Delivery of Instructional Content

Here are some general guidelines on standardizing facilitation of an activity.

Plan

Make sure you plan your content and you do research if needed, so you can speak confidently about the topic. If you are developing a facilitation guide, consider what information a substitute speaker might need to know, to present the content.

Practice

Practice your presentation. It is crucial that you keep your delivery within the time that is allocated for the activity. Check the spelling and grammar of your content.

Public speaking

Do not read your slides! Practice the presentation so you can speak from bullet points or an image on a slide. The text on your slides should be a cue for the presenter rather than a message for the student. Do not turn your back on the audience if possible. Speak comfortably and clearly. Know your audience.

Use of Poll Everywhere

Poll Everywhere (PE) is an audience response tool that is used by many faculty facilitators to do a quick knowledge check of students or to encourage more in-depth discussion. While it is a great tool, it can easily be over-utilized. There are many different types of polls you can ask, other than the ubiquitous multiple choice. It includes open-ended response with four different output viewer options, rank order, clickable image, and more. It is possible to seamlessly integrate it into your presentation software slide deck. Tip: If you are embedding PE polls into your presentation slide deck, first include a slide with the questions and answer choices and after it include the PE slide. This is primarily useful for later – if there is a need to review the slides, or if you want to make the slide deck available to students with the questions. The embedded slide is not going to be useful to be able to see the question and answers when PE is actually not in use. Note that you can also use polling in Zoom though it is not as robust.

This could go under design as well as delivery as it truly entails both concepts. Digital storytelling is powerful. It is a dynamic way to connect with your learners by creating and sharing information via video. Rather than just recording a lecture or narrating a PowerPoint slide deck, you can include video inside your video (e.g. show a snippet of a YouTube video), images, and do something really innovative like interview someone in the field. There are resources available to you! You do not have to learn how to do this in isolation. Use the resources (people, spaces, equipment) available to you at your campus. Ask your coordinators, block leaders, or instructional designers for more information.

Below are some general guidelines for recording a micro-lecture or tutorial.

Lecturing

Recording micro-lectures does not translate to recording a standard hour-long lecture you would normally give in person. There have been numerous studies that show that attention begins to fade after about 9 minutes. This corroborates previous studies of student focus during in-class lectures, where attention wanes within about 20 minutes. Note: this does not mean breaking up a 50-minute lecture into 5 10-minute videos.

A better approach? Look through your material, identify key points or ideas that work together, and have those be the focus of a short video segment.

Scripting / Storyboarding

When making a recording, start out by creating a script and/or a storyboard. It helps you to balance two main factors: engagement and understanding. Creating a script will also help you organize your thoughts and create a smoother recording. Work with an instructional designer and/or multimedia specialist at your campus to make sure there is a natural flow to your script and storyboard.

To write scripts that are easy to understand, aim to write how you speak. Avoid using overly complicated language or long sentences. Read your content back to yourself prior to recording to ensure there aren’t any words that trip you up for when you actually record. Sometimes, sentences sound better in your head than they do when spoken aloud. If you discover sentences like these, reword them.

Try to stay away from creating recordings that are lengthy. Attention spans for adults these days is shorter and shorter. So, in order to increase retention, break your content into smaller pieces. Studies show that micro-learning, where you break complex topics into much smaller videos, lessons, or modules, is more effective for retention and understanding.

If you are planning on recording a short series of videos, make sure you have set your learning objectives and content that will be delivered for each video. Highlight the LO’s at the beginning of the video and then again at the end, to summarize what was covered. You do not have to read the learning objectives out loud. Place written pauses in your script so you know when to pause to allow students to stop the recording when necessary such as contemplate a case study and associated questions.

Recording

Try to not refer to specific dates, times, names of people, courses, or what they covered in a previous course or will cover in a future course. The biggest compliment to a micro-lecture is when it can be used again in the curriculum to remind students what they already learned.

• Practice! Even before recording, practice your presentation. Does your content flow well? Does your script line up with your slides or other content? Are there sections where you get tongue-tied that could be rewritten?
• Try recording in chunks. Record a big, stop and prepare. Record a little more, stop and prepare. Mistakes can be avoided much easier by recording in small bits!
• Rewind and watch your recording to determine if you need to re-record due to audio mishaps, etc.

Length

Researchers suggest keeping micro-lectures short and to the point. A rule-of-thumb is to keep them under 10 minutes of video / audio recorded content; 5-7 minutes is even better.

Peer review process

Any videos you create must go through a peer review process. Contact the key people at your campus for more information.

Some examples of software programs we can use to create videos:

• Articulate (small number of licenses – check with your campus coordinators for more information)
• Camtasia
• Captivate
• Echo360 Universal Capture
  • Log in to Echo360 with your UIC credentials and download from the settings wheel in the upper right corner)
• Explain Everything (tablet app) (not officially supported by ACCC)
• Panopto (from within Blackboard)
• Zoom

SCORM

“SCORM, which stands for Shareable Content Object Reference Model,  is a set of technical standards for eLearning software products. SCORM tells programmers how to write their code so that it can “play well” with other eLearning software. It is the de facto industry standard for eLearning interoperability. Specifically, SCORM governs how online learning content and Learning Management Systems (LMSs) communicate with each other. SCORM does not speak to instructional design or any other pedagogical concern — it is purely a technical standard.”

SCORM. (2020). SCORM explained 101: An introduction to SCORM. Retrieved from https://scorm.com/scorm-explained/one-minute-scorm-overview/

Articulate users should export their modules for LMS  SCORM 2004, 4th ed. to create a .zip file. This .zip file should be uploaded to the correct place in Box so a coordinator can retrieve it and place into Blackboard.

Articulate

Articulate has two key products that we use, Storyline360 and Rise360, which help us to create well-received interactive lessons. We have a team license with ~10 people who currently have access to these programs. As of April 2022, our team license was merged with Learning Technology Support at the university level.

The lesson can be added to Blackboard with a simple link for students to follow from the modules website (requires authentication with NETID/password: http://modules.medicine.uic.edu), or it can be embedded in Blackboard using SCORM 2004, 4th ed. Embedding this content in Blackboard creates a grade center column and faculty can see who has completed the module and who has not. Typically, a coordinator will place these packages in Blackboard.

Active learning is any approach to instruction in which all students are asked to engage more fully in the learning process. Active learning stands in contrast to “traditional” modes of instruction such as didactics in which students are passive recipients of knowledge from an expert.

Active learning can take many forms and be executed in any discipline. Commonly, students will engage in small or large activities centered around writing, talking/discussion, problem solving, or reflecting on problems and/or situations.

Here is an article on students and their perceptions of active learning in medical education. White, C., Bradley, E., Martindale, J., Roy, P., Patel, K., Yoon, M., & Worden, M-K. (2014). Why are medical students ‘checking out’ of active learning in a new curriculum? Medical Education, 48, 315-324.

The conclusions by the authors suggested that if classroom practices are passive and not consistently well-designed or executed as active learning, students do not perceive them as enhancing their learning. It’s also possible that students have not achieved the developmental level compatible with adult and active learning. In essence, it’s important to also teach students how to better understand and practice deep learning techniques.

• It is important to start using active learning strategies early in the curriculum. Introduce the concept (what is active learning, why is it important) during the first week of a Block or clerkship, and let students know that they will be expected to participate in various activities throughout the block course or clerkship.
• Active learning activities should be incorporated somewhat frequently – for non-lecture, incorporate active learning at least once in a given class if possible. It’s also important to vary the active learning strategies you use. After the first several sessions, students will understand that you’re serious about active learning and will accept their role as participants more readily.
• Give students clear instructions as to your expectations. State the goal students should meet, how much time they have for the activity, what procedures they should follow, and with whom they should partner (i.e., “turn to the person next to you” if in person or “form groups of four with the people nearest you” – this is possible in Zoom).  Be explicit with directions perhaps on a PowerPoint slide so that students have something to refer to as they begin the activity.
• Explain to students why you’re using active learning and the benefits they can expect from it.
• Be committed to your choice to use active learning and communicate that confidently to students. Students will be put at ease if they understand that you’re in charge and have good reasons for what you’re doing.
• Start small and simple; you’ll get more buy-in from students if you approach active learning this way. Use low-impact strategies such as think-pair-share exercises. These strategies take only a moment or two, and are “low stakes” for students who may be unsure or uncomfortable with participating in active learning either in-person or online. Graduate your activities to more complex as you and the students become more comfortable.

Some additional thoughts:

• Use strategies to efficiently reconvene the large group at the end of active learning activities. For example, you might use your microphone or use some other way to gain students’ attention.
• Consider the learning objectives (LO) for the session carefully. Based on these LOs, what content is most important for students to master? Consider removing non-essential content so you can spend more time on activities that lead to better student learning.
• Consider what content you must cover in class (in person or online) and what content students can / should cover outside of class by themselves. It may be necessary to create assignments, activities, or other support to help students master material on their own.
• Adjust your active learning strategies to start out slowly yet quickly. Space the activities throughout the session to break it up and keep students engaged.
• Use the Google Doc for each Block course in Phase 1 to determine what students are learning and what is confusing them. These can help you decide when (and whether) you need to spend more time working with particular material either in a subsequent session or during office hours.
• Avoid the trap of rushing to ensure you get through all material by the end of the session. Examples include flipping through PowerPoint slides as you run out of time. This is almost always counterproductive and students tend to become overwhelmed and discouraged.
• As part of your activity instructions, tell students to get into groups (either in-person or online). If the activity instructions are explicitly laid out, it sets the expectation that they may be working with others whom they do not know very well during random assignment group work and allows them space to build rapport.
• Does your activity require two more people to work on it? Is it sufficiently challenging?  Design activities where there is genuine value in working together.
• In Phase 1, use TBL groups so students know who they are accountable to all semester.

Modified from https://cei.umn.edu/active-learning#anchor-challenge1.

Clinical learning experiences promote learner motivation and responsibility as well as higher level cognitive, attitudinal, skill, and performance skills. Reflection is a method that goes quite well with these types of experiences.

Here are some helpful tips for clinical teaching: https://libguides.hofstra.edu/mededresources/teachingresources

In addition, this crowd-sourced document gives some useful ideas and tips for clinical teaching.

Additional Resources for Clinical Cases

• Aquifer – https://aquifer.org/
• BMJ Case Reports – https://casereports.bmj.com/pages/
• Clinical Case of the Month from LSU School of Medicine – https://www.medschool.lsuhsc.edu/internal_medicine/case_of_month.aspx
  • The Clinical Case of the Month is a regular educational feature coordinated by the Louisiana State University Department of Medicine in New Orleans. Medical students, residents, postdoctoral fellows, and faculty collaborate in the preparation of these discussions. These articles are published regularly in the Journal of the Louisiana State Medical Society, and are made available here in PDF form by permission from the Society.
• Clinical Cases from NEOMED – https://libraryguides.neomed.edu/c.php?g=324101&p=2171653
• New England Journal of Medicine – https://www.nejm.org/medical-articles/clinical-cases?date=5years
  • Browse clinical cases by specialty or article type.
• AccessMedicine (Clinical Rotation Cases – Case Files (AccessMedicine)
  • Anesthesiology, Cardiology, Critical Care, Emergency Medicine, Family Medicine, Geriatrics, Internal Medicine, Medical Ethics & Professionalism, Neurology, Obstetrics & Gynecology, Pediatrics, Psychiatry, Surgery
• CT Case Studies – https://www.ctisus.com/responsive/teachingfiles
  • By Anatomical Region – Explore the numerous CT Scans, MRI, and X-Rays with the diagnosis in different anatomical regions and other Body CT topics. These case studies are designed for the education of medical professionals and radiologist.
• BMC Journal of Medical Case Reports – https://jmedicalcasereports.biomedcentral.com/
  • Journal of Medical Case Reports will consider any original case report that expands the field of general medical knowledge, and original research relating to case reports.
• Case Studies in Environmental Medicine – https://www.atsdr.cdc.gov/csem/csem.html
  • From the Agency for Toxic Substances and Disease Registry
• CDC Case Studies – https://www.cdc.gov/dpdx/monthlycasestudies/2019/index.html
  • Laboratory Identification of Parasites of Public Health Concern
• American Thoracic S0ciety Clinical Cases – https://www.thoracic.org/professionals/clinical-resources/environmental-and-occupational/clinical-cases/index.php
  • Environmental, Occupational and Population Health Clinical Cases
• American College of Physicians Cases in Ethics – https://www.acponline.org/clinical-information/ethics-and-professionalism/ethics-case-studies-education

The flipped classroom approach to instruction sometimes relies on technology to shift some instructional practices that are typically done in the classroom, to out of regular classroom time. The goal is generally to provide in-class time for students to make sense of course content and engage in meaningful tasks to cement knowledge. As educators, we try to help students learn to think about what they are learning, and apply it within context in a face-to-face or online environment. Instructors need to consider how they can enable students to communicate their thinking and critique the reasoning of their classmates and instructors.

What it is not: sometimes instructors use a service like Poll Everywhere to add some interactivity to a face-to-face or online session. This is not really a flipped classroom. It is essentially a lecture with some questions thrown in.

Some thoughts to consider:

Why do you want to flip? What does ‘flip’ mean to you? How do you interpret it? Will flipping your content offer some benefit to student learning that other modalities can not achieve?

Here are some universal principles of the Flipped Classroom method of instruction.

1. Use out-of-class tasks to encourage student reflection and elicit a response from students.
   What is important for students to do as preparation to make in-class tasks as practical as possible? How can you assess their knowledge based on their preparatory work or previous learning experiences?
2. Use in-class tasks to build new knowledge as part of a learning community.
   Employ tasks that encourage students to draw on their past experiences and / or initiate new ones.
3. Connect out-of-class tasks and in-class tasks using the same instructional approach.
   Use real-life examples to ‘connect the dots’ between prep work at how it is being applied during in-class sessions. Have students interact with each other to further their knowledge. A flipped classroom does not mean the instructor has to be ‘in charge’ of instruction the entire time. 
4. When providing preparatory work to students, it helps to annotate each required or supplemental resource that you want them to review. For example, let’s say you want them to read a 30-page chapter on hematoma and you also suggest they watch an Osmosis video on the same topic. Why do you want them to review both? Even if one is supplementary and another is required, students often feel they must review everything. Give a brief disclaimer (annotation) that can be posted to our learning management system. Something like: ‘these specific sections in the required reading are really crucial for understanding’ and ‘the video is helpful for more visual learners to understand the topic.’ This way, students are informed as to why you want them to review certain material.
5. Do not lecture twice. They’ve perhaps watched videos outside of class that explains content, so when they come to class, don’t lecture again on the same material.

Here is an interesting mnemonic:

Target instruction to address the source of their errors or confusion.
Engage learners in higher-level thinking (discussions of what-if scenarios, problem solving, analyzing a topic, summarizing key ideas.)
Assess student understanding of the most essential points of the topic.
Challenge students with more rigorous examples, problems or tasks.
Help students who need it with assistance and more practice.

This is an excerpt of Wenger’s Descriptive Principles for Instructional Design

1. Design for practice is always distributed between participation and reification – and its realization depends on how these two sides fit together.
2. There is an inherent uncertainty between design and its realization in practice, since practice is not a result of design, but rather a response to it.
3. No community can fully design the learning of another; no community can fully design its own learning.
4. Design creates fields of identification and negotiability that orient the practices of those involved to various forms of participation and non-participation (Strayer, 2017, p. 329).

Reference

Strayer, J. F. (2017). Designing instruction for flipped classrooms. In C. M. Reigeluth, B. J. Beatty, & R. M. Meyers (eds)., Instructional-design theories and models: The learner-centered paradigm of education. New York: Routledge.

Lectures are didactic sessions that typically have no required preparatory work for students to complete. Supplementary preparatory work can be assigned to support the content of the session, but students are not required to complete it prior to the session.

This method can accommodate a large number of learners though it is much more teacher-centered (such as ‘sage on the stage’) and the learning is more or less passive in nature. The quality of a lecture depends on the multimedia and audiovisual materials shared as well as the skill of the instructor to keep the content interesting and students paying attention.

Unlike active learning sessions, lectures have limited discussion (occasional question and answer periods or polls). At UICOM, student attendance to these sessions is typically not mandatory and content is typically recorded for students to view later.

Reflection is a methodology that promotes learning from experience, self-awareness, purposefulness, and mindfulness. It can be built into an activity such as giving students a specific amount of time during an activity to reflect on what they have just learned. This activity can be done by individual students or in teams and can be achieved in multiple ways such as verbal discussion, writings, & portfolios.

The researcher Donald Schön developed a model of ‘reflection-in-action.’ If you can find a copy of his book The Reflective Practitioner somewhere, it’s worth a read.

This method offers students an approximate experience to ‘real life’ and provides a safe environment for skills practice. Learners can receive valuable feedback on their performance. This method does require substantial expertise in developing and training standardized patients.

At the Chicago campus, there is the Simulation and Integrative Learning Institute (SAIL), in Peoria, there is Jump Simulation, and in Rockford, there is also a simulation learning presence.

Small group learning is an educational approach that focuses on individuals learning in small groups and is distinguished from learning climate and organizational learning. It can take the form of a classroom-based training through experiential learning activities such as case study analysis, role plays, games, simulations, and brainstorming, among others. These activities require the learners to work together to achieve a learning goal.

This is seen as a powerful learning method for students of all ages and linked to the active learning research showing increased student motivation and attainment. In a recent meta analysis of group learning studies based on 49 independent samples, from 37 studies encompassing 116 separate findings, students who learned in small groups demonstrated greater achievement.

Springer, Leonard; Stanne, Mary Elizabeth; Donovan, Samuel S. (1999-03-01). “Effects of Small-Group Learning on Undergraduates in Science, Mathematics, Engineering, and Technology: A Meta-Analysis”. Review of Educational Research. 69 (1): 21–51. doi:10.3102/00346543069001021. ISSN 0034-6543.

However, studies that do produce positive outcomes are not always received with so positively by those in the teaching profession because of classroom management issues.

Smith, Alexandra (2006-03-31). “Group work benefits pupils, study finds”. The Guardian. ISSN 0261-3077. Retrieved 2019-11-14.

The group work has to be carefully planned and frequently requires a facilitator to ensure group progress. In addition, the group function and the learning that takes place needs to be assessed and evaluated. In important part of this process is planning purposeful questions and getting students to talk to each other and within the class.

The material learned is just as important as the group’s ability to achieve a common goal. Facilitatory skills are important and require the teacher to ensure that both the task is achieved and the group functioning is maintained. One of the key issues is the way one or two people can begin to dominate the possible ‘airtime’ by doing 50-70% of the talking.

Group size can also effect the way small group share and learning together, for instance a size of group over 7 tends to split into smaller groups, and may need a student to act as a chairperson to help facilitate the learning.

Practical techniques or technologies that the group can used to share their understand with each other and their teacher include, mindmapping, Delphi technique or using specific software solutions.

Team-based Learning (TBL) is a very structured delivery method. In TBL, students take more responsibility for their own learning and it helps them to co-construct knowledge.

There are multiple phases involved in a TBL and include:

• the prep work for students to complete so they can actively participate,
• the individual readiness assurance test (IRAT) which is typically a timed and graded 10 question multiple choice test on the content.
• the team readiness assurance test (TRAT) which is also timed and graded. Students in their established teams work on the same 10 questions. Research has shown that the teams typically perform better on these tests than the individuals alone.
• application cases and questions which are typically not graded.

The IRAT and TRAT (key words ‘readiness assurance’) confirm if the students have prepared well-enough to participate in more detailed case-based questions in the application phase.

There is more to it, but this should give you the basics. The Team-Based Learning Collaborative can give you more insight into this teaching method.