Why Won`t They Learn? Part 3

This is the conclusion to a 3-part series by EMS educator Rommie Duckworth.

It's easy to target an individual or group of students as the "problem" in class, but remember that all students have issues to deal with, as well as something to contribute, even if it takes work to find the silver lining. Be sure that you and your fellow instructors identify the problem "issue," not the problem student.

The primary "issue" may not be immediately apparent, so begin by considering the common barriers to adult education:

• Age: Are you teaching traditionalists (authority-oriented), baby-boomers ("show-me" oriented), Gen-X (entrepreneurial) or millennials (autonomous), or some combination? Are you teaching the material in a way that connects with the age group of the students?¹

• Education: What is the education level of the students in question? Do they need additional background information or skills to be able to process the knowledge that you are trying to relay? How can you help them obtain this? What is the students' background? Are you teaching information that is boring for those with experience in emergency services or using words and phrases that are unfamiliar to students who are new to EMS?²

• Culture: Are you being sensitive to the culture and ethnicity of students? This is not just a matter of political correctness, but rather, are you using terms and concepts that may be so foreign to the students' culture that they are unable to assimilate the knowledge you are trying to relay? How can you re-phrase the information in a way that is understandable to someone with a particular cultural background?³

• Style: What is the students' preferred learning style? While most students will tell you they "learn best by doing," that does not mean that every student is primarily a kinesthetic learner. Auditory learners best process information by discussion. Visual learners process information best when presented with symbols, graphics and diagrams. Kinesthetic learners learn best by discovery and practice.⁴

• Responsibilities: What are the students' adult life responsibilities? As much as it may shock and surprise educators, students often have responsibilities outside of the classroom that may interfere with the learning process. While these obligations are the students', as educators we must keep them in mind when considering the logistics and syllabus of the class, including scheduling, reading assignments and homework.⁵

Help! I Need Somebody!

It is rare to have only a single student with a single issue in each class. Addressing multiple student issues within a single class can be difficult and overwhelming, especially if the curriculum is otherwise working for the rest of the class. In these in-stances, a variety of outside-the-class techniques can help the student achieve adequate if not excellent performance without bogging down the educator.

• Mentoring: Mentoring is a process through which one instructor or assistant may oversee and guide a group of students through a program. The value in mentoring lies not only in more student-focused instruction, but also in closely monitoring the students so their difficulties can be recognized early enough in the program to allow for correction.⁶
• Peers: Peer counseling is another great method where students work in groups to achieve success together. This is a method through which diversity in the class is used to allow students of different backgrounds and learning styles to teach and encourage the achievement of fellow students.⁶
• E-Learning: Computer-based education, distance learning and e-learning are all terms that refer to student-driven supplements to traditional in-class learning. The sheer volume of material available almost ensures that there is a quality online education component to assist your challenged students, whether they need help with basic math skills, core EMS education or, if they are advanced students, additional, higher level learning to keep them engaged with the course.^7-10

• Tutoring: The last step that may be required to address student problems is to deal with the student as an individual. While one-on-one tutoring can be an effective way to address a student's educational deficiencies, because it is tremendously time and resource intensive, this method is best saved for last. Rest assured, however, that if you have employed the other techniques listed here, you will be focusing your attention only on the students who truly need it.¹¹

Keeping the Blood Pumping and the Mind Active

In order to really achieve that level of educational excellence, learning needs to be a functional process. Activities like the ones listed below not only make class more fun, but they also reinforce core materials, facilitate different learning styles, and encourage student-student and student-teacher interaction. Most important, they aid in the transference of textbook information to a variety of real-world circumstances and scenarios:

• Small Groups/Short Sessions: While not an activity per-se, SG/SS help encourage new partnerships, break up cliques and demand individual participation and performance without leaving students completely out on their own. In addition, they keep the momentum of a class high for both instructors and students, which is especially important for the success of long-format programs.¹²
• Think, Pair, Share: In this activity, students are asked to gather in pairs (or small groups) and come up with an answer to a given question or solution to a given problem. Students are given approximately five minutes to come up with their answer and then, in their groups, explain and defend their answers to the rest of class and the instructor. This not only encourages greater student involvement than standard "Q&A" sessions, but is a great way to let experienced students share what they know.¹³
• Scenarios/Simulations: Rather than have students perform the scenarios, in this activity, students are asked to come up with scenarios for topics like medical problems or traumatic injuries, which can then be assigned as narrative, story-like scenarios or in the form of fill-in-the-blank worksheets. Either way, the activity encourages students to visualize not only the external signs and symptoms of a particular patient presentation, but also the correct actions and responses.^8,9,14,15
• Flow Charts: In this activity, small groups of students are presented with a particular disease or injury and asked to create a flow chart showing the progression of the problem both with and without appropriate EMS interventions. This is another activity which shows how scenarios evolve dynamically and encourages students to "put it all together."¹⁶
• Concept (Mind) Maps: Concept Mapping is a form of Mind Mapping activity in which the instructor utilizes a white board, easel paper, blank PowerPoint screen or blackboard to write a core concept to be discussed in the center, then asks students to call out words or ideas related to the core concept, which are drawn on the board like spokes coming off the hub (core concept). The instructor can then pursue each "spoke" for additional discussion and branching. In this way, students lead the discussion and the instructor acts as a true moderator and facilitator. This activity is a great way to eliminate PowerPoint slides that simply list a number of ideas related to a core concept. Students can work together to come up with the list, with the instructor filling in any critical gaps.¹⁶
• Contrast Maps: Much like Concept Maps, Contrast Maps let students lead the discussion with the instructor moderating and ensuring that the objectives are met. The difference is that in Contrast Maps, students are given two topics (e.g., pneumonia and CHF) and are asked to list the properties of each. The instructor can write these on a board and then have the students indicate what properties are the same between the two topics (SOB, apply O₂, coughing, etc.) and what properties contrast or differentiate the two (lung sounds, body temperature, mucus color, etc.). This is an excellent way to encourage critical thinking and powers of differential diagnosis.¹⁶
• Analogical Reasoning: In this activity, the instructor gives the students a concept and asks them to work individually or in small groups to come up with an analog--an explanation by way of using an example of a similar concept (e.g. the arteries and veins are like plumbing and the heart is like a pump). This type of activity focuses on having the students develop their own connections be-tween prior knowledge and experiences and the scenarios and concepts presented in class.¹⁷
• Summary: In this activity, an individual or small group of students is asked to summarize and explain a lesson or concept from class using their own words. This is not just a great way to get students to make additional cognitive connections, but also provides excellent immediate feedback on the level of retention of lessons you have taught.⁹

Conclusion

As EMS educators, we're certainly not in it for the money. We put our heart and soul into the programs we teach and, as such, it can be tremendously frustrating when students don't perform as we believe they should.

As easy as it can be to blame the curriculum or the students, we are the hub through which all aspects of the educational program are connected. Although we may not be able to completely control every factor of our programs, we can and should positively affect them through our approach to teaching.

Begin by looking at the curriculum through the core concepts of adult education. Next, consider why your students are in class. Then make sure that you, as the channel through which that course content reaches those students, do your PREPS to deliver an exceptional educational experience.

If a few stragglers are still having problems, identify their issues by considering the barriers to education that may be specific to particular students and use instructor-student resources to overcome those barriers.

Finally, use activities not only to achieve greater success in your programs, but to just make them more fun.

In an age of mandated curricula and prepackaged course materials, it can be easy for instructors to underestimate their contributions to the programs they teach. As an educator, know that you are the medium through which the information flows, receives context and is shaped for students to receive. While it may take slightly more work than just reading the prescribed lesson to the students, when you review and prepare for your classes, you will supercharge your educational programs and affect not only the lives of those whom you teach, but also the lives of those whom they treat with the knowledge that you have given.

References

1. Lovely S. Generations at School: Building An Age-Friendly Learning Communi-ty, 2007.

2. Rekkedal T. Enhancing student progress in Norway. Teaching at a Distance, pp. 19-24. The Open University, 1983.

3. Nieto S, Bode P. Affirming diversity. The Sociopolitical Context of Multicultural Education, 6th Edition, p. 480). Allyn &Bacon, 2011.

4. Fleming ND. Teaching and Learning Styles: VARK Strategies, 1st ed., p. 128, 2001.

5. Knox AB. Adult Development and Learning. Jossey-Bass Higher Adult Education and Behavioral Science Series, Proquest Info & Learning, 1977.

6. Daloz LA. Effective Teaching and Mentoring. Realizing the Transformational Power of Adult Learning Experiences. Jossey-Bass Higher Adult Education, 1st ed., p. 256, 1986.

7. Boettcher JV, Conrad RM. The Online Teaching Survival Guide. Simple and Practical Pedagogical Tips. Jossey-Bass, p. 288, 2010.

8. Bonnel W, Smith K. Teaching Technologies in Nursing & the Health Professions: Beyond Simulation and Online Courses, 1st ed., p. 280. Springer Publishing Company, 2010.

9. Davis M, Forrest K. How to Teach Continuing Medical Education. A Reference Handbook, p. 1032. Sage Publications, Inc., 2008.

10. NAEMSE, N. A. O. E. E. Foundations of Education: An EMS Approach. D. Cason, ed., p. 336. Mosby/JEMS, 2005.

11. Chi M. Learning from human tutoring. Cognitive Science 25(4):471-533, 2001. doi:10.1016/S0364-0213(01)00044-1

12. Michaelsen LK, Knight AB, Fink LD, eds. Team-Based Learning: A Transformative Use of Small Groups in College Teaching, 1st ed., p. 304. Stylus Publishing, 2004.

13. Holcomb EL. Asking the Right Questions. Tools for collaboration and school change, p. 205. Corwin Press, 2008.

14. Dent JA, Harden RM. A Practical Guide for Medical Teachers, Third Ed., p. 435. Churchill Livingstone, 2009.

15. Gaberson K, Gaberson KB, Oermann M, Oermann MH. Clinical Teaching Strategies in Nursing, p. 442. Springer Publishing Company, 2010.

16. Canas AJ, Carnot M, Feltovich P, et al. A summary of literature pertaining to the use of concept mapping techniques and technologies for education and performance support. The Chief of Naval Education and Training, p. 108. Pensacola, FL, 2003.

17. Brown DE, Clement J. Overcoming misconceptions via analogical reasoning: Abstract transfer versus explanatory model construction. Instructional Science18(4):237-261, 1989. doi:10.1007

Bibliography

Barwell CAP. Teaching EMS: An Educator's Guide to Improved EMS Instruction, p. 384. Mosby, 1995.

Camerer C, Loewenstein G, Weber M. The curse of knowledge in economic settings: An experimental analysis. The Journal of Political Economy 97(5):1232-1254. Chicago: The University of Chicago Press, 1989.

Heath C, Heath D. Made to Stick: Why Some Ideas Survive and Others Die, 1st ed., p. 291. Random House, 2007.

Knowles MS. The Modern Practice of Adult Education: Andragogy versus Pedagogy, p. 384. Association Press, 1970.

Knowles MS, Holton EF, III, Swanson RA. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development, 6th ed., p. 390. Butterworth-Heinemann, 2005.

Lieb S, 1991. Principles of adult learning. Retrieved May 2011.

Lovely S, 2007. Generations at school: Building an age-friendly learning community. McClincy WD. Instructional Methods in Emergency Services, 2nd Ed., p. 288. Prentice Hall, 2002.

An emergency responder for more than 20 years with career and volunteer fire departments, public and private emergency medical services and hospital-based healthcare, Rom Duckworth is an internationally recognized subject matter expert, fire officer, paramedic and educator. Rom is currently a career fire lieutenant, EMS coordinator and an American Heart Association national faculty member.

Related

• Why Won't They Learn? Part 2
• Why Won't They Learn? Part 1