Effective Teaching Study with a Effective Teaching Study with a Modified Flanders Interaction Modified Flanders Interaction

Analysis at LMU Analysis at LMU and TUMand TUM

HAROLD C. LYON, JR.HAROLD C. LYON, JR.Guest Professor of Medical Education Guest Professor of Medical Education

Ludwig Maximilians University and Ludwig Maximilians University and TUMTUM

Munich, GermanyMunich, Germany

Module 3 MeetingModule 3 Meeting

January 15, 2009January 15, 2009

My Goals for this Short My Goals for this Short PresentationPresentation

(with apologies for not speaking to you in (with apologies for not speaking to you in German)German) That you hear about the largest study

of effective teaching ever done and its findings

That you learn about the results of the randomized study we did here at LMU and TUM

That you might spread the word that I am available to work with volunteers here who wish to improve their teaching through the modified Flanders Interaction Analysis process

Review StepHow many of you speak English?

LMU Medical Curricula in state of dramatic LMU Medical Curricula in state of dramatic transformation!transformation!

Lectures reduced from 70% to 30% in past Lectures reduced from 70% to 30% in past decadedecade

Murrhardt KrisisMurrhardt Krisis

BolognaBologna

Cost containmentCost containment

StudentsStudents

My Flanders work in 1991-2007 at LMU and TUMMy Flanders work in 1991-2007 at LMU and TUM

OOverview Step of my verview Step of my Presentation Presentation If you master main points made

in this presentation, you could significantly improve the teaching effectiveness of teachers in Module 3, including your own

~It ain’t so much the things we don’t know that get us in trouble.

It’s the things we know that ain’t so~

Research Results on Research Results on Effective TeachingEffective Teaching

Based on 200,000 hours of classroom teaching at all

academic levels, over 25 years, in 42 states and 7 countries including Germany! (Aspy, Roebuck,

Rogers and Tausch)In the average classroom:In the average classroom:1. Teachers talk 80% of the time

2. Students talk 10% of the time

3. 10% is silence or confusion4. Virtually no responses to feelings

5. Only 1 minute of laughter out of every 12,000 hours of instruction!

More Research Results on More Research Results on Effective TeachingEffective Teaching

Based on 200,000 hours of classroom teaching at all

academic levels, over 25 years, in 42 states and 7 countries including Germany! (Aspy,

Roebuck and Rogers and Tausch)In the average classroom:In the average classroom:

6. 85% of students nonparticipating – just going along passing time

7. The average teacher used only 2 of the 15 steps found to be important for organizing effective teaching8. Teachers with certain personality traits and skills tended to be significantly more effective

Outcomes of students who Outcomes of students who had teachers with THE had teachers with THE

certain traits:certain traits:1. Increased standardized achievement scores

2. Less absenteeism

3. Fewer discipline problems

4. Increased IQ scores

5. Increased self-concept scores

6. Improved attitudes toward school

7. Increased levels of cognitive functioning -- more thinking

More results of students More results of students who had teachers with THE who had teachers with THE

certain traits:certain traits:8. Increased creative (divergent thinking) responses

9. Much greater percentage of "student talk" than in the average classroom10. Increases in teacher's energy and satisfaction levels and correlation with physical fitness and humor in the classroom

What were the personality What were the personality traits found in the most traits found in the most

effective teachers?effective teachers?- - Rogers, Aspy, Roebuck, Tausch Rogers, Aspy, Roebuck, Tausch -- EMPATHY- (Einfühlungsvermögen)

Can we train people to have Can we train people to have these traits?these traits?

PRIZING - caring about students - (Würdigung)

GENUINE or CONGRUENT - (Authentizität)(Not perfect, or God-like, but a person with

strengths and weaknesses)

And many used HUMOR in their classes… ~ shortest book in the world?~

THE 15 STEP R-O-P-E-S THE 15 STEP R-O-P-E-S MATRIX for indelible MATRIX for indelible

teachingteachingDrs. Carkhuff, Aspy and Roebuck tested Drs. Carkhuff, Aspy and Roebuck tested these principles and built the steps these principles and built the steps to incorporate the principles of to incorporate the principles of

effective teaching effective teaching

3. Present the instruction using multi sensory methods (tell-show-do) & have students Exercise the methods)

5. Generate thinking and respond to it (question asking and problem-solving)

2. Insure motivation of students by relating content to their real world (Overview)

1. Diagnose the learners’ entry level skills before teaching (Review)

6. Facilitate skill development, transfer, and application (Summary)

4. Respond to student’s ideas

Tell, Show, and Do – add Tell, Show, and Do – add these to ROPES making a these to ROPES making a

15 cell matrix15 cell matrix TELLTELL the learners (in words) what skills to do and how to do them.

SHOWSHOW the learners (in pictures, audiovisual aids, or modeling) how to do the skills DO DO provide the learners a hands-on (kinesethetic) opportunity to do the skill Tell one

Show one Do one = Teach one

Organizing Teaching with Organizing Teaching with the ROPES Matrixthe ROPES Matrix

ROPES TELL SHOW DO

Review

Overview

Present

Exercise

Summary

Comparison: Traditional Comparison: Traditional vrs Most Effective vrs Most Effective

TeachersTeachers(Using Flanders Interation (Using Flanders Interation

Analysis)Analysis) Traditional Traditional Best Best TeachersTeachers YouYou

Teacher talk: 80% 30% ? Student talk: 10% 50% ? Question Asking: 8% 38% ?

Thinking activities: 10% 50% ?

Stillness or confusion: 10% 20% Responses to feelings: 0 26% ? Indirect to Direct ratio: <.4 >.7 ?

(Indirect: accepts feelings, praises, accepts ideas, asks questions, Direct: lecturer, criticizes, directing) # of ROPES cells used: 2 or 3 8-15 ?

What does the research show What does the research show when you teach using the when you teach using the

“Effective Teacher” Traits “Effective Teacher” Traits and practices?and practices?

You actually transform a lecture into something quite different and far more effective. You increase student talking and thinking which makes it quite different from a lecture and significantly more indelible (dauerhaft) and transferable in terms of learning.

LMU-TU Flanders Study LMU-TU Flanders Study DesignDesign

Lecture 1Winter Semester

Lecture 2Summer Semester

FIA 1 FIA 2

FeedbackCritique

Experimental Group:

Lecture 1Winter Semester

Lecture 2Summer Semester

Control Group:

FIA 1 FIA 2

MethodsMethods 22 freiwillige Dozenten wurden nach Lehrerfahrung stratifiziert und in zwei Gruppen randomisiert, eine Ereignisgruppe und eine Kontrollgruppe.

Jeder Dozent hielt die gleiche Vorlesung im WS und im SS.

Es wurden jeweils beide Vorlesungen der Flanders Interaktions-Analyse unterzogen.

Die Dozenten der Ereignisgruppe erhielt nach der ersten Vorlesung ein Feedback über die Ergebnisse der Analyse, die Dozenten der Kontrollgruppe nicht.

Flanders Interaction Flanders Interaction AnalysisAnalysis1. Accept feelings

2. Praise3. Use student ideas4. Asks questions5. Lecture6. Giving directions7. Criticizing8. Student talk: responding9. Student talk: initiating10. Silence or confusionIndirect to Direct Ratio = 1+2+3+4/5+6+7

Flanders Interaction Flanders Interaction Analysis FormAnalysis Form

FindingsFindings

Significant improvment of  I/D Ratio - FIA 1: EG: Mean 0,60 (SD 0,49); CG: 0,61 (0,49) – FIA 2: EG: 1,68 (0,78); CG: 0,71 (0,60)

Significant improvment of  Questions asked - FIA 1: EG: 16,90 (10,44); CG: 13,90 (9,04) – FIA 2: EG: 28,50 (7,38); CG: 18,64 (11,07)

FindingsFindings

Significant improvment in Teacher Talk - FIA 1: EG: 80,90 (12,27); CG: 76,73 (9,86) – FIA 2: EG: 68,00 (5,60); CG: 79,09 (11,80)Significant improvment in Student Talk - FIA 1: EG: 18,10 (11,72); CG: 19,64 (9,16) – FIA 2: EG: 30,10 (6,08); CG: 19,45 (12,15)

FindingsFindings

Improvment of   ROPES - FIA 1: EG: 5,60 (2,12); CG: 5,00 (2,24) – FIA 2: EG: 7,90 (1,37); CG: 6,45 (2,91)

Significant improvment of  Empathy - FIA 1: EG: 2,76 (0,87); CG: 2,85 (1,05) – FIA 2: EG: 4,15 (0,43); CG: 2,78 (1,19)

Summary of the findingsSummary of the findings

• Mit Hilfe der Modfied Flanders Interaktions-Analyse konnten die Vorlesung der Experimentalgruppe hinsichtlich folgender Faktoren verbessert werden:

- Höherer Anteil an indirektem Unterricht

- Mehr studentische Beteiligung am Unterricht

- Bessere Organisation des Unterrichtsablaufes

- Höhere Zufriedenheit von Seiten der Studenten und

der Dozenten

» Die Flanders Interaktions-Analyse ist eine unaufwendige, kostengünstige und damit sehr ökonomische Möglichkeit die Vorlesungs-Qualität zu verbessern.

Teachers‘ Post-Teachers‘ Post-Questionnaire Sample Questionnaire Sample

CommentsComments „Selbst wenn man denkt, man hält einen interaktiven Unterricht, wird durch die minuziöse Beobachtung klar, dass man noch viel interaktiver werden kann.“

„ Die freundschaftlichen und kollegialen Gespräche nach der Analyse der 1. Vorlesung haben weiter geholfen.

Motiviert durch die Analyse der 2. Vorlesung wird man versuchen müssen, die Vorlesung noch mehr in der

beschriebenen Richtung zu gestalten.“

„ Die konkrete Analyse und das persönliche Gespräch vor dem Hintergrund des medizindidaktischen Grundkonzepts hat mir eigentlich zum ersten Mal klar gemacht, was ich bisher falsch oder richtig gemacht habe.“„Die Beteiligung an dem Projekt hat mir auch weit

darüber hinaus genützt- bei wissenschaftlichen Vorträgen und auch beim Umgang mit meinen Kollegen

und in verschiedenen Gremien.“

SummarySummary•LMU has undergone significant curriculum reform•There is a big body of research on effective teaching using the FIA

•We did a study which shows significant gains from an intervention which is based on the results of that big study and which resulted in significant improvement in volunteer teachers who had our FIA intervention

•I am available to work with volunteer teachers to diagnose (not to evaluate) their teaching and give them the same intervention which resulted in significant improvements in our study

•Please use me, my experience, and energy

Danke für Ihre Danke für Ihre Aufmerksamkeit!Aufmerksamkeit!

Email: halclyon@yahoo.com

The LectureThe Lecture

15 years ago, 67% of the first 2 years of Dartmouth Medical School was passive lecture.

(Prof. Reincke: LMU reduced lectures in past 5 years from 70% to 30%)

But good question asking in a lecture can stimulate thinking

And good interactive case-based or E-Learning like CASUS can transform lectures

Lecture teaches mostly to memory instead of thinking

More About the LectureMore About the LectureB.F. Skinner in Walden Two (1948)B.F. Skinner in Walden Two (1948)

"The lecture is the most inefficient method of diffusing culture. It became obsolete with the invention of printing. It survives only in our universities and their lay imitators, and a few other backward institutions....Why don't you just hand printed lectures to your students?

Yes, I know. Because they won't read them. A fine institution it is that must solve that problem with platform chicanery."

Lectures Lectures areare effective effective for:for:

Transmitting new material which does not appear in print

Synthesizing knowledge from many sources

Forums for introducing patient diagnostic problem-solving and E-Learning cases

Research Evidence on the Research Evidence on the Value of MentoringValue of Mentoring

White House Task Force on Gifted & Talented:

most effective intervention for education of gifted person =

mentorship -- a one to one human relationship with a person who possessed nurturing traits: empathy, prizing, genuiness.

The Value of MentorsThe Value of Mentors

There appears to be an interesting multiplier effect in mentorship. Those who have them tend to perpetuate the concept by becoming mentors themselves. Certainly, this has important implications for mentorships in all professional fields.

Women entering professional career fields need mentors even more. Studies of successful women (J. Walters, 1981) reveal that they often had several mentors (usually men) and that they, in turn, became mentors for several proteges (usually women).

The Functions of the The Functions of the MentorMentor

These traits of the successful mentor are an ideal model. In reality no one mentor practices or has them available all the time. We do the best in our unique manner with the gifts we have. Our genuineness is expressed in our human imperfection.

Teacher: to enhance the student's skills and professional development Sponsor: to facilitate the student's entry and advancement in the profession by opening doors through influence and by providing opportunities for exceptional experiences. Host and guide: to welcome the initiate into a new professional and social world and acquaint her with the values, customs, resources and cast of characters. Exemplar/role model: to model through your own virtues, achievements and way of living. Counselor: to provide moral & counseling support in times of stress & crisis. Parent analogue: to support and facilitate the realization of the "dream."

Studies of highly successful Studies of highly successful people show that those who people show that those who had mentors gained more had mentors gained more “success” than those without “success” than those without mentors including the mentors including the following:following:

• Achieved a higher education at a younger age

• Were more likely to follow a career plan and, in turn sponsor more proteges than those who did not have mentors

• Published more works

• Made greater contributions to their career fields

• Earned more money

• Had greater career satisfaction

Dvorak Keyboard – much Dvorak Keyboard – much faster and more faster and more efficient…but …efficient…but …

Dvorak vrs Standard KeyboardDvorak vrs Standard KeyboardAdvantageous Innovations not Always Advantageous Innovations not Always

AdoptedAdoptedStandard keyboard (inefficient):

Designed in 1873 by Prof. Christopher Sholes and to slow down typists to prevent jamming of keys on early typewriters

32% of typing on home row

Unnecessary movements cause tension, carpel tunnel syndrome, frequent typo errors

Still used

Dvorak keyboard (efficient):

Designed by Prof. August Dvorak in 1932 using time and motion studies to create most efficient keyboard arrangement

70% of typing on main row and successive keystrokes fall on alternative hands. Valves (40% of all letters typed) on left, consonants on right

Approved by Amer. Standards Institute but not used!

Diffusion of Innovations Diffusion of Innovations ResearchResearch

New idea New idea >Diffused > Adopted/rejected >Diffused > Adopted/rejected > Consequences = Social Change> Consequences = Social Change

Stages in Diffusion:*

1. Knowledge (exposure and understanding of innovation)

2. Persuasion (attitude development: favorable or unfavorable)

3. Decision (thinking and deciding > choice to adopt or reject)

4. Implementation (puts idea to use and can re-invent)

5. Confirmation (reinforcement for innovation decision)

LUM: from 70% Lecture to 30% in 5 years – efficient diffusion

Dvorak Keyboard and High Empathy Teaching Research: died at Implementation stage – not adapted WHY?

*Rogers, EV: Diffusion of Innovations, NY Free Press 2003 pp 168-201

SSummary Stepummary Step You do lots of teaching – vital part of your profession

You can learn how to teach better. Good teachers are not born that way

You are not well trained for teaching

Most teaching (80%) is teacher-talk (lecture) with lots of memory and little thinking on the part of students

Transform lectures into thought provoking, effective teaching using the ROPES matrix. It will become almost automatic as you practice it a few times

3 traits found in most effective teachers:

What are they? Empathy (Einfühlungsmögen), Prizing (Würdigung), Genuiness (Authentizität)

How far have you How far have you progressed today?progressed today?Hopefully from ”unconsciously incompetent" to a

higher level such as “consciously incompetent”.

If you apply what I have covered today, you can become “consciously competent” soon, with some practice.

Some of you are already there !

Hal’s Life LessonsHal’s Life Lessonswith thanks to Steven Wrightwith thanks to Steven Wright

They told me I was gullible. And I believed them

I used to be indecisive. Now I'm not sure…

One nice thing about egotists: they don't talk

about other peopleDon’t just do something, stand there!Indecision is the key to flexibilityAs I said before, I never repeat myself.Each talk I give is better than the next.

More of Hal’s Life More of Hal’s Life LessonsLessons

Half the people you know are below average.

Ninety-nine percent of lawyers give the rest a bad name.

The early bird gets the worm, but the second mouse gets the cheese.

Support bacteria - they’re the only culture some people have.

Still More of Hal’s Life Still More of Hal’s Life LessonsLessons

Ambition is a poor excuse for not having enough sense to be lazy.

Only two things are infinite: the universe and human stupidity, and I’m not sure about the former. (Albert Einstein)

It’s better to be a good winner than a poor loser.

Times flies like an arrow. Fruit flies like a banana.

Tips from the Redneck Book Tips from the Redneck Book of Mannersof Manners Always identify people in your yard

before shooting at them. If you have to vacuum the bed, it is time to change the sheets.

DINING OUT Avoid throwing bones and food scraps on the floor as the restaurant may not have dogs.

ENTERTAINING IN YOUR HOME A centerpiece for the table should never be anything prepared by a taxidermist.

Do not allow the dog to eat at the table no matter how good his manners are.

PERSONAL HYGIENE

While ears need to be cleaned regularly, this is a job that should be done in private using one's OWN truck keys.

Proper use of toiletries can forestall bathing for several days. However, if you live alone..... deodorant is a waste of good money.DATING

Always offer to bait your date's hook, especially on the first date.

DRIVING ETIQUETTE

Dim your headlights for approaching vehicles; even if the gun is loaded, and the deer is in sight.

When sending your wife down the road with a gas can, it is impolite to ask her to bring back beer.

Never relieve yourself from a moving vehicle, especially when driving.

Viewpoints on learning Viewpoints on learning vrs. Teachingvrs. Teaching

Some believe if there was no learning, there was no teaching. Do you believe this?

Significance of this viewpoint is that we cannot say someone is a good teacher just because they seem to teach well.

What counts is whether learners learned.

Viewpoints on Learning Viewpoints on Learning vrs. Teachingvrs. Teaching

Another viewpoint: "Anything done by a teacher that intentionally promotes learning is teaching."

Value of this viewpoint is that it recognizes the reality that good teaching may occur under circumstances so adverse, ( like with the student asleep), that little learning takes place. When something is given, it may not be received. (And when received, it may not be used.) But the effort deserves to be acknowledged as teaching.

PPresentationresentation

• Physician training can contribute to cynicism in students.

Warning: Physician training Warning: Physician training may be hazardous to your may be hazardous to your interpersonal skills!interpersonal skills!

Findings about physician training and Findings about physician training and teaching:teaching: • As students become increasingly proficient in analysis of pathophysiology, without formal training in interpersonal skills, their ability to relate to patients interpersonally declined.

An Effective An Effective Teacher --Teacher --

Both Useful & NovelBoth Useful & NovelA teacher who is novel but not useful is a charlatan.

A teacher who is useful but not novel is a pedantic bore.

A teacher who is both useful and novel is an inspirational teacher… and they are rare.

Teaching vrs. LearningTeaching vrs. LearningBalance of both views: Bottom line is whether, as a result of your teaching, there IS learning. So teaching and learning is a two way process, and students and teachers share the responsibility for it.

The “Dr. Fox Effect”The “Dr. Fox Effect”

Student ratings of instructor are affected by the personal style of the teacher rather than by the teacher's knowledge of instructional material

PresentationPresentation

Is this a true statement: "If the learner didn't learn then the teacher didn't teach.”

I tell you: “I taught my dog how to whistle.”You say,"I don't hear him whistling." I reply, "I said I taught him to

whistle. I didn't say he learned it."

What is the difference between teaching and learning?

An example:

OOverview Step of my verview Step of my Presentation Presentation

Why is it important for you to Why is it important for you to be an effective teacher?be an effective teacher?

Doctors spend 80% of their time teaching:

Teaching students (60-70% of teaching done by residents -- informal "modeling" in clinic)

Teaching other healthcare providers Teaching patients -- a very difficult challenge to teach someone to change her lifestyle!