nectar provided by the flowers and gaining nourishment. Without that occasional noisy intervention, the flowers would not cross-pollinate and and would not flourish so beautifully.
It’s also helpful to be reminded that the vast majority of students integrate well and even contribute positively to our community. For a group of eager medical students, that contribution occurred recently in an immunization clinic.
Thank you, Dr. Yates, for the reminder. When it comes to students and Kingston, it’s not “them” and “us”. They are us.
What are those learning event types, anyway?
Tucked on the right-hand side of every Learning Event Page on Elentra are notations about the date & time and location of the class, followed by the length of the session and then the “Breakdown” of how the time will be spent. In other words: the learning event type.
After the last 18 months of learning event types being broadly divided into “Zoom” and “not-Zoom”, it’s worth having a look at what these notations (really) mean as we get back to more face-to-face on-campus teaching.
We use 18 learning event types* in the Queen’s UGME program. The identification of a learning event type indicates the type of teaching and learning experience to be expected at that session.
Broadly speaking, our learning event types can be divided into two categories: Content Delivery and Content Application.
For content delivery, students are presented with core knowledge and/or skills with specific direction and/or commentary from an expert teacher. Content delivery learning events include:
Independent Learning (DIL) — these are
independent learning sessions which are assigned curricular time. Typically,
students are expected to spend up to double the assigned time to complete the
tasks – i.e. some of the work may occur in “homework time”. DIL’s have a
specific structure and must include:
- Specific learning objectives
- A resource or set of resources chosen by the teacher
- Teacher guidance indicating the task or particular focus that is required of students. This may be a formal assignment, informal worksheet or study guide.
- The session must link to a subsequent content application session.
- Formative testing in the form of MCQ or reflective questions are an optional component of DILs
While students have nicknamed these “do it later”, it’s important that learners complete the assigned material prior to the related in-class sessions in order to be ready for what comes next. DILs aren’t an alternative delivery of material covered elsewhere, but essential curricular delivery.
- Lecture – Whole class session which is largely teacher-directed. We encourage the use of case illustrations during lectures, however these alone do not fulfil the criteria for content application or active learning.
- Demonstration – Session where a skill or technique is demonstrated to students.
For content application (sometimes described as “active learning”), students work in teams or individually to use and clarify previously-acquired knowledge, usually while working through case-based problems. These learning event types include:
- Small group learning (SGL): Students work in teams to solve case-base problems which are revealed progressively. Simultaneous reporting and facilitated inter-team discussion is a key component of this learning strategy which is modeled on Team-Based Learning. SGL cases may be preceded by in class readiness assessment testing (RAT) done individually and then as a team. This serves to debrief the preparation and provide for individual accountability for preparation.
- Facilitated small group learning (FSGL): Students work in teams and with a faculty tutor to solve case-base problems which are revealed progressively. While there is structure to FSGL cases, students are encouraged to seek out and share knowledge based on individual research.
- Simulation: Session where students participate in a simulated procedure or clinical encounter.
- Patient or Panel Presentation (PPP): Session where students interact with guest patients and/or health care providers who share their experience. Builds on prior learning and often includes interactive Q+A component.
- Laboratory: Hands-on or simulated exercises in which learners collect or use data to test and/or verify hypotheses or to address questions about principles and/or phenomena, such as Anatomy Labs.
The other learning event types we use don’t fit as neatly into the content delivery/content application algorithm. These include:
- Clerkship seminar – instruction provided to a learner or small group of learners by direct interaction with an instructor. Depending on design, clerkship seminars may be either content delivery or content application.
- Self-Directed Learning (SDL) is scheduled time set aside for students to take the initiative for their own learning. A minimum of eight hours per week (pro-rated in short weeks) is designated SDL time. (This is referred to as “Independent Learning” or “IL Time” in the UGME Policy Governing Curricular Time).
- Peer Teaching is learner-to-learner instruction for the mutual learning experience of both “teacher” and “learner” which includes active learning components. This includes sessions that require students to work together in small groups without a teaching, such as Being a Medical Student (BAMS) sessions, the Community Based Project and some Critical Enquiry sessions.
- Career Counseling sessions, which provide guidance, direction and support; these may be in groups or one-on-one.
Two other notations you’ll see are “Other-curricular” and “Other—non-curricular”. Other—curricular is used for sessions that are directly linked to a course but that are not included in calculations of instructional methods. This includes things like examinations, post-exam reviews, and orientation sessions. Other—non-curricular are sessions of an administrative nature that are not directly linked to a particular course and are outside of curricular time, for example, class town hall meetings and optional events or conferences.
Incorporating a variety of learning event types in each course is important to ensure a balance of knowledge acquisition and application. Course plans are set by course directors with their year director, in consultation with the course teachers and with support from the UG Education Team.
*In 2015, Queen’s UGME adopted the MedBiquitous learning event naming conventions to ease sharing of data amongst institutions. For this reason, some learning event type categories may be different from ones used here prior to 2015, or ones used at other, non-medical schools or medical schools which have not adopted these conventions.
Together again, in person and with gusto
The last in-person, full-class teaching session in the Queen’s School of Medicine took place over 18 months ago. Seems much longer. Since then, as is known to all reading this article, we’ve been providing our curriculum with a combination of virtual and appropriately regulated small group teaching events. These arrangements, contrived and cumbersome as they may appear, have allowed programming to continue and student learning to progress.
Just last week, we received very welcome news from the province and university that restrictions could be reduced to allow full class, in person sessions to proceed as of September 7th. Unfortunately, this didn’t arrive in time for our Orientation Week which was scheduled to begin August 30th. We had therefore planned and received approval from the university for a modified program which would be compliant with current requirements. The week kicked off with a welcoming event for all first, second and third year students (our fourth years being on clinical rotations and unable to attend) held in the main gymnasium of the ARC (Athletics and Recreation Centre). Our fully vaccinated, screened, disease-free, and masked students were welcomed back to the school year and to a “more normal” learning environment by faculty and student leadership. The significance and poignancy of assembling after such a long period of relative isolation cannot be overstated. To add to the celebration, music was provided by “Old Docs New Tricks” (ODNT), a group of SOM faculty physicians who not only entertained the crowd but demonstrated how busy practicing physicians can maintain personal interests while achieving great things in their professional lives.
Below is a small album of photos from the event, all by Lars Hagberg, go-to photographer extraordinaire and friend of the School of Medicine.
ODNT performing for the crowd
Many thanks to our Student Affairs group, capably led by Dr. Renee Fitzpatrick and supported by Erin Meyer and Hayley Morgenstern, who worked tirelessly and with great adaptability to make these arrangements.
We all recognize that the pandemic is far from resolved. We remain guided by continuing public health requirements. We recognize that further adaptations will likely be required in the weeks and months to come. We remain committed to providing the best possible educational experience for our students and learning environment for all involved.
But, for now, we’re just grateful to be in our classrooms and in person. We’re back!