TEACHING METHODOLOGY

Main Objective
• By the end of the unit, the learner should be able to apply the
concepts and principles of teaching and learning
Sub objectives
• By the end of the unit the learner should be able to
• Explain the basic concepts and theories of learning
• Participate in curriculum development
• Develop instructional materials for teaching and learning
• Plan, implement and evaluate teaching/learning situation
Concepts and Theories of learning
• Definition of terms
• Learning domains/ stages of learning
• Factors that influence teaching and learning
• Trends in nursing education
• Characteristics of a good teacher
• Principles and skills used in teaching and learning
• Theories of learning
A. Definition of terms
• Learning
• A continuous process that results in the acquisition of new
behavior pattern through experience or practice
• Teaching
• The act of assisting the learner to modify his behavior through
experience, study or intuition. Imparting knowledge
• Learner
• Person acquiring knowledge or skills
• Teacher
• The person who transmits knowledge through personal contact
• Teaching methodology
• Technique used by the teacher to promote learning
• Climate setting
• The process of creating an atmosphere of free interaction
between the participants themselves and their facilitators
Learning
• A continuous process that alters behavior through training
• A learning situation is potentiated through four ingredients
a)Motivation
b) Information
c) Practice
d) Feedback
The change in behavior addresses a felt need, which occurs
through experience
Principles of learning
• What is a principle?
• A fact, rule, law about something that occur as a result of
repeated experience leading to the deeper understanding of
ideas on the processes of teaching and learning
Principles of learning
• Students learn what is relevant and useful
• When the material is presented in a sequential and logical
manner
• Learn when actively involved
• When they receive feedback on their performance
• Conducive environment
• Recognizes peoples right to make mistakes
• Encourages openness of mind and trust in self
• Involves practice and repetition
• Speed of presenting and speed at which learners learn match
• Message is clear
• Learners are motivated
• People learn and remember things that are exciting, dramatic
or pleasant more easily than those boring unpleasant things
Principles of adult learning (Andragogy)
• Andragogy is the art of helping adults learn while pedagogy is
the art of helping children learn.
• The principles of adult learning include
It is self directed
The teacher facilitates learning rather than directing it
Adult learners learn best by being active rather than passive
Learning is optimum when the content are applicable
immediately to existing problems or their own situations
Principles of andragogy
Adult learners bring with them a wealth of experience
Adult learners can help each other because of their experience,
encourage them to do so
The learners should be encouraged to continuously evaluate
their learning
ASSIGNMENT
• Outline the principles of pedagogy

• Review the trends in nursing education: history of nursing

education, influencing factors, challenges and emerging issues
What makes one a better learner?
Small tutorial groups
Working at own pace
When you know the goals
When motivated by the relevance of the goals
Lively atmosphere
Practicing what has been learnt
When learning will help solve a problem
When exposed to different kinds of stimuli
 Characteristics of learning
• It produces a behavior change in the learner
• It leads to a relatively permanent change
• It results from practice and repetition of experience
• It is directly observant ie, abstract
Factors influencing learning (conditions)
1. Maturation/ age
Mature enough to adapt to the expected behavior
2. Ability potential (intelligence)
One's ability to acquire knowledge and carry out a particular
responsibility
3. Previous learning experience
Extra couching needed where there is no previous experience
• 4. Motivation
• Internal and external conditions of learning
• 5. Level of aspiration
• 6. Physical & emotional state: sickness, fatigue, physical
disability
• 7. Psychological state: fear, anxiety, excitement
• 8. Importance of material to the learner
• 9. Participation of the learner: should be actively involved eg
asking and answering questions
• 10. Socio economic factors
• 11. Feedback
• Should be given in time to ensure learning takes place
• 12. Learners environment: conducive
• 13. Practice and guidance: more improves performance &
learning
• 14. Methods of teaching
• 15. Re enforcement
• A re enforcer is anything that strengthens behavior and
increases the probability of its reoccurrence
• Eg attention, recognition, praise, awards, confirmation of the
right answer
• 2 types positive and negative re enforcement
Positive encourage positive behavior
Negative discourage unacceptable behavior
• Components of re enforcement
Verbal : praise, encouragement, feedback
Gestures: nodding, clapping, thumbing
Activity: related to the lesson
Proximity: closeness to the student, physical content,
handshake
Token/ rewards
NB: Effective re enforcement should be immediate,
understandable and meaningful to the student
Learning Domains (Stages of learning)
1) Cognitive learning
2) Psychomotor learning
3) Affective learning
a) Cognitive Learning
• Relates to recall of knowledge & development of intellectual
abilities and skills
• Concerned with knowledge of facts, concepts of information,
thinking and reasoning
• Used in academic studies
• Involves 6 levels of knowledge acquisition
Levels of knowledge acquisition
1. Simple knowledge
2. Identification
3. Application
4. Analysis
5. Synthesis
6. Evaluation
• Simple knowledge: recall and memorization of facts. A.k.a
discrimination . It is the lowest level of learning.
• Verbs used include name, list

• Identification: learner needs to learn more. A.k.a

comprehensive level. The learner should be able to recognize,
interpret and state different things .
• Verbs: describe, classify, identify, indicate
• Application: the ability to use theories or principles in new
situations.
• Verbs: apply, discuss, determine, illustrate

• Analysis: the ability to divide the complex knowledge into

separate parts.
• Verbs: analyze, categorize, calculate, differentiate, compare
• Synthesis: the ability to put together separate elements of
knowledge and generate principles to form new patterns or a
whole component.
• Verbs: create, manage, plan, formulate, construct, write a
proposal

• Evaluate: the ability to make judgment & make decisions using

the acquired knowledge or inform action
• Verbs: evaluate, argue, select
b) Psychomotor Learning
• It involves learning of skills or practical ability.
• The skills involve movement thus motor/ psychomotor
• Levels in this domain include:
Imitation
Manipulation
Precision
Articulation
Naturalization
Levels of psychomotor learning
• Imitation: the learner is exposed to an observable action at
the level of his/her muscular system guided by an impulse to
imitate it.
• Involves gross body movements
• Manipulation: learner is prepared for adjustment to a
particular action followed by finely coordinated movement
• The learner performs and acts according to instruction
• Precision: a high level performance. There is proficiency in
performance to reproduce a given act under instruction and
guidance

• Articulation: involves the coordination of a series of acts by

establishing an appropriate sequence among different acts,
ability to communicate, verbal & non verbal
• Naturalization: skills of performance attains its highest level
of proficiency in a single act or a series of articulated acts.
• The act is performed with minimal expenditure of energy
c) Affective learning
• Concerned with interest, attitudes & values of people &
development of appreciation &adequate adjustment.
• In this domain, learners learn to share, argue & cooperate with
one another
• Certain attitudes are formed or changed through training
Levels in affective domain
• Receiving: willingness to pay attention to the information
• Responding: willingness to accept an event through some form
of participation. Learner shows interest to what is happening
• Valuing: willingness to accept an event through expression of
positive attitude
• Organization: the learner meets the situation of which more
than one value is relevant.
• Characterization: the learner consistently acts in accordance
with the value s/he accepts & incorporates this behavior as part
of their personality
How learning takes place
• Through reasoning, getting facts, organizing & choosing the
best alternative
• Can take place in the absence of the teacher
• In a learning situation the teacher is the facilitator
• Learning can be formal or informal
• Learning takes time
• Attitudes and values are developed through observation
THEORIES OF LEARNING
• What is a theory?
• Refers to an idea used to account for a situation or justify a
course of action
• A set of principles on which the practice of an activity is based
3 Main Learning Theories
1. Cognitive theories
2. Behaviorist theories
3. Humanistic/ social psychologist
1. Behaviorist theories
• B.F.Skinner: operant conditioning
• suggests that learning will occur if behavior is followed by
pleasant consequences.
• Look Skinner box experiment
• He introduced the law of effect thus reinforcement
• The teacher determines the direction of learning depending on
the kind of reward
• The theory elicits 3 kinds of responses:
• Neutral operants:
• Reinforcers
• Punishers
Thorndike theory
• Proposed that learning is more meaningful when the outcome
is made clear.
• Learning occurs by creating associations between stimuli and
responses
• Transfer of learning depends on the presence of identical
elements in the original & new learning situations .
• These should be specific, not general
Ivan Pavlov Theory
• Classical conditioning
• Reinforcement and punishment
• Automatic responses
• Association between the stimuli to produce certain responses
• Learning to associate unconditioned stimuli UCS that results in
a certain unconditioned response UCR, with a conditioned
stimuli CS, such that the new stimuli brings about same effect
Watson theory
• Emphasized active participation in learning or learning by
practice
• A child's behavior is influenced by their environment rather
than their genetic makeup or natural temperament

• Little Albert's experiment

2. Cognitive Theories
• B S Bloom theory
• 3 domains of learning
• Affective, cognitive, psychomotor
• Outlines levels of learning in each domain from basic to
complex
D P Ausubel theory
• Proposed that theory is the basis for practice of beginning with
learners existing knowledge
• Learning is related to learners knowledge base before new
content is presented
• New material is an extension of what is already known
J.BRUNNER
• He recommended that learns should be encouraged to work out
things for themselves.
• Learner should relate new material to pre existing knowledge
and deduce a meaning
• Aim of education should be to create an autonomous learner
• Learning to learn
• Teacher facilitates thinking and imparts problem solving skills
• Discovery learning
• Learners have goals and are provided with resources that
allows them to work out solutions too their problems through
own effort and use of appropriate resources
HUMANISTIC/SOCIAL PSYCHOLOGIST
• CARL ROGERS> Learner centered approach to learning
• His main propositions included:
All humans have a natural potential and desire to learn
Learning occurs when the learner perceives relevance related
to their own purpose
Significant learning is through doing
Learner chooses their direction discovers resources and
formulates problems
Most learning is self initiated and involves the whole person
Self evaluation is key in effective mature learning
Learners should retain a continuing openness to change
• The theory contributed to adult learning principles
• It emphasizes use of small group discussion
• The teacher is guide/facilitator
• Rogers philosophy
ABRAHAM MASLOW THEORY
• He encouraged the need to focus on the development of the
student as a person with a role in the society
• Self knowledge: one develops a set of values to guide them
through life
• Learning for self enhancement rather than for utility
• Learning out of interest than to gain more qualifications
• Individual decides what to learn and how to learn it
PRINCIPLES OF TEACHING
• Teaching is assisting the learner to modify his behavior through
training or experience
• Purpose of teaching: help learner to
a) Acquire, retain and utilize the knowledge
b) Acquire skills
c) Establish habits and develop attitudes
d) Understand, analyze, synthesize and evaluate the
knowledge
CHARACTERISTICS OF A GOOD TEACHER
1. Warmth
2. Cognitive organization
3. Orderliness
4. Indirectness
5. Ability to solve instructional problems
• Warmth> emotional support, praise and encourage the learner

• Cognitive organization> aims learner to acquire

understanding/ meaning not memorize .
• presents ideas in a logical sequential manner
• Assesses learners capability to learn, factors in slow learners
• Orderliness> should be systematic and methodical
• Indirectness> learning are indirectly involved through active
participation. Self discovery is key in the learning process
• Ability to solve instructional problems>
• The ability to provide solutions to problems encountered in the
teaching/learning situation
• Includes technical problems eg poor performance, managerial
problems
General principles of teaching
• The teacher helps students learn through:
Active learning: involve them and give feedback
Clarity: your teaching should be clear, speak loudly, write
neatly and use visual aids
Ensure mastery: check that all students know and can do it
Individualize: allow for individual differences and abilities,
vary your teaching methods
Motivation: make teaching interesting, relevant and
rewarding
Active learning
• You can do this in many ways
• Give students activities to perform
• Ask questions
• Set problems or projects
• Give feedback or tell them how they could have done better
The tasks of a teacher
• 6, which include:
1. Planning
2. Communication
3. Providing resources
4. Counselling
5. Assessment
6. Continuing self education
1. PLANNING
• Decide what the students should learn, eg by preparing
learning objectives
• Put content in a suitable sequence
• Allocate amounts of time to different learning activities
• Select appropriate learning activities and teaching method
• Choose assessment procedures: evaluation methods
2.COMMUNICATION
• Ineffective teachers communication leads to ineffective
learning
• Ways to promote effective communication
• Explaining to and advising the learner
• Helping the learner to exchange ideas
• Provoking the learners to think
• Using varied teaching methods
• Evaluating whether the learners understand or not and taking
necessary measures
3. PROVIDING RESOURCES
• Adequate resources must be provided to ensure effective
teaching/learning . These should be obtained prior to teaching
• A teacher ensures availability of resources by:
• Requesting all required resources in advance
• Preparing, selecting or adapting educational materials for the
session
• Arranging learning experiences especially those that provide
opportunities to practice skills eg field visits
Resources
• Arranging for learners attachments and projects
• Involving other health service personnel in teaching the
learner
• Arranging access to materials eg libraries
4. COUNSELING
• Teaching and learning can be difficult for both teacher and
learner thus, the teacher ought to be supportive to the learner
• This can be achieved by:
• Showing the learners that you care
• Listening and attempting to understand the learner
• Helping the learner to identify his/her options so as to make
decisions
• Providing advice and information that is useful to learners
5. ASSESSMENT
• Design an assessment that measures how much students have
learnt
• Use the assessment to guide students learning
• Use the assessment to give feedback that modifies teaching
• Use the assessment to decide whether your learner is
competent to provide healthcare
• Encourage the learner to do self evaluation and assess others
6. CONTINUING SELF EDUCATION
• Continuing education is vital for all health professionals
because of rapid increase in knowledge and technological
changes is todays world
• The learner perceives the teacher as a resource for
information, skills and advice
• Thus the teacher should stay informed through self education
Ct…..
• Therefore the teacher should:
• Know the subject matter that should be taught & where to find
relevant information
• Know healthcare delivery systems & any other relevant
resources that are available locally
• Learners should view the teacher as a model for continuing
learning
Skills used in teaching
1. Setting the audience> introduce the topic, state the
objectives to be covered
2. Stimulus variation> movement, gestures, focus on the
important points, tonal variation
3. Re enforcement> verbal or non verbal reinforcement
4. Basic questioning> distribute questions
5. Appropriateness> based on objective and level of learners
6. Explanations> clarity and fluency of language, key points
noted
7. Paraphrasing on the main points> put points in different ways
while maintaining same meaning
8. Giving examples>give examples within the range of learners
knowledge and experience

9. Emphasis> use of voice, vary pitch, volume, repeat main points

10. Closure of the topic> summarize major points, state relevance
and usefulness to the learner
BALANCE BETWEEN THEORY AND
PRACTICE
• The teacher should strive to maintain a balance between
theory and practice
• Give more time to teaching rather than learning
• Skills are best learnt through practice
• Practical sessions need more time to reinforce skill learning
and application of theory to practice
METHODS OF TEACHING
• These methods are chosen prior to the teaching session
• Varying the teaching strategies assist learning process.
• The methods are divided into 2 kinds>
• Traditional teaching methods
• Innovative teaching methods
Traditional Vs Innovative
• Traditional: the emphasis is in the teacher and how he or she
facilitates learning for the students

• Innovative: the focus shifts to the learner while the teachers

role is to facilitate learning
• The teacher must define area to be taught, define the subject
and topic to be learnt, the objectives and content from the
curriculum
• In innovative teaching, the teacher develops tutorial problems
which will be used to guide achievement of objectives stated in
the curriculum
• The teacher also produces a booklet containing the problems,
as they will be used in teaching the course
• Also develops a tutor guide to be used by the facilitator for the
course, which must contain solutions and useful tips for
guiding the learner
• Innovative learning processes are best described after the
tutorial booklet and tutor guide have been developed
• Once these are developed, a tutor can then carry a copy of the
booklets for each learner and his own and tutor guide to his
tutorial room
• These processes are difficult during preparation but easy
during tutorials and actual course delivery
Types of innovative teaching methods
• 1. problem based learning PBL
• 2. self directed learning SDL
Teaching methods
1. Lecture
2. Discussion
3. Demonstration
4. Simulation
5. Role play
6. Practical
7. Field visits
8. Independent study projects
• 9. Seminars
• 10.Tutorial
• 11.Project
• 12.Critical incident technique
• 13.Team teaching
• 14.Case study
• LECTURE:
• A lesson given orally by the teacher, with no student participation.
• Content may be distributed in printed form
• Traditional method
• Indications
• Introducing new topic
• Large audience
• Introducing facts
• Limited time
2. DISCUSSION
• Two way exchange of information, ideas, and feelings between
the teacher and the learners
Methods include
I. Small group discussion
II. Question and answer
III.Syndicate discussion
IV. Debate and panel
V. Snowball discussion
VI. Brainstorming
• Small group discussion:
• Teacher divides a class in small groups, gives tasks and
facilitates learning
• Question and answer:
• Introduction of the topic, what do the learners already know
• Review of learning experience eg field visit
• Informal revision of knowledge, discuss controversial issue
• Syndicate discussion:
• A class is divided into several groups. Each group prepares a
different assignment and report back to the whole class.
• Used to cover wide area of study
• Learners working on common surveys
• Debate and panels:
• When working with controversial topics
• Debates: the teacher controls the activity ensures arguments
are based on facts
• Panels: several students prepare a topic and present it to class,
who then ask the panel questions
• Snowball discussion:
• Every single person is involved in the discussion
• Each learner practices the facts to consider, uses these factors
to make a decision and listen to other peoples arguments
• Aka pyramidal group discussion
• Brainstorming:
• A method of collecting ideas from individual members of a
group on how to solve a problem
• Useful in generation of ideas
• Demonstration
• Refers to an inhibition/experiment/explanation of procedures
involving practical skills
• Evaluated through return demonstration
• Indications for demonstration
• To reinforce learning
• To show desired performance
• Ensures active participation
• To help students comprehend and learn information/facts
• To provide practical example as reinforcement for practical
work
• Used to illustrate certain attitudes involved in skills
• Simulation
• A dynamic representation
• An imitation of real life situation
• Used to teach attitudes
Role play
Learner experiences or relives an event
Used to teach communication skills, decision making skills and
attitude
• Practical:
• Involves learners learning in their future working areas

• Field work/ visits

• Students leave the training school to do the work for which they
are trained for
• Mainly observational
• Reinforces knowledge gained in class to a meaningful learning
experience
• Independent study project:
• A process in which the individual takes the initiative with or
without the help of others in diagnosing their learning needs,
formulates learning goals, identifies learning resources,
chooses and implements appropriate learning strategies and
evaluation outcomes
• Occurs in 2 forms:
• A requirement in a program
• Motivated by learners needs
Characteristics of ISP
1. Learning objectives are identified by either the learner or the
teacher
2. Involves active student participation
3. There is use of variety of human and material resources
4. Individual pacing level of achievement varies
5. Feedback device is put in place so that the teacher/learner
can monitor progress
6. The is high degree of student autonomy
• Seminar:
• A session headed by the teacher, trained senior student or an
enthusiastic student fro the class where an assigned subject is
discussed.
• The subject is prepared prior to the class session and presented
by different students .
• Other students discuss, criticize and comment on the material
presented
Tutorial:
• This is a discussion between a teacher and a small number of
students
• The smaller the number of students the more effective the
tutorial , should not be more than 8
• The teacher should do less talking and encourage the students
to think and learn independently.
• PROJECT:
• An assignment is given to an individual student, a pair orgroup
of students in which they carry out a oiece of independent
work on a particular topic.
• The students organize the assignment and prepare a written
report to submit to the teacher.
• Specified duration for the assignment is given eg within a week
or a month
• CRITICAL INCIDENT TECHNIQUE
• The learner learns from a critical incident which occurs in the
course of study of work due to the alarm he/she learns to
depict future occurrence
• Eg a health inspector who passes diseased meat as safe for
human consumption thus affecting customers
• TEAM TEACHING:
• It is a cooperative approach to teaching where 2 or more teachers take part
in planning, teaching and evaluating a group of students.
• It improves the quality of instruction by giving teachers opportunity to learn
from other team members
• Factors to consider
• Objectives of the session
• Student expectation
• Learning activities
• Teachers capabilities
• Content to be covered
• team teaching
• Guidelines to be considered include:
• Team members should participate
• Contribution of different ideas
• Carrying out teaching functions in the presence of their
colleagues
• Periodic evaluation
Case history/studies
• More less the same concept
• Case history refers to patient while case studies refer to
situations
• Case studies describe what happened in a specific situation eg
how a specific HIV/AIDS control program was planned and
implemented and what the results were
• Case history describes a specific part eg presenting symptoms,
pmshx,dx, investigations, rx and outcome
• Both forms provide useful examples to illustrate general
principles
MICRO TEACHING SKILLS
• Refer to skills used in the implementation of a good lesson plan
in the traditional teaching process
• Include:
i. Set induction
ii. Stimulus variation
iii. Questioning
iv. Re enforcement
v. Use of examples and explanation
vi. Closer/summary
• Set induction: introduce the topic, start a lesson to capture
learners attention
• Stimulus variation: varying focus movement, speech and
content delivery to retain learners attention
• Questioning: ask questions to promote interaction with the
learners and to hold attention
• Re enforcement: reward students to provide good behavior
and attention
• Use of examples and explanations: these promote learning
• Closer/summary: mental closure of the lesson.
LESSON PLAN
• This is a written description used in a teaching/learning
situation to guide the teacher to systematically present the
subject matter in a logical, interrelated and integrated
manner such that learning is reinforced and enhanced.
Purpose of a lesson plan
1. Helps the teacher to know the topic to teach
2. Helps the teacher in setting objectives to be taught
3. Assists the facilitator to plan ahead of time to avoid
disorderliness
4. Enhances systematic flow of information or event
5. Enables the facilitator to check if the set objectives have been met
6. Helps in self assessment of the facilitator and allows room for
improvement or correction
7. Helps in outcome of learning
Contents of a lesson plan
• Topic and specific objectives
• Date
• Time
• Venue
• teaching/learning method
• Audience
• Teaching aid
• Institution
• Evaluation
INNOVATIVE TEACHING METHODS
In traditional teaching/learning processes, the emphasis is on the
teacher & how he/she facilitates learning for the students.
-In innovative educational processes, the burden of learning
shifts to the learner. The teacher is transformed into a
facilitator.
• In the innovative teaching/learning process, the teacher, like in
the traditional process,
• must identify the area to be taught,
• define the subject & topic to be learnt as well as the objectives&
content to be learnt from a curriculum.
INNOVATIVE TEACHING METHODS
They include:
• Problem Based Learning(PBL)
• Self Directed Learning(SDL)
• Small Group Tutorial (SGT)
• Community Based Education & Service(COBES)
• Computer Aided Education (CAE)
• Student-centered, Problem based, Integrated,
Community-oriented, Electives & Systematic (SPICES)
• Of all the above innovative methods, the best known is
PBL
For innovative teaching/learning methods such as
Problem Based Learning(PBL),the teacher must then
develop tutorial problems which will be used to guide
the achievement of the objectives as stated in the
curriculum.
The teacher will also produce a booklet, which contains
those problems, as they will be used in teaching the
course.
-In addition, the teacher will also develop a tutor guide
to be used by the facilitator for the course, which must
contain the solutions & useful tips for guiding the
learner.
-Innovative learning processes are best described after
the tutorial booklet & tutor guide have been developed.
After this have been developed, a tutor can then carry
a copy of the booklets for each of his students & his
own booklet& tutor guide to his tutorial room.
-Innovative processes are, therefore, more difficult
during preparation but easier during tutorials & actual
course delivery
-Inside his tutorial room with his group of students, the
tutor can follow any one of the following processes to
conduct his tutorial
STEP 1-Tutorial 1
-Read through the problem,define terms,clarify concept,
analyse problem & set learning objectives.
Solve any problem(if possible at this point)eg.on Monday.
Students identify their own learning objectives(SOLO)
STEP 2-SDL
• -Self-Directed Learning means that the students study & look
for information on their own.
• They may do this on Tuesday, Wednesday & Thursday in
preparation for the tutorial session on Friday
STEP 3-Tutorial 2
-This is the second tutorial during which students do presentation
of gathered information, solution of problems & synthesis.
This would take place on a Friday
• STEP 1:Clarify terms & concepts not readily comprehensible
• STEP 2:Define the problem
• STEP 3:Analyse the problem
• STEP 4:Draw a systematic inventory of the explanations
inferred in step 3
• STEP 5:Formulate learning objectives
• STEP 6:Collect additional information outside the group(SDL)
• STEP 7:Synthesize & test the newly acquired information
• STEP 1 to STEP 7:Similar to the 7 steps PBL Tutorial process
• STEP 8:Meet as groups to draw inventory of unresolved issues
• STEP 9:Second Self-Directed Learning
• STEP 10:Meet again & synthesize the newly acquired
information
Was developed at Moi University Faculty of Health Sciences
First Tutorial
STEP 1:Group organization: Introductions
:Selection of chairman
:Selection of secretary
• STEP 2:Reading through the problem(aloud)
• STEP 3:Identifyng the problem
• STEP 4:Defining the problem
• STEP 5:Raising learning issues
• STEP 6:Resolving issues based on prior knowledge
• STEP 7:Organization of the unresolved issues
• STEP 8:Developing learning objectives from the organized
unresolved issues
First Self-Directed Learning(SDL)

• STEP 9:Information gathering from all available resources

• STEP 10:Students meeting alone under their chairman to
collate information & identify the objectives based on
information that is so far not available
Second Tutorial

• STEP 11:Discussion of available information to check for

correctness & completeness
• STEP 12:Identification of objectives so far not addressed with
a view to identifying the resources from which to obtain
information.
Second SDL Period(usually Saturday & Sunday)

• STEP 13;Information gathering on difficult objectives

• STEP 14:Final collation of information & solving of the
problem(students meeting alone under their chairman)
• STEP 15:Identifyng areas that are difficult to understand &
seeking help ,eg.overview (if necessary)or seminar
NOTE>
• Of all these various processes, the major steps are
encompassed in the 3 step process.
• This simply presents a problem to the learner,gives him/her
time to do self-directed study & enables him to discover &
present his/her solutions.
• All this is done with the help of the tutor.
These are modern innovative teaching /learning skills & are most
appropriate for adult learners.
-Super skills, which bear the acronym FAGIPW, emphasize that a
tutor ought to:
• Facilitate
• Advice
• Guide
• Inform
• Participate
• Withdraw
Tutorial Problem In PBL

In PBL,a problem may mean any of the following:

• A problem that is clinical,theoretical,research-based or related to real life
• An idea
• A situation
• An event
• An outbreak of disease/disaster
• A newspaper cutting
• A list of objectives
-Innovative methods are often used in combination with other methods to
facilitate student learning.
Learning skills developed from
innovative teaching methods
• Communication skills
• Problem solving skills
• Clinical reasoning skills
• Self directed learning skills
• Emotional/social support skillsThinking skills
• Team-work
• Continuing education skills
The disadvantages of innovative educational methods are:
• Their resource-intensive nature
• The need to have many tutorial rooms to accommodate the
small groups of students instead of the traditional huge
lecture hall.
The Role of the Tutor in the PBL Process

• In the innovative teaching/learning processes, the tutor plays

as many roles & even more roles than the teachers in the
traditional teaching methods.
Establishing rapport
Explaining goals, objectives & functions
Explaining procedures & roles of students & tutor in PBL
Focusing attention
Encouraging active participation
Referring back questions, comments, suggestions to group
Intervening in conflict situations
Reinforcing group discussions
Control group
Distribute & re-direct questions
Probe further, if necessary
Encourage analysis, synthesis & evaluation of problem(data)
Encourage students to develop qualities of individuals in group
Intervene to keep group& discussion on track & stimulate
thinking by encouraging hypothesizing
Encourage students to review& redefine explanations
The Role of the student in the PBL
Process
1. Active participation ie. listening, contribution to the discussion &
asking questions
2. Carrying out analysis, synthesis& evaluation of the whole learning
process
3. Making connections, linking concepts & applying principles
4. Reviewing & redefining explanations
5. Evaluating achievements
6. Summarizing at various stages
7. Acting as change agent, ie, as a solution giver, process helper,
resource linker & catalyst
CLINICAL TEACHING
Clinical teaching is teaching in the clinical or practical setting,
similar to the environment within which the learner will practice
in future.
-In clinical teaching, you want your learner to put the
knowledge of a task or skill into action
-You want your student to get involved with the patient/client
-Involvement brings in emotions & feelings
Ct…
You must teach the learner to emphasize so that he/she can
nurture or care without getting carried away by the effects of
the illness or situation
-No learning can take place until certain basic needs of the
learner have been met
-When the basic needs get fulfilled, your learner will want to
learn at a higher level& exercise mastery of the skills.
Ct….
As the learner carries out procedures,she/he needs to learn how
to contain personal negative feelings eg.contempt,revulsion of
unpleasant sights or aversion
-Above all,the learner must learn how to maintain his/her
integrity&the professional code of ethics &etiquette
-This is necessary because the student will be learning how to
protect his/her patient/client from malpractice & negligence
Mastery of the theory is important because it gives you the
foundation
-Scientific knowledge adds appropriate technical skills &
encourages you to develop the right attitudes
-The result is the development of sound clinical judgement,
which is the sign of an experienced nurse.
Role of a Clinical teacher/ instructor
As a clinical teacher,you should be:
I. A skilled,experienced nurse concerned with the maintenance
& improvement of standards of patient care
II. Concerned to help your learner to develop his/her potential
as a nurse
III.Able to gain satisfaction from caring for patients
Role of a clinical teacher
IV. Able to gain satisfaction from teaching, especially
individuals & small groups
V. Keen to create a favorable environment for learning.
VI. Alert to the opportunities available for facilitating learning
in the clinical situation
VII. A model for your learner
Factors to consider when choosing a
teaching method
• 1. Teaching/ learning objectives
• What do you want the students to be able to do at the end of
the session?
• 2. Practicality of the method
• How much time is needed? Where is the teaching taking place?
Number of students involved, level of the students ,
• 3. Resources needed
• Gather resources early enough and make the sessions
interesting for learning to take place
ATTITUDES, KNOWLEDGE AND SKILLS
• HOW ATTITUDES ARE TAUGHT
• An attitude is a tendency to behave or think in a certain way
• Methods of teaching attitudes
• Providing information to shape attitudes: films, lectures
• Providing examples: model
• Providing experience to shape attitudes
• Providing discussion to shape attitudes
• Role play exercise
•
HOW SKILLS ARE TAUGHT
• There are 3 types of skills:
• Communication skills: persuading, talking, encouraging
• Cognitive skills: thinking, decision making
• Psychomotor skills: practical skills, involve movement. Using
hands
Methods of teaching skills
• Describing a skill > explain the rationale and stages in
performing it
• Demonstrate a skill> students see an expert performing the
skill correctly with an explanation of what s/he is doing
• Practice> students should perform skills through projects,
simulations, ward rotations and case studies
HOW KNOWLEDGE IS TAUGHT
It includes the facts that a health worker must know.
Sources of facts include teachers, manuals, books, models,
posters
Methods for teaching knowledge
Lecture
Symposium
Seminar
Conference
Panel
EDUCATIONAL OBJECTIVES
• What is an Objective?
• It is a precise statement that answers the question of what a
student should do in order to show that s/he has learnt what
the teacher want him/her to learn fro the session .
• it is a statement describing an instructional outcome
• Objectives enable the teacher to help the learner gain the
knowledge, skill or attitude specified
Types of objectives
• A)Instructional objective ( practical performance)
• These describe what the learners and the teacher intend to
achieve as a result of instruction
• It includes the three domains ie cognitive, affective and
psychomotor

• B) Educational objectives
• State clear, simple, precise and observable behavior
Ct….
• C) Behavioral objectives
• They state the actual behavior to be performed, the condition
under which it will be performed, the result of the
performance and the criteria that will be used to evaluate the
product of the performance
Purpose of objectives
1. Guides the teacher and the learner to remain focused
2. Helps in keeping to the scope of study
3. Helps the teacher to be systematic
4. Influences self directed learning
5. Allows the teacher/learner to understand the subject with
greater clarity
6. Predetermines the expected outcomes for students
CHARACTERISTICS OF OBJECTIVES
• The objectives should be SMART
• S-smart
• M-measurable
• A-attainable/achievable
• R- realistic
• T-time bound
QUALITIES OF GOOD OBJECTIVES
• RELEVANCE> most essential to the health needs of a community
• CONSISTENT> provides the same meaning /result each time
• UNEQUIVOCAL> no argument /dispute about the meaning
• FEASIBLE> can be attained or performed
• OBSERVABLE> seen to be happening
• MEASURABLE> quantified in an objective way
Components/criteria of behavioral
objective
• There are three parts of an objectives, namely:
1) A verb
2) The condition under which the achievement will be
demonstrated
3) The standard or criteria by which the performance will be
evaluated
1. ACTION VERB ( act or performance)
• It describes what the learner is expected to do.
• It describes the specific behavior or activity of the learner
• The student will be able to, list, describe, illustrate,
demonstrate
• The performance indicator is the act whose satisfactory
performance implies that the student is able to accomplish the
task required
2. THE CONDITION
• Describes how the learner is going to carry out the activity to
behave in a specific manner under certain conditions.
• The teacher should describe the situation or specific condition
under which the learner is expected to carry out the activity
• Eg giving immunization in MCH
• It includes data, limitations &restrictions
3. STANDARD/CRITERIA
• This is the minimum acceptable accomplishment by the learner
• Note that the learner may not perform the expected task at a
maximum level but should acquire at least a certain amount of
the total knowledge or skill taught to them
ASSIGNMENT
• READ AND MAKE NOTES ON THE ADVANTAGES AND
DISADVANTAGES OF OBJECTIVES
TEACHING AIDS/ INSTRUCTIONAL MEDIA
• These are objects or situations which facilitate teaching/learning
process and at the same time permits a teacher and learner to
interact as much as possible.
• The use of teaching aid simulates the learner through the following
senses:
• Sight
• Hearing
• Touch
• Taste
• smell
Types of teaching aid
• Categorized into 3
1. Projected
2. Non projected
3. Sound
PROJECTED NON PROJECTED SOUND
OVERHEAD PROJECTOR FLIPCHARTS RADIO
VIDEOS FLANNEL BOARD VIDEO
TELEVISION PICTURES TELEVISION
LED- POWERPOINT POSTERS
WRITING BOARD
HAND OUTS
VALUE OF TEACHING AID
• Arouses interest
• Time saving in teaching
• Gives a new concept accurate impression
• Stimulates active teaching provides a shared experience
• Creates an opportunity for active learning
Factors influencing selection of teaching
aids
• The subject matter
• The objectives
• The type of learning tasks ie skills, attitude,or knowledge
• The learners background ie age, level of learning
Categories of media
Visual- seeing
Audio- hearing
Audio-visual- seeing and visual
GROUP ASSIGNMENT
• DISCUSS THE VARIOUS TYPES OF TEACHING AIDS, OUTLINING
THE ADVANTAGES AND DISADVANTAGES
a) Overhead projector
It projects transparencies from a horizontal table via a prism or
mirror & a lens
-A bright image appears on a screen behind the teacher
-The setting up of the screen depends on the type of room & the
size of the audience.
-There are two possibilities of projection:
a)projection from behind
b)projection slightly to the side (better viewing)
OHP CT….
• When lecturing, stand to the right or left of the
projector so that you can easily point out the
important areas that you want the learner to grasp.
• You can also view what the learner is seeing
simultaneously
• Expose only what you are discussing & not the whole
transparency so that the learners can concentrate &
take down important points.
• In this way, the rest of the presentation will not
distract learners
When preparing transparencies
• Do not write too near the edge or you might lose half of
the image; Leave at least an inch of margin all around.
• For more complex drawings, prepare a pencil sketch
then lay the transparency over the sketch & copy onto
the transparency. You can also copy a diagram from a
book.
• Lettering should not be too small, about 4mm(1/8 of an
inch)
• A transparency should convey one theme.
• Put as much information as necessary but as little as
possible on a transparency.
• Ensure clarity & impact
• Leave room for future alterations.
• Store your transparencies with care to avoid moisture &
dirt.
• Keep content down to 10 lines with 10 words on each
line.
• When masking, use thin paper. This ensures that the
lecturer sees the whole transparency but the audience
only the information that has been revealed
Advantages of OHP
1. You are able to face the classroom & point out features
appearing on the screen easily using a pointer
2. It may not be necessary to darken the room
3. You are able to project a wide variety of materials.
4. Alternatively, they can be put up on top of each other
showing stages of development of an idea or structure
Disadvantages of using an OHP
1. The acetate sheets are expensive to obtain, but spoiled &
cleaned X-ray film is a useful alternative.
2. You should get a transparent & slightly bluish sheet that can
be used in the same way as transparent acetate sheets
3. Special felt pens are used for writing on the transparent
sheets. If they are difficult to obtain, the glass pencils used
in laboratories are a substitute.
4. Needs a lot of time 2 prepare &Erase with water or with spirit
for semi-permanent ink
Care and Maintenance of an OHP
 After projection, do not remove the wire plug from the socket
but switch off the lamp & keep fan running until the bulb has
cooled down.
 Keep lenses & mirrors free of dirt
 Keep a spare bulb in stock at all times
 Store semi-permanent transparencies together with master
copies of handouts in a file with unit block or subject
concerned, so it can be found easily &used again the following
year.
B) LCD PROJECTOR AND LAPTOP
• In this system, content is typed in the power point in
the computer & projected onto a screen using the
Liquefied crystal device (LCD) projector.
2. NON-PROJECTED TEACHING AIDS
These are aids that you can find within your environment
-You can select these well in advance of the lesson & pre-test them
before classroom use.
These include:
The chalkboard & chalk/ white board & marker
Pictures
Flipcharts/ charts
Posters
Handouts
flannel boards
a) The chalk/white board
• These are the most easily available, convenient & most
used teaching aid
Guidelines in using the chalkboard to enhance learning
• Write only the essential points & examples e.g. your
lesson plan outline.
• This helps the learner copy & fill in all other relevant
information as you build up from introduction to
conclusion.
• Write large enough letters/figures to be seen by all
learners.
Ct…..
• Plan the board so that information develops from one
stage to the next stage.
• Deliver the lecture to your audience & not to the board,
ie.if you have to write, lecture first, then write on the
board.
• Stand next to the board at an angle so that you can
see your learners frequently.
• -Maintain eye contact with the class
Advantages of chalk/white boards
• Easy to use
• Inexpensive
• Excellent for brainstorming
• Displays information
Disadvantages
• Time consuming
• Messy
• Cannot hold a large amount of information
• No permanent record of information
• Lecture maybe delivered to the board instead of the learners
b) Pictures
• Can be in form of slides, photographs, picture-
drawings, line drawings or cartoons
• Good & appropriate pictures are sometimes difficult to
obtain or prepare
C) Charts
• Are cheap & easy aids to prepare
• Simple charts Can be made from butcher paper, old calendars,
paper boxes, manila paper, etc
• Flip charts are commercial plain papers
• -The pictures can be drawn by somebody else or traced from a book
• -The pictures should be labeled in legible handwriting
• -When labeling, remember to:
• Use thick felt pens
• Use different colors for emphasis
• Write in lower case letters, not capitals
• Do not write too much / don’t congest it
• When making a presentation using flipcharts, do not read
the chart as you talk.
• As you prepare the lesson or the materials for teaching,
make notes on your lesson plan to guide your discussion.
• This way, you can read your notes as you teach & yet be
facing the audience
Flipcharts
• Large sheets of paper usually in a tripod stand
• Used to display previously prepared notes or drawings
• Also used for brainstorming or discussions
• Advantages
1. Inexpensive
2. Excellent for brainstorming
3. Portable
Disadvantages of flipcharts
1. Time consuming
2. Messy
3. Cannot hold a large amount of information
d) Posters
They take longer to prepare than charts
-They may consist of words only, pictures only, or a mixture of
both.
-Unlike flipcharts, posters are usually single-leafed.
-Posters need a lot of planning & testing before use.
Posters ct…..
-They can be prepared for two types of viewers:
1. For a mixed (heterogeneous)audience eg.on a street for the
public
-In this case, it should deliver the message at a glance
2. For a captive audience, eg.in a class
• NB: When preparing a poster, remember to make it simple, use
simple language & avoid difficult words or slang & put as little
as possible on the poster
e) The real thing or object
• -It is the best teaching aid e.g. real baby instead of a
doll
• -Try as much as possible to use the ‘real thing’ in your
lesson
• -If it is not possible to demonstrate ‘the real thing’
think of other teaching aids that are simulations of
the real thing.
• The closer the simulation to the real thing, the better
the teaching aid is.
• This helps the learner to internalize & transfer the
impression he gets to the real thing
• It also helps the learner to start using the right
attitudes & find the right expressions to use from the
start.
f) Handouts
• These are written papers given out by teachers to students
• They act as guides for work to be done, or references to be
looked up.
• They help remind students of the main points to remember
from a learning experience
• They should not be used as substitutes for manuals, texts &
references
• A handout is both a visual aid to learning & an addition to
private study.
Purpose of a handout
It is to help the teacher to:
1. Indicate the objectives of the lesson exercise
2. Indicate the relevance & define the area to be covered
3. Provide additional theoretical information
4. Provide a stimulus for further thinking
5. Give instructions for practical work; these should be specific &
complete
Uses/features/characteristics of a good
handout
A good handout should:
1. Set out the structure of a lesson to promote attainment of
the objectives
2. Benefit learning
3. Provide an infrastructure for the topic
4. Emphasize a framework for interaction between the
facilitator & learner
5. Help the learner to receive detailed information
6. Guarantee the accuracy of the transferred information
Useful guidelines when preparing a
handout
The introduction should relate the new material to the learner’s
past experience
 Summarize the major ideas
Use major & minor topics
Leave space between paragraphs & sections for learners to make
notes
 Simplify your expressions
Label your illustrations, tables & graphs appropriately. A series of
diagrams building up to a complete concept may be more helpful
than one detailed diagram
 Put questions & exercises within the text to stimulate
thinking
The content, language & spelling should be accurate.
The statements should be consistent with other texts or
manuals which the learners use.
Your handouts must be clear & arranged in a logical
order with good arrangement of headings, words &
diagrams on the page
g) Flannel board
• This is the device of choice for teaching villagers.
• All rural educators should know how to use it
• It is based on the fact that materials with rough
surfaces tend to adhere to each other
• If flannel cloth is not available, alternatives can be
found.
Ct…..
• The board is put in front of the class, sloping slightly
backwards
• Cards with a rough backing eg. sand paper, can be placed on
the board in the desired position.
• The cards can be moved or taken down at will.
• Make cards from large print or written words eg. newspaper
cuttings, photographs or dissected posters
Advantages of flannel board
1. It tells a story in which you can see things happen
2. It has strong colors that please
3. The pictures are large enough to be seen from some
way off.
4. It looks like things that people are familiar with
5. It arouses interest & questions
Disadvantages of flannel board
• Barazas are usually too big for flannel pictures to be
seen from the back
• when flannels are used in the open air, the wind may
blow the flannel graphs away

• NB: even the best designed teaching aid cannot replace

practical work with patients & in the community
HOW TO USE TEACHING AIDS
• Good use of teaching aids involve
• Selecting
• Previewing
• Planning
• Presenting
• Evaluating
How to use teaching aids
• 1. Select: the teaching aids to suit the lesson
• 2. Preview the teaching aid to ensure they convey the message
you want
• Avoid unpleasant surprises
• During the preview, plan explanations or comments you may
wish to make during presentation of your lesson
• 3. Plan how and in what order you intend to use your teaching
aid eg by numbering them
• In the plan: introduce the subject in an interesting way,
describe the body of the topic and then summarize the lesson
to ensure consolidation of knowledge
• Tell the learner what to look for as you explain and comment
where necessary
• 4. Present: your teaching aid appropriately and give adequate
explanation
• The students view the teacher as an expert
• Check the mechanical equipment to ensure it is in good working
condition
• If working in a community eg field trip, obtain consent from
the persons involved
• 5.Evaluate: your teaching aids with the same class
• After presenting your teaching aid, find out if the
presentation was successful, whether the aid achieved its
purpose and if the objective was attained
GENERAL STORAGE OF TEACHING AIDS
• Good durable teaching aids can be reused.
• Keep your teaching aids neatly in a resource learning
kit(cupboard/store)
• Each item should be labeled clearly for easy access
• Maintain an inventory of the various aids in stock
• When you lend out items, they should be signed for.
Storage ct…
• On their return, you should check their condition first before
storing so that you keep readily usable items in your resource
centre or cupboard
Storage of specific teaching aids
• Maps &charts are stored rolled up.
• To avoid long searches, their titles should be written on the
back & facing the door so that they can be seen easily.
• Slides are best kept in hanging files with a list of contents on
the filing cabinet.
• Overhead transparencies & master copies of handouts are put
in a master file together with other material on that special
unit.
The master copies are given numbers corresponding to the no.
of stencils, which are stored in or near the stencil room
-These are filed in either alphabetical order or numerically
-When a handout is needed, it is easy to trace back the old
stencil & run off the quantity needed.
-Handouts need to be updated with current information.
-Models, samples & specimens may be kept for a permanent
exhibit in the library.
ASSESSMENT AND EVALUATION
Evaluation involves placing a value on the learner’s performance in
order to make a decision about the learner& the subject or course
that was taught
Components of Evaluation
a)Examination
-Is the formal mechanism or process used to determine the degree
of learning of the learner
b)Assessment
-Refers to the process of finding out to what extent the learner has
achieved the set objectives
PURPOSE/AIMS/SIGNIFICANCE OF
EVALUATION
• You should evaluate the learner in order to:
Help the learner to understand him/herself
Help in retention & transfer of learning
Motivate the learner
Predict the level of learners’ future performance
Judge the learners achievements
Monitor the learners progress for the purpose of providing
feedback
Determine teaching effectiveness
License practice of a profession
Identify weak & strong areas of a course
Grade & rank students
Gauge reputation of school performance
Protect society,ie,to inform the community of the extent to
which graduates constitute a potential danger
TYPES OF EVALUATION
1)Formative evaluation
-This is a progressive evaluation in that the learner &
learning are evaluated on a continuous basis
-It provides feedback on the strengths & weaknesses of
the performer
-It is performed frequently,ie,after small units of
learning
Importance of formative evaluation
It gives an early diagnosis of the learner’s
problems during the learning process, which
enables corrective measures to be taken
• Eg. placement testing or pretesting which are
conducted for the purpose of gauging to what
extent the learner possesses the skill & abilities
needed to begin instruction
Advantages
1. Tends to be more reliable
2. It removes the tension and worries of the single final
examination
3. The motivation to pass an exam is spread over the whole
course so students work hard all through
4. Students are shown right through the course what is expected
ie the standards
5. In case of poor performance, students have the time to
correct their errors before the end of the course
Disadvantages
• It takes more time and effort to organize
2) Summative or terminal Evaluation
It refers to evaluation which is carried out at the end of a term or
course or programme
Importance
-It enables you to award grades, award certificates, license the
student for practice and/or select learners for a further
educational programme.
• NB:A good evaluation system should include both formative &
summative evaluation.
-Formative evaluation gives diagnostic feedback to both teacher&
learner,while summative evaluation reveals the student’s ability to
integrate & apply learning
CONTENT OF EVALUATION
The content evaluated is selected from the entire course work
covered in the term/year with samples of all learning tasks.
-It should include:
• Knowledge
• Skills
• Attitudes
ASSESSING KNOWLEDGE
This can be assessed by essays, short answer questions,, multiple
choice questions (MCQs), true-false questions, matching
taskscompletion of blanks & verbal/oral questions
1. Essays
-It is important to remember to make them valid, reliable &
objective
-They should ask the learner to describe & analyse issues
-Be very specific & describe exactly what the student should do.
-Prepare a marking scheme.
Scoring used in preparing a marking
scheme
It can be tricky & one of the main objectives of scoring is to
award the correct marks for a given test, exam or evaluation.
Types of scoring
1)Analytical scoring
-Analyze the correct response by making out a list of crucial
points, which must appear in the answer in advance.
-You should then compare the student’s answer to these points &
award marks for them, as well as integration, coordination &
organization
2)Impression scoring
-In this type of scoring, you should first analyze the correct
responses as in analytical scoring, then read the script to get
an impression for adequacy.
-You should then transfer the impression into a grade.
-The papers(scripts)may be sorted out by quality,ie,25% low,
50% middle,25% high
Rules to be observed when marking
essays
Since you may have many scripts to mark, you need to organize
yourself in order to be able to mark them fairly.
-The following points can help you achieve this:
1. Arrange for independent marking of papers or at least a
sample of them if the class is too large
2. Conceal the name of the student,ie,use numbers or letters
3. Grade answers question by question, & not student by student
4. Discuss the answers with students to ensure learning,ie,
provide feedback
MULTIPLE CHOICE QUESTIONS
These are questions where 4 or 5 answers are given & the student
has to choose the correct or best answer.
-A typical MCQ has 3 parts:
i)The question itself or the stem
ii)The correct answer
iii)Distracters or incorrect answers
Factors to consider when choosing MCQs

1. Questions should be simple, straight forward & should relate

to what was taught
2. The question should emphasize the aspects you want to teach
3. Choose good distracters
4. Do not make incorrect answers ridiculous
5. Choose distracters from among the type of mistakes the
students commonly make
6. Do not make the correct answers obvious
Importance/uses of MCQs

• Can be used to test different sorts of knowledge

• For pre-test & post-test purposes
• To see how effective your teaching is
• To determine whether or not the students are learning

• READ ON ADVANTAGES AND DISADVATAGES OF MCQs

Points to remember when using MCQs
i. Allow about 2 minutes for each part true/false question in
an exam
ii. For true/false question, give 1 mark for correct choice, 0 for
wrong choice and deduct 1 mark for each wrong choice
iii. The pass mark should be quite high because these questions
test basic knowledge
iv. Marking is made much faster if a separate response is used
for student answers
ORAL EXAMINATION
• One student is interviewed by one or more examiners.
• The learner is asked questions to gauge what s/he knows about
some topic

• Read on advantages and disadvantages

Short answer questions
• Involves a set of questions that test various levels of knowledge
• Questions ask the student to list, state or draw a digram and so
forth

• Read on advantages and disadvantages

ASSESSING SKILLS
Skills can be assessed through the use of:
1. Objective structured clinical examination(OSCE)
2. Objective structured practical examination(OSPE)
-For both methods, candidates pass through a no. of
examination stations to answer or solve various problems.
-Questions vary from practical skills, knowledge application &
testing of attitudes
-All candidates get the same experience
OSCE
• A modern type of examination often used in health sciences
• Its designed to test clinical skill performance and competence
in skills eg communication,clinical examination, medical
procedures/prescriptions.
• It is a hands-on , real world approach to learning that keeps
examinees engaged.
• It comprises of a short circuit of stations in which the
candidate is examined on one to one basics .
• Each station has a different examiner.
• Candidate rotate through stations, completing all stations on a
circuit
• Its objective in that all students pass through the same
stations and are assessed using the same marking scheme.
OSPE

• Practical skills are considered among the more important

components of training in all professions, that is, failure in
practical tests is equivalent to failure in the whole examination.
• -We should not allow excellence in theory to compensate for
failure in practical.
• -These examinations must be objective, valid & reliable
• -They should define the competencies a worker needs to
develop to successfully perform the job
ASSESSING ATTITUDE
• The student’s attitude is an important
ingredient in delivering a good service
• By assessing this skill, a student will learn the
importance of having appropriate attitude &
will better understand what is expected of him/
her
• Attitudes can be assessed indirectly, as the
candidate performs a skill
• This will have to be over a long period so that your
assessment is based on repetition of the same attitude
over time.
• Assessing of attitudes should be a continuous process
to give a student the chance to internalize the specific
attitude
• Simulations, which allow the observation of gestures &
actions, are a better way to see the actual display of
attitude
You can use a rating scale based on a table
analysis (TA).
-There are two types of scales:
1)Scale of 5-1:eg
i) students’ XY forms filled in by the ward in-
charge
ii)A simple satisfactory to unsatisfactory scale
2)Semantic differential-ie a scale on opposite characteristics
-This can be used on attitudes alone.
• Eg. please tick where the student exhibits this behavioural
characteristic
• Keen & willing- does minimum work
• Accepts instructions- ignores instructions
• Polite to patients- rude
You can develop an assessment tool by following these basic steps:

1) List the objectives you wish to evaluate

2) Identify the expected learner outcomes(knowledge, attitude &
skills)
3) Specify the tools of assessment such as essays, MCQs, OSPE,etc
4) Allocate marks for each objective & develop a marking scheme
5) Construct questions for the whole test
6) Arrange questions from the first to the last
How to administer attitude-assessment tests:
practical hints
• For attitude assessment to be meaningful, both students &
assessors must be well briefed.
• Students must know:
• What is being assessed & how. Show them the form
• Who will assess them & when? Discuss the form
• What effect the assessment has.How many marks? Where it
means pass or fail
• Assessors need to be trained how to use the form
& how their judgment affects students
• The assessment must always be shown to the
student & discussed with the student
• NB: What is assessed is likely to be learnt &
valued by students
Characteristics of a good evaluation/
assessment tool
Valid-it should measure what it is supposed to measure
Reliable-it should measure accurately & consistently what it is
supposed to measure
Objective -it should be free of individual bias, especially in marking.
 Discriminate -it should reveal a reasonable range in the scores
between students knowing the most & students knowing the least.
 Practical -in terms of available resources & no. of students to be
examined
GRADING
This refers to the awarding of marks or a score or a value to the
assignment performed
-It is attaching a grade to a learner’s performance in an
examination.
-Some examples of grading include:
• Percentage of 0-100%
• Pass or fail; Good, Average ,Excellent
• Percentiles
• Letter grades, like A,B,C,D,E & F
• Evaluation of student performance is important mainly
because it
• gauges the extent to which educational objectives have been
achieved &
• guides the teacher in deciding what steps to be planned next to
facilitate learning for the students
CURRICULUM DESIGN & DEVELOPMENT
• WHAT IS A CURRICULUM?

• A curriculum is a description of all that takes place in an

educational institution from the first day of training to the
last day of training.
• A curriculum is also the document in which all the activities ,
transactions &the events of a training program are described
COMPONENTS OF A CURRICULUM
1. A statement of justification
2. Resources
3. Entry requirements
4. Educational goals and objectives
5. Content
6. Learning experience
7. Program
8. Duration
9. Assessment
10.Course description
Components of a curriculum
1.A statement of justification-gives the justification /rationale
& philosophy of the training program & why the programme is
required

2.Resources- It gives an outline of the physical, administrative

& financial requirements for the course. It is also a description
of the minimal facilities in terms of buildings, equipment &
personnel
Ct…..
3.Entry requirements-is a description of the entry requirements
for the students & methods of selection
4.Educational goals & objectives-describing the goals &
educational objectives of the course.
5.Content to be covered in a course according to stated
objectives
6.Learning Experiences-are intended to be descriptions of the
teaching/learning methods to be employed during the
educational program
7.Program-outlines a logical sequence of events
8.Duration-a specification of how long each unit or learning
block should last.
9.Assessment-outlines methods of continuous evaluation, final
certification, remedial activities & referral of failed
candidates
10.Course descriptions-including the title, unit, course objectives,
course content & code for each course taught in the program
Factors influencing the development of
a curriculum
1. Academic factors
2. Social factors
3. Economic factors
4. Political factors
1. Academic factors
• The teachers who teach the main subjects of a discipline often
borrow from their past experiences & merge them with the
current trends of the discipline
• Eg we now have more nurse graduates who are prepared in
advanced nursing practices & we can introduce content that
was not included before
• Incorporation of research in diploma training
• Thus, theories of nursing, trends, research, etc that
were only taught in higher nursing programmes at
university level previously, are now incorporated in the
KRCHN curriculum
• The new content is designed to make the KRCHN
student a more effective practitioner to provision of
quality health care.
2. Social factors
• What is taught has to reflect what is current within the
contemporary society.
• This means it has to be relevant to the needs of the
local people socially & culturally
• eg. HIV/AIDS has had to be included in the content
because it bears a lot of importance to human
existence & is emphasized in all branches of health
care & development
• Gender issues
• VMMC
• Disaster management
• Palliative care:
3. Economic factors
• The cost of implementation of curriculum can determine the
type of health worker trained by a given country.
• In developing countries, we often train staff at a lower level
of education in skills that are usually taught to university
graduates in highly industrialized countries.
• This is because in developing countries, university education
adds a cost burden to the limited resources.
• E.g. midwives in developing countries carry out life saving
measures that are left for experts in industrialized countries.
4. Political factors
• Politicians or political investors can influence the
numbers to be trained & even the level of training.
• E.g. the introduction of the quota system in the
Kenyan basic education system was politically
motivated with the aim that all ethnic groups might
receive equal attention
Participants in curriculum development
• Internal participants:
• They include individuals from professional associations,
ministries of health & education, boards of examinations,
administrators of the training institutions, teachers & students.
• This group of participants is called internal because they
actually have direct involvement in the curriculum & so have
the greater impact on its development.
• They develop the curriculum, teach it & evaluate the
curriculum & the students
External participants
 They do not have direct involvement in the curriculum
development, but they are either beneficiaries of the product,
service or provide resources to facilitate its implementation or
may liase with the institution in various ways.
 This group comprises the community, business, industry & NGOs,
they can easily influence decisions made by the internal group.
 When consulted properly, the 2 groups ought to produce a
curriculum that enables the desired change in health care
services.
STEPS IN CURRICULUM DEVELOPMENT
1. Identification of health problems/needs eg change of
curriculum from KRN to KRCHN
2. Identification of professional roles and functions
3. Performing task analysis on professional roles and functions
4. Development of educational goals and objectives on the basis
of professional functions and task analysis
5. Identification and selection of subject matter/content to be
taught
6. Identification of teaching/learning methods
7. Identification/selection of learning resources
8. Identification of assessment tools to determine learners
performance
9. Execution of the curriculum
10. Curriculum review and change
Types of curriculum / Approaches to
curriculum development
1)Subject-centred approach
-It is carried out by subject specialists, who determine
the subdivision of content, the methods & timing of
instruction.
-It assumes that nursing is a series of discrete
independent disciplines, the sum of which form the
required body of knowledge for a competent health
worker.
2)Integrated approach
-It attempts to integrate or combine in a meaningful way
disciplined knowledge to impart wholesome learning for
student application.

3)Competency-based approach(Task-based approach)

-Aims at identifying professional competencies required &
teaching to achieve competencies in a specified setting.
Typical features of a competency-based
approach
1.The curriculum is organized around the functions of a health
worker in a specified setting
2.The “output”of training is a health worker who can practice at a
defined level of proficiency in accordance with local conditions.
3.It is assumed that the majority of individuals can master the
required level of proficiency-given appropriate instruction &
sufficient time.
• NB:The approach emphasizes that the setting within which the
health worker will be expected to operate is an extremely important
determinant of the required level & type of competence
Advantages/Disadvantages of these
approaches
a) The subject-centred approach emphasizes the acquisition of
disciplined knowledge rather than its application.
b) In the integrated approach,knowledge can be wholesome &
meaningful but integration may fall short of adequate
vertical & horizontal integration.
c) The competency-based approach is preferred for
professional training by most curriculum developers.
Disadvantages of Competency-based
approach
1.The dynamic nature of jobs-when jobs change, health workers may
be stranded unless continuing education is provided & this may be
costly
2.Lists of tasks to be mastered-normally, this list is long & demands
that the duration of training be prolonged. This can also turn out to
be costly.
3.It focuses on tasks which health workers perform (operative
competencies)This is a major handicap when the health worker is
exposed to situations which demand initiative &independent
thinking eg. when drugs/equipment change, the health worker
cannot adopt
Summary: components of a curriculum
• Objectives
• Content
• Teaching methodology
• Assessments
• Entry requirements
• Program schedule
TASK ANALYSIS
• DEFINITION
• The process of breaking down a task into sub tasks which are
necessary to achieve that task
• Involves the following steps:
a) Identifying a job
b) Listing the tasks
c) Selecting the task for analysis
d) Listing the actions involved in performance of the task
e) Identifying knowledge, skills and attitudes
Uses of task analysis
• It can be used for assessment of students
• Can be used in choosing the appropriate teaching methods
• Can lead to relevant objective leading to appropriate content
OSCE
• It is the assessment of practical skills trained in a skills lab at
the end of semester 1 and 2
• From all the skills training during the semester, a minimum of
30% shall be assessed during OSCE
• Critical skills have to be assessed while assessment of other
skills varies
• Each OSCE has to be passed with a pass mark of 70% before the
student can proceed for clinical placement