suggestion for teaching methodology

A description of some of the suggested methodologies

• The formal lecture (unidirectional monologue) and mini-lecture: The advantages of the formal lecture are they can be structured, use low technology, and offer the ability to teach many learners in a short period of time. The principal disadvantage is that the learners are the passive recipients of information. Formal lectures are often considered to be optimal if speaking time is limited to 20-30 minutes followed by a ‘discussion period’ of a roughly equal length. A short form of the formal lecture, the mini-lecture of 5 to 15 minutes may be used to introduce a topic and structure; or animate a further activity which directly engages the learners, such as a ‘group session’.

• The interactive lecture with active breaks involving the students: A formal lecture may be notably enhanced by strategies which involve the learners. With a little creativeness, a teacher may include several different methods such as ‘problem solving exercises’ and ‘case studies’ which deliberately engage the learners in a more active process. You can also use ‘active breaks involving students’ during which the learners discuss specific issues concerning the presented topic with one another.

• Reading: The efficiency of the learners’ reading is greatly increased if they are given a specific list of references to draw on, and a number of explicit questions to answer from their reading. A review of the medical literature including journal articles and textbooks is an efficient method for gathering available information. Clinical practice guidelines can also be reviewed.

• Field work (observations, discussions with adolescents etc): Learners are invited to go out into various settings such as schools, local shops, fast food restaurants, and discos to observe adolescents’ behaviours and engage them in relevant discussions. The field work can provide a unique opportunity for many learners to gain first hand experience of the contemporary world of adolescents.

• Audio visual materials (CD-ROM, tapes etc): These methodologies tend to be expensive because of the equipment needed. In the field of adolescent medicine, audio visual materials are at the present time, not readily available in some countries, nor in many languages, other than English. Some Internet sites can be used as audio visual material (e.g. www.healthteenagefreak.org). A search of the Internet around the subject of ‘teenage health’ can be useful to find this material

• Case studies: Case studies are ‘real life’ cases that can be used in class to illustrate major problems and solutions encountered in clinical practice. Case studies may be presented for general class discussion; for use in small work groups; or as an impetus for role playing. They allow the learners to practice applying recently acquired knowledge, and to obtain views from various other disciplines . The ‘cases’ chosen for any particular topic should be complex enough to ‘bring up’ the major points for discussion. Many short cases are provided within each EuTEACH module so as to allow the teacher to add on specific details. Such details can be elaborated in line with the needs of the class. Another efficient and useful source of ‘case studies’ is the learners themselves, who can present cases from their own clinical practice and experience. Case studies can also be obtained from Internet websites such as www.dipex.org

• Individual research (the Internet, the Cochrane reviews, local data sets, literature review etc): Like general reading assignments, individual research is best guided by the teacher. It is the teacher’s role is to steer the learner to relevant resources in such a way that they understand how, in the future, they can use these resources by themselves. The advantages is that this approach promotes ‘self directed’ learning. The disadvantages is that it is time consuming and depends on the motivation of the learner.

• Group discussion: Discussion can be used in many different teaching situations and helps to promote an understanding about the different views and opinions that may arise from clinical situations. While the interaction it induces amongst peers is valuable it needs, where possible, to be structured and directed by the teacher in order to obtain maximum benefit. The teacher’s skills in questioning, keeping the discussion focused, and summarizing is vitally important

• Simulations (artificial models, standardised/simulated patients, role play): Of these ‘role play’, whereby learners assume the roles of the different people involved in a complex problematic situation and try, through spontaneous acting, to find solutions, is the easiest to implement and does not normally need many resources. It allows learners to try new techniques, experience different roles, actively test their ideas and reactions, make mistakes and repeat their performance until a skill is achieved. The performances can be videotaped for feedback or used as audio visual resources in other situations¹.

• Supervised clinical practice: The classical approach to this is ‘see one; do one; teach one’. A ‘learner’ watches a demonstration by an experienced clinician, then practices the skills demonstrated under supervision with feedback on their performance, and finally teaches a fellow ‘learner’ in order to consolidate and condense the key elements of the experience. The development and use of checklists can enhance this approach.

• Video taping clinical situations: Clinical situations can be videotaped for use as a teaching tool, and is especially good for stimulating dialogue about good and bad practices.

• Guidelines for good practice: Guidelines (often in terms of flow diagrams) are available for the treatment and management of a number of health problems. These are ideally linked with a review of the relevant medical literature, a can act as a hallmark for practicing ‘evidence based medicine’.

• Exploration of Personal Attitudes: Methods to facilitate learner ‘attitude openness’ and ‘introspection’ include individual exercises in self reflection, group discussion, and focus groups. In order to elaborate a non-judgmental approach to the practice of adolescent medicine, exercises are designed to expose the learners to situations where they have to reflect on or confront their own beliefs, values and attitudes which might influence the way in which they manage their adolescent patients. For example, patients/videos/case histories of adolescents heavily involved with drugs may be used to provoke group discussion wherein individual learners are challenged to inspect their personal attitudes, and the roots of their individual reactions to drug taking amongst young people. Because discussions of personal attitude may be tinged with emotion, the teacher needs to provide some structure and be alert to the possible need for guidance.

• Exposure to a variety of views and perspectives on adolescents and adolescent behaviour: Trigger tools for this approach can include real or ‘simulated’ patients, novels, biographies, videos, websites (DIPEx = date base of individual patients experiences), adolescent role models. These exercises allow the learners to be exposed to a variety of different (and sometimes opposing) views and values about adolescence and adolescents.

• Focus groups: Focus groups are made up of 8-12 learners and are normally set up with the purpose an carrying out an ‘in depth’ exploration of a variety of views around a particular topic/s. It represents a ‘brainstorming’ session in order to obtain as wide a range of views as possible, rather than attempting to obtain a consensus view. Focus groups may also include outside experts or other representatives interested in the issues (see reference below).

 Role play can evoke strong emotions. Less experienced teachers may want to refer to the guidelines available for running role play sessions (see ref 5 below). Standardised/simulated patient is someone who has been trained to act the ‘part’ of a patient