PSTMLS REVIEWER

choice of instructional activities, materials,

LESSON 1: MANAGEMENT OF INSTRUCTION practice assignments, and assessment tasks.
These outcomes are understood by students and
ELEMENTS OF EFFECTIVE INSTRUCTION used to prompt self-reflection and goal setting.

- “Student engagement refers to the degree of - Everyone involved in the learning process must
attention, curiosity, interest, optimism, and passion know where we are going and why the work
that students show when they are learning or being matters.
taught, which extends to the level of motivation
they have to learn and progress in their - Teachers and students need choice in their
education.” learning experiences to be invested in and
- When students are engaged, they are interested achieve outcomes.
and invested in their learning, can explain the
relevance and importance of their work, and their - A culture of reflection is necessary for students to
learning improves. set and adjust personalized goals.
- Student engagement results from the weaving
together of the following elements of effective
instruction by skillful teachers in ways that promote
and facilitate student ownership and choice.

Learning Environment

- The classroom learning environment supports

learning for all students. This includes the physical
environment, the routines and procedures,
classroom management practices and the
development of positive relationships that support Varied Content, Materials, and Methods of
a physically and socially/emotionally safe and Instruction
supportive environment for taking risks, asking
questions and making mistakes. - Ideas and information are explored in varied ways
so that a wide range of learners can find access
- The environment is a shared domain between points to the learning. Materials are selected and
students, teachers, and other partners in learning. available to engage and accommodate all
learners.
- The learning environment is a space that fosters
risk-taking for students and teachers; positive and - Different entry points, options for exploration and
meaningful relationships are the foundation of a end products are critical for student engagement
productive learning culture. and success.

- Learners must see themselves represented in the

materials and connect to the content in authentic
ways.

Clear, Shared Outcomes

- The learning outcomes are shared and

understood by teachers and students. These
outcomes are used as an anchor to guide the
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Complex Thinking and Transfer
- Students are coached and taught to engage in
higher order thinking through instructional activities
and practice tasks. Assessments are designed to
prompt complex thinking, integration of concepts
and ideas, and application of learned skills to new
material or situations.
- Every student is capable of complex thought.
- Higher order thinking promotes student
engagement.
- Learning that promotes transfer of knowledge
and skills prepares students for the future.
Practice and Feedback
- Students are given opportunities to practice what
they are learning and given timely feedback
based on their current performance in relation to
the desired outcomes.
- Learning is a cycle that includes mistakes, multiple
attempts, difficulties, and course corrections.
- Timely, specific, and varied feedback is a catalyst
for growth.
- Productive practice and novel application of skills
are essential for learning.
PROPER MANAGEMENT OF INSTRUCTION IN
TEACHING
- Typical behavior is associated with the desire to
meet the student’s needs which may be personal,
social and academic. When such needs are not
satisfied or even recognized, teaching is
hampered and the opportunity for
learning is reduced significantly.
- While it is accepted that teachers if at all
have little control over changes that occur in the
environment like home and school, the teacher
however has full control over her instructional
competence. The chances of controlling
the effects of misbehavior and all others deter
learning are great.
The following are the underlying principles
- Instructional competence lessens the effect of
negative forces from the environment.
- Recurring misbehavior results from poor
instruction.
- The use of positive approaches/techniques in
teaching arising from complete awareness of the
underlying causes of misbehavior brings about
better learning results.
- Understanding by the teacher of the basic human
needs such as food, security, belonging and
recognition eliminates behavior problems in the
classroom.
- Teachers must be willing to recognize the
student’s needs for instruction to be more fulfilling.
- Teacher behavior facilitates student’s
achievements.
- Effective teaching enhances the teacher’s
instructional competence and helps prevent
classroom management problems.
Planning for Purposeful Instructional
- Planning for effective learning experiences is one
of the skills the teacher has to develop. Planning
insures more or less the direction that his efforts will
take. It helps create whole-some discipline, a
pleasant classroom atmosphere, and purposeful
teaching-learning activities that are free from
waste in terms of time and effort.
- Careful planning can give the teacher a sense of
confidence in overcoming nervousness and
preventing wastage and confusion especially
during the first days of teaching.
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- Planning for teaching involves sequences of
steps. It calls for decisions with respect to each of
the tasks involved. If all these tasks are
accomplished successfully, the prospects that
students will master what has been taught are
excellent. The interrelationships among these tasks
are presented as a cycle.
The first tasks, diagnosing student’s needs and
abilities, imparts to the teacher the necessity of
discovering the needs, interest, and capabilities of
his capabilities of his students.
Systematic techniques are available to the
teacher which he can use in gathering information
about the student’s needs and abilities (Armstrong
& Savage, 1938: 114-24): work samples;
conferences; anectodal records; checklist; interest
inventory; teacher test; and cloze test.
The second task, setting up of objectives and
selecting content, involves selecting appropriate
learning materials suited to the needs and interest
of the students. The instructional objectives
describes what the students are expected to do at
the completion of the instructional sequence to
show they have learned.
The third task is preparing the setting for learning
and selecting instructional strategies. Once the
objectives have been established, the teacher has
to decide on the technique that will help the
students achieve the goals. To provide for an
intellectual settings and an emotional atmosphere
conductive to learning, it will help the teacher to
keep in mind that an orderly, well-disciplined class
is essential for successful teaching and learning.
Good classroom management is a perquisite to
the maintenance of discipline and control in a
class. Many teachers usually find discipline
and control of classes very difficult.
The fourth tasks is formalizing units and
making lesson plans. This involves
organizing information about individual
students, objectives, materials and techniques
into a resource unit that can serve as reference
to the teacher as he does his
work from day to day.
- An instructional unit is planned sequence of
learning activities or lessons covering a period of
several weeks and centered around some major
concepts, mainly content-oriented lessons or semi-
individualized, laboratory-oriented, experience-
oriented unit assignments, or any of a variety of
combinations. Some units may be shorter than
two weeks but others maybe longer than six weeks
in length (Clark and Starr, 1981:144).
- Instructional units provide the teacher with
opportunities to use his creativity as he plans
instructional sequences systematically for students.
In planning the units, the teacher has to take into
account the needs and the varying levels of the
students. He has to consider individual differences
among students and has to be selective, taking
care, taking care that relevant topics are not
omitted.
- Units are generally designed to be taught over a
number of days. After they have been developed,
the teacher has to prepare more specific plans for
a given period. These are called lesson plan,
consisting of very specific outline describing in
detail what the teacher and the students will do on
a day to implement the unit’s objectives. Lesson
plans give a sense of direction and organization to
both teacher and students.
CREATE A LESSON PLAN
Content or Subject Matter and Materials
- The teacher indicates the subject matter that he
believes will help attain his objectives. This may be
indicated as generalizations in outline form.
Sometimes, it can be a part of the procedure or it
can be written on a separate sheet of paper if
the teacher wants more details in the outline.
- The teacher should also consider the materials
and equipment that he may need. Illustrations and
posters may be prepared to help students
concretize what are to be emphasized.
Procedure or Strategy
- The teacher should write down in the order of
occurrence the activities that he and his students
are going to do during the period.
- He should avoid skimping the planning of the
teaching procedure. He should not just indicate
“lecture on the principle of capillary for 15 minutes”
- what he will says and the questions he will
asks;
- the main points he will bring out; and
- the experiments he may ask students to
under- take. It is not enough that he
indicates some problems that will be done
on the board.
- The teacher should plan which problems he
should work out the answer to beforehand. If he
plans to ask questions, he should decide what
questions to asks and the answer to the most
important ones. Student teachers and new
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teachers are usually required to indicate “Teacher

Activity” and “Student Activity”. The elements
under procedure may vary according to the
subject matter and grade level of students.

CREATE A COURSE SYLLABI

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LESSON 2: CLASSROOM MANAGEMENT

What is Classroom Management?

- Classroom management is the process of

creating and maintaining orderly classrooms. It is
what you do to prepare the lesson, the
environment, and the
students for learning.

- Is the way of organizing the resources, pupils and

helpers so that teaching and learning can process
in an efficient and safe manner.

- Satisfaction and enjoyment in teaching are

dependent upon leading students to cooperate.

- Classroom management issues are of highest

concern for beginning teachers.

Effective classroom management consists of

teacher behaviors that produce:

- high levels of student involvement in classroom

activities

- minimal amounts of student behavior that

interfere with the teacher’s or other students’ work

- efficient use of instructional time

Importance of Classroom management

- keeps students motivated to continue their work

- allows more time for the teacher to teach the

lesson to the students

- keeps disruptive behaviors down to a minimum

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PRINCIPLES OF CLASSROOM MANAGEMENT
Consistent, proactive discipline is the crux of
effective classroom management
- Prevention is better than cure”, so goes the
adage. If we are proactive in our approach to
discipline we prevent unnecessary disciplinary
problems from cropping up. We have not to wait
for disciplinary problems to erupt for us to take a
move.
Establish routines for all daily tasks and needs
- Routinized collection of assignments, passing of
papers, and preparation for experiments saves as
a lot of time and effort. We have not to explain or
instruct our pupils/ students on how to pass papers,
collect assignments, prepare for experiments day
in and day out because we have established the
routines for these everyday tasks. They have
become habitual for each member of the class.
Orchestrate smooth transitions and continuity of
momentum throughout the day
- Smooth transitions and continuity of momentum
throughout the day ensure us that every
instructional moment is made use of wisely. No
unnecessary lull is created that will breed
classroom restlessness, which is the father of
disciplinary problems.
Strike a balance between variety and challenge in
students’ activities.
- A variety of student activities will ensure that
students’ multiple intelligences and varied learning
styles are considered in the conduct of student
activities. Most of the time our activities fall under
the word use, talking, writing will certainly
challenge the linguistically intelligent students but
bore the logic and math wizards and other groups
of different intelligences. When boredom creeps
into the classroom, we have disciplinary problems
in our hands.
As classroom manager, be aware of all actions
and activities in the classroom
- Our heightened awareness of everything that is
happening in our classroom puts our pupils and
students on their toes all the time. While our back
faces them when we write on the board, our “eyes
on the back of our heads” will make our pupils and
students feel that we know what they are doing.
Resolve minor inattention and disruption before
they become major disruptions
- The old adage “a stitch on time saves nine aptly
applies here. We have not to wait until our class is
out of control. Misdemeanor has a “ripple effect” if
not checked early. Conflagration begins with a
spark. Put out the spark early enough to avoid
conflagration. We ought to respond to
inappropriate behavior promptly.
Reinforce positive behavior
- Be generous with genuine praise. Some teachers
are quite stingy with praise. These are the teachers
who think will become less when they praise others.
They have the so-called “subtraction mentality.”
Other teachers are overgenerous with their praise.
Their praises overflow so much that they give praise
even when is not appropriate. For our praise to be
genuine it must be given according to merit. It is
our way of appreciating and recognizing hard
work and good behavior.
Treat minor disturbance calmly
- “Do not make a mountain out of a mole.” If a stern
look or gesture can kill the inappropriate behavior
so be it. That’s the end period! Let us not make a
fuss about it.
Work out a physical arrangement of chairs that
facilitates an interactive teaching-learning
process.
- There is no doubt that external environment
affects us. The most common arrangement of
tables and chair in the classroom is one where the
teachers’ table and chairs are in front and the
student’s desk or chairs are arranged in rows facing
the teacher. This seat arrangement does not
always enhance interaction among students.
Let us work for a flexible seating arrangement
where we can re-arrange seats or desk to suit our
learning needs and conditions.
Make good use of every instructional moment.
Minimize discipline time to maximize instructional
time.
CLASSROOM MANAGEMENT TECHNIQUES
Management of Time
- Time is of the essence in learning. How much
students learn depends upon the amount of time
they spend in learning. The impact of time however
on achievement is influenced also by the quality of
instruction and the learning tasks. No matter what
amount of time is spent, no learning takes place if
there is poor instruction and poorly devised
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learning tasks. It is observed that classes where
students are occupied with learning activities,
where time is managed properly, learned more.
- Orchestrate smooth classroom transitions.
- Remain involved with the students during the
entire class period allowing for no idle time.
- Use fillers, in case you finish the lesson ahead of
time. Examples of fillers are reciting a favorite
stanza then letting others explain the meaning or
conducting a short contest about the lesson.
- Use a common place to keep materials such as
scissors, school supplies. This saves time.
- You have not to look for them when you need
them.
- Follow a consistent schedule and maintain the
procedures and routines established at the
beginning of the year.
- Prepare materials in advance.
- Make clear and smooth transitions.
- Limit disruptions and interruptions through
appropriate behavioral management technique.
FOR QUALITY OUTPUT WITHIN AN ALLOTTED PERIOD,
HERE ARE SOME SUGGESTIONS:
- Schedule all activities with corresponding time
allotment way ahead of time. Early preparations
could avoid haste and confusion.
- Provide enough time for everything you expect to
happen.
- Avoid rushing since you know you have carefully
allotted required time for every activity. Quality
may suffer.
- Anticipate difficulties or failure of some operations
in order to be able to pursue alternative actions
- Be flexible with time assignments. If students are
observed to be so interested and eager to
continue working, allow a little more time for them
to complete and achieve the objectives with
satisfaction.
- Set the example by showing that you are time-
conscious. They will develop the same precision
regarding time utilization.
Management of Discipline
- Discipline is controlled behavior. It constitutes the
next important concern of teachers as part of
good management. No matter how well-
managed a learning environment is, students will
occasionally misbehave. Teachers must be ready
to deal with them with utmost care and
consideration.
SOME CAUSES OF DISCIPLINARY PROBLEMS
- Unfavorable learning conditions
- Teacher’s poor management skills
- Students’ varied background
HOW TO PREVENT DISCIPLINE PROBLEMS
- implement group-oriented methodologies such
as:
1. cooperative learning approach
2. team learning
3. peer tutoring, and
4. Group projects and collections.
- use varied teaching techniques
- develop patience, compassion, genuine respect
and care for the students.
- Discipline is the students’ responsibility. If they
misbehave, the teacher accepts no excuses. They
must be ready for the consequences.
- Discipline is the teachers’ way of establishing a
desirable student- oriented environment for
learning.
- Discipline is coupled with effective teaching
strategies and techniques.
- Discipline is achieved through the effects of group
dynamics on behavior.
- Discipline is believed to be the exclusive
responsibility of the teachers.
Acceptable ways of dealing with discipline
problems
1. Use verbal reinforcers that encourage good
behavior and discourage bad tendencies.
2. Use nonverbal gestures, frown or a hard look to
dissuade them from mischiefs.
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3. Dialogues can help in discovering problems and
agreeing on mutually beneficial solutions
4. Focus attention on one who is unruly and is about
to disturb the neighbors.
5. Award merits for good behavior and demerits for
inconsistencies and lapses.
6. A private one-on- one brief conference can
lead to a better understanding of mistakes that
need to be remedied or improved.
7. Give students the free to express or explain
agitated feelings and misgivings rather than
censure them right away.
Unacceptable ways of dealing with discipline
problems
1. Scolding and harsh words as a reprimand will
have a negative effect on the entire class.
2. Nagging and faultfinding, together with long
“sermons” are repugnant and nasty.
3. keeping a student in a “detention area” during
or after classes as a penalty for misbehavior is a
waste of time and occasion for learning. The
shameful experience is not easy to forget.
4. Denying a student some privileges due to
unnecessary hyperactivity can all the more
encourage repetitions
5.Assignment of additional homework compared
to the rest can make them dislike the subject.
6.Use of ridicule or sarcasm could humiliate and
embarrass a student.
7.Grades for academic achievement should not
be affected due to misdemeanor.
Management of Physical Environment
- FURNITURE ARRANGEMENT
- SEATING ARRANGEMENT
- PHYSICAL CONDITION OF THE CLASSROOM
Management of Routines
Refers to the established activities or procedures
that are repeatedly done.
1. Teach pupils to learn how to form various
grouping and return to standard arrangement with
minimum confusion.
2. Do not use the first few minutes of the class
session to collect materials when students are
potentially most alert to instruction
3. “Overlapping” technique is used for collection
and distribution of materials. It refers to the
teacher’s ability to attend to the task at hand
and at the same time prevent an extraneous
situation from getting out of control.
4. Prepare for transition by planning distinct types
and sequences of teacher- pupil activity e.g.
checking homework assignment, presentation of
new material, giving assignment, monitoring
seatwork. Transition should be quick and quiet
Management of Relationship
This refers to emotional climate and
communications affecting learning conditions.
1. Maintain positive climate characteristics which
allow students to choose a variety of activities to
achieve common goals.
2. Develop sense of interdependence, common
bonds, defined group expectations and
relationship qualities that enhance wholesome
emotional climate
3. Develop communication characteristics that
promote wholesome classroom relationship like
positive constructive conversations aimed at
understanding on another’s point of view.
4 . Render different forms of assistance by providing
class meetings or students to have an opportunity
to examine the ideas and feelings
that influence value judgment.
LESSON 4: TEACHING STRATEGIES
What is Teaching Strategies?
- The classroom is a dynamic environment, bringing
together students from different backgrounds with
various abilities and personalities. Being an
effective teacher therefore requires the
implementation of creative and innovative
teaching strategies in order to meet student
individual needs.
- It refers to the structure, system, methods,
techniques, procedures and processes that a
teacher uses during instruction. These are strategies
the teacher employs to assist student learning.
Learning activities refer to the teacher guided
instructional tasks or assignments for students.
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Visualization
- Bring dull academic into concepts to with visual
and practical learning experience s, helping your
students to understand how their schooling applies
in the real-world.
- Examples include using the interactive
whiteboard to display photos, audio clips and
videos, as well ad encouraging your students to
get out of their seats with classroom experiments
and local fieldtrips.
Cooperative Learning
- Encourage students of mixed abilities to work
together by promoting small group or whole class
activities.
- Through verbally expressing their ideas and
responding to others your students will develop
their self-confidence, as well as enhance their
communication and critical thinking skills which are
vital throughout life.
- Solving mathematical puzzles, conducting
scientific experiments and acting out short drama
sketches are just few examples of how cooperative
learning can be incorporated into classroom
lessons.
Inquiry Based Instruction
- Encouraging students to ask questions and
investigate their own ideas helps improve their
problem-solving skills as well as gain a deeper
understanding of academic concepts. Both of
which are important life skills.
- Inquiries can be science or math-based such as
‘why does my shadow change size?’ or ‘is the sum
of two odd numbers always an even number?’.
However, they can also be subjective and
encourage students to express their unique views,
e.g. ‘do poems have to rhyme?’ or ‘should all
students wear uniform?’
Differentiation
- Assigning classroom activities according to
students’ unique learning needs means individuals
with higher academic capabilities are stretched
and those who are struggling get the appropriate
support.
- This can involve handing out worksheets that vary
in complexity to different groups of students, or
setting up a range of work stations around the
classroom which contain an assortment of tasks for
students to choose from.
Technology in the Classroom
- Assigning classroom activities according to
students’ unique learning needs means individuals
with higher academic capabilities are stretched
and those who are struggling get the appropriate
support.
- This can involve handing out worksheets that vary
in complexity to different groups of students, or
setting up a range of work stations around the
classroom which contain an assortment of tasks for
students to choose from.
Behavior Management
- Noisy, disruptive classrooms do no encourage a
productive learning environment, therefore
developing an atmosphere of mutual respect
through a combination of discipline and reward
can be beneficial for both
you and your students.
- Examples include fun and interactive reward
charts for younger students, where individuals
move up or down based on behavior with the
top student receiving a prize at the end of the
week. ‘Golden time’ can also work for students of
all ages, with a choice of various activities such as
games or no homework in reward for their hard
work.
Professional Management
- With educational policies constantly changing it
is extremely useful to attend events where you can
gain inspiration from other teachers and
academics. It’s also a great excuse to get out of
the classroom and work alongside other
teachers just like you!
- Sessions can include learning about new
educational technologies, online safety training,
advice on how to use your teaching assistant(s)
and much more. Being an effective teacher is a
challenge because every student is unique,
however, by using a combination of teaching
strategies you can address students’ varying
learning styles and academic capabilities as well
as make your classroom a dynamic and
motivational environment for students.
TEACHING METHODS
Common teaching Methods]
- Traditional
- The Internet
- Computer Managed Instruction
- Computer Assisted Instruction
- Computer Technology and Learning
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- Computer Teaching Strategies
- Self-learning Modules
Internet
- Internet is a global system of interconnected
computer networks that use the standard Internet
Protocol suite (IP) to serve billions of users
‘worldwide.
- Educational material at all levels from pre-school
to post-doctoral is available from websites in the
internet.
- The Internet in general and the World Wide Web
in particular are important enablers of both formal
and informal education.
- Internet can be used as a resource for problems,
answers, ideas and more. This can also be used in
a “how to research” lessons and assignments. A
group can also cheaply communicate and discuss
ideas via chatting and online conference (online
class). Messages can be exchanged even more
quickly and conveniently via email or online chat
This may allow files to be exchanged, drawings
and images to be shared, or voice and video
contact between team members.
Computer Managed Instruction
- An instructional strategy whereby the computer is
used to provide learning objectives, learning
resources, and assessment of learner performance
- This aids the instructor in instructional
management without actually doing the
teaching.
- A system in which a computer is used to manage
several aspects of instruction, including learning
assessment through administration of pretests and
posttests; design and preparation of learning
prescriptions; and calculation, analysis, and
storage of student scores. (Google
Classroom/Moodle/Edmodo/schoology, etc)
Computer Assisted Instruction
- A self-learning technique, usually offline/online,
involving interaction of the student with
programmed instructional materials.
- Computer-assisted instruction (CAI) is an
interactive instructional technique whereby a
computer is used to present the instructional
material and monitor the learning that takes place.
- CAI uses a combination of text, graphics, sound
and video in enhancing the learning process.
CAI provides
1. text or multimedia content
2. multiple-choice questions
3. problems
4. immediate feedback
5. notes on incorrect responses
6. summarizes students' performance
7. exercises for practice
8. Worksheets and tests.
Types of CAI
1. Drill-and-practice- Drill and practice provide
opportunities or students to repeatedly practice
the skills that have previously been presented and
that further practice is necessary for mastery.
2. Tutorial- Tutorial activity includes both the
presentation of information and its extension into
different forms of work, including drill and practice,
games and simulation.
3. Games- Game software often creates a contest
to achieve the highest score and either beat others
or beat the computer.
4. Simulation- Simulation software can provide an
approximation of reality that does not require the
expense of real life or its risks.
5. Discovery- Discovery approach provides a large
database of information specific to a course or
content area and challenges the learner to
analyze, compare, infer and evaluate based on
their explorations of the data.
6. Problem Solving- This approach helps children
develop specific problem solving skills and
strategies.
Computer technology and Learning
- How Does Technology Enhance Student
Achievement?
- Advanced Skills Instruction
- Interactive educational technologies, including:
- Computer-generated simulations
- Videodiscs
- Internet
- CD-ROM
- Students learn to: organize complex information,
recognize patterns, draw inferences,
communicate findings
- Learn better organizational and problem solving
skill.
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Computer technology and Learning
- How Does Technology Enhance Student
Achievement?
- Assessment of Student Progress
- More comprehensive with multimedia
- Assessments which require student’s
active participation
- Electronic portfolios
- Student Motivation
- They like it better
- Increased family involvement
- Improved teachers’ skills
- Improved School Administration and
Management
Virtual Reality
- A computer- based, simulated three dimensional
environment in which the participant interacts with
a virtual world.
- Only in virtual reality can the learner enter a virtual
world and feel an object, move it, and measure its
movement.
Self- Learning Module
- These are learning activities designed for
participants to do independently when they are
unable to attend individual or group education
sessions.
HOW TO CREATE A SELF LEARNING MODULE
1. Course Title
- Name of the course/subject
2. Number of Units
- Write the number of units mandated by
CHED/institution.
3. Course Description
- It orients students by outlining the rationale for the
course or theme, a brief overview of the key
content, knowledge, and skills and the major
learning strategies and activities.
4. Course Outcomes
- Identify the unique knowledge and
expected to be gained from given course.
5. Course Outlines
- These are the topics to be covered for the whole
course. (Note: Instead of Topic 1, replaced it with
Module 1)
6. Content Discussion
- Discuss first the learning outcomes based on
CHED/ course syllabus.
- Learning outcomes- based on CHED
sample or suggested syllabus, or course
syllabus.
- Insertion of Instructional Materials- at the
end of every topic, author may insert or
add instructional materials such as movie
clips, videos and etc.
7. Assessment
- In every module, there should be an assessment.
These should be aligned with learning outcome.
- Assessments can be in the form of
- Multiple choice
- Poster display
- Case study
- Essay
- Graded recitation
8. References
- Add the book/journal references you’ve
acquired the information.
LESSON 5: CLINICAL TEACHING AND
COMMUNICATION
Clinical Teaching
- Clinical Teaching is a form of interpersonal
communication between a teacher and a learner.
It solely involves an exchange between a teacher
and a learner. However, this type of teaching now
involves a patient scenario.
- It involves past didactic learning, laboratory
values, physical exam, patient needs, patient
questions which uses subjective, and objective
data to make an assessment. This is based on
medical, pharmacologic knowledge.
- Medical educators often think that their role is to
“provide a lecture” and be a “reservoir of
knowledge” that occasionally and unpredictably
spills over its dam, letting information flow randomly
down a canyon of learning
skills - We must remember that EXPERTISE ALONE IS NOT
SUFFICIENT FOR GOOD TEACHING.
Who is involved in Clinical teaching?
- Clinician Teacher
- Adult learner
- Patient
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The Adult Learning Theory
- Teaching is more effective when:
- Educational needs are identified by
learners
- Learners are ready/motivated
- Set their own goals, take responsibility for
their learning
- Want to select educational content
- Want to participate in decisions affecting
their learning
One Teaching Model
- Orients students; establishes a positive learning
climate
- Elicits student ideas
- Assesses student’s conceptions; involves student
in self-assessment
- Intervenes to correct knowledge gaps (confusion
errors)
- Collaborates with student on best teaching
format
- Allows new knowledge application
- Reviews learning, encourages self-reflection
- “See one, Do one, Teach one”
Barriers to Clinical Teaching
- Time
- Space
- Environment
- Balance patient care with instructing
students
- Patient care “challenges”
- Student learning individualization
Teaching issues for students
- What if the student does not recognize his/her
knowledge limitations?
- What if they cannot formulate clear questions as
to what they want to learn?
- Teacher must first assess the student
- Must understand the stages of learning first
- Must assess the student’s current stage of learning
Stages of Learning
1. Consciously Incompetent - Learner doesn’t
recognize what they don’t know
2. Unconsciously Incompetent - Learner recognizes
that they don’t have insufficient knowledge or skills;
they are learning and practicing
3. Consciously Competent - Learner is aware, they
have sufficient knowledge and skills but have to
consciously think about what they are doing
4. Unconsciously Competent - Learner is not aware
that they have sufficient knowledge/skills and
don’t have to think about what they are doing.
Clinical Teaching Skills
1. Demonstration- Teacher demonstrates at normal
speed, without commentary
2. Deconstruction- Teacher demonstrating while
describing steps
3. Comprehension- Teacher demonstrates while
learner describes steps
4. Performance- Learner demonstrates while
learner describes steps
- Teaching consistent high standards of clinical skills
is core to both the development of safe healthcare
practitioners and the delivery of quality care for
patients.
- A specialized skills teaching center or facility,
whether static or mobile, provides the ideal setting
for facilitating practitioners’ technical and
nontechnical skills while also protecting patients.
Any such facility should be built around a balance
between the needs of the users and those of the
organization.
Clinical skills facilities
- provide specialist expertise for all those who
deliver healthcare services to patients and
communities.
- The success of a clinical skills facility relies on three
key factors: geography of the facility, leadership
and management, and financial infrastructure.
A clinical skills center can be defined in
terms of:
Facilities- should be flexible to enable different
simulations to be undertaken by different sizes of
groups of learners for different levels of simulation.
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- Most clinical skills can be best taught and
learnt in a small-group setting, and so
multipurpose small-group teaching rooms
linked together both geographically and
by audio-visual links provide maximum
flexibility.
- Facilities such as an outpatient, dedicated
ward, theatre and laboratory area can
provide contextual simulations for learners.
Contextual fidelity supports the transfer of
skills to the workplace and creates a
suspension of disbelief to enhance learning
- Every facility needs to be working in
collaboration with the healthcare system to
ensure that teaching and learning reflect
the needs of both current and future
healthcare practitioners.
Specialist equipment- should reflect the reality of
practice in relation to medical equipment and
consumables. Environmental cues are crucial for
learner engagement in simulation events, whether
as a novice or expert.
- increase in the use of technology to provide
realistic simulations, especially of highly complex
technical skills such as laparoscopic techniques.
There is increasing evidence that these virtual
reality simulators can enhance cognitive skills.
- Simulation can develop students
- Communication skills
- History and physical examination
- Noninvasive procedural skills
- Consultation skills
Specialist faculty- Faculty expertise is a definite
prerequisite for a successful clinical skills facility.
- There are a number of different types of faculty in
clinical skills:
- Clinical skills educators with expertise in
the use of simulation
- Clinicians with expertise in communication
skills
- Clinicians with an interest in teaching.
- Faculty have to develop experience in how much
of the simulation they need to prepare the learners
for and how much they should participate in the
event as a facilitator or assessor. They also need to
be trained to be familiar with the use of simulators,
in whatever form, as part of the simulation learning
event.
- Faculty need to be supported by administrative,
academic support and technical staff, the latter of
whom have expertise in maintaining part task
trainers and simulators.
Why is there a need of clinical skills center?
Educational drivers- There is evidence that
rehearsing skills (cognitive, psychomotor and
affective) in preparation for practice reduces the
evidence of adverse events. There is also
increasing evidence that behaviors observed in a
simulated clinical setting can predict how
professionals will behave in the reality of practice.
This ‘knowing how’ can only be gained through
professional clinical experience, which clinical skills
center teaching can enhance through
preparation, deliberate practice and reflection.
Clinical skills centers, through a focus on the learner
rather than the patient, can prepare the novice
clinician for the healthcare environment. Clinical
skills centers can be used to provide standard
reliable evidence of competence to practice at all
levels: undergraduate, postgraduate and as part
of continuing professional development as part of
more robust regulatory requirements.
Political drivers- Patients now have an expectation
that healthcare practitioners will have been
prepared to an agrees standard of competence
prior to their participation in the reality of
healthcare practice. In addition, there has been a
move towards developing national clinical skills
strategies to enhance the quality of clinical skills
and to increase their cost-effectiveness.
Service drivers- Clinical skills facilities, both fixed
and mobile units, have been developed as a result
of changes in healthcare provision (Issenberg
2002). Most developed countries now follow a
system of short inpatient admissions with shift-
working and changing roles and skills within the
healthcare team. Patients are therefore more
reliant on robust chains of communication for their
quality of care. This has affected both the quantity
and quality of students’ clinical
experience.
What should we teach in clinical skills
environment?
REHEARSAL- The use of simulation in the clinical skills
environment enables novice or expert practitioners
to rehearse new skills in their component parts and
then to practice them together without
compromising patient care, and with the support
of a facilitator using a structured program.
REINFORCEMENT- Reinforcement of clinical skills
can be achieved through providing e-learning
support in clinical skills, which enables learners in
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their own time to participate in an interactive
patient scenario, thus linking both technical and
nontechnical skills and providing feedback.
RENEWAL- Clinical skills provide opportunities for
experts in practice to revisit their skills proficiencies
and relearn skills which can fade when seldom
used.
REDESIGN- In developing new ways of working, the
skills facilities provide the opportunity to safely try
out new roles and develop new systems for their
integration into clinical practice.
RISK REDUCTION- There is now a knowledge
platform in relation to how and why adverse
events in healthcare practice occur. Clinical skills
and simulation provide an opportunity to re-enact
critical incidents and also ensure there is no
unwarranted variation in the way skills education is
delivered to different healthcare practitioners.
REGULATION- Clinical skills facilities and simulation
are increasingly being used for assessment, as they
provide objective evidence of ability. Regulation is
of increasing importance in all health professional
practice, as explicit evidence of competence is
required. Increasingly peer assessment is being
used in clinical skills assessment.
RESEARCH- Clinical skills and the use of simulation
are relatively new in the development of capable
and proficient healthcare practitioners, and there
is an opportunity to identify the most effective and
efficient methods through research.
How should we teach clinical skills?
Ker and Bradley (2007) simplified these dimensions
into three key elements:
• Purpose element: Refinement, rehearsal,
research, regulation
• Process element: Reality/fidelity of the simulation
based event
• Participants’ element: Individuals, teams,
organization.
- In the clinical skills environment how the teaching
and learning are carried out is dependent on the
learning outcomes for the session as part of the
overall curricular program.
Approaches to clinical teaching: Technical
1. Cognitive phase: Consciously develop a routine
with cues from facilitator.
2. Associative phase: Deliberate practice to
integrate component parts. Rest periods
interspersed with practice have been shown to be
most effective.
3. Autonomous phase: Skill automatic to enable
cognitive activity.
- Students should be increasingly involved in
identifying how they would like to run the session,
as it is their learning time. Tutoring the same group
each week enables the tutor to identify those who
volunteer and those who are more reticent and
require practice.
Approached to clinical teaching: non-technical
- A useful approach to structuring a nontechnical
skills session with novices includes the SIS-FR
method, which involves structured immersion
and interventions:
S – Set the context and identify roles and
outcomes.
I – Immerse in roles and practice for agreed time
frame.
S – Intervention to summarize progress.
F – Feedback from self, peers and tutor.
R – Refine practice, building on feedback by re-
immersion.
Current Trends in Clinical Teaching
- EVIDENCE BASE FOR CLINICAL SKILLS PRACTICE
- INTERPROFESSIONAL TEAM TRAINING AND
LEADERSHIP SKILLS
- PEER LEARNING IN CLINICAL SKILLS
- TECHNOLOGY
- PERFORMANCE ASSESSMENT
- PREDICTORS OF PERFORMANCE
LESSON 6: MOTIVATION TO WORK
WHAT IS MOTIVATION?
MOTIVATION: is the reason people do the things
they do
- It implies the existence of incentives,
motives and purpose
- Drive, desires, and needs of an individual
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- The reason someone behaves in an
specific way
A. Motive- a desire or need that acts as a stimuli
for action
B. Definitional limitations- implies a cause and
effect model.
- A causal relationship between a motive
and a reaction.
- Example: people may take a statement as
a joke but feels insulted at the same time
C. Attitude- a person’s outward disposition toward
his or her job and coworkers
MAJOR THEORIES OF MOTIVATION: “CONTENT
MOTIVATIONAL THEORY”
Theories that examine the internal forces that drive
the individual toward specific actions
1. Maslow’s hierarchy of needs
2. Alderfer’s ERG needs theory
3. Herzberg two-factor theory
4. McClelland’s achievement motivation
1. Maslow’s hierarchy of needs
2. Alderfer’s ERG Needs Theory
- Clayton P. Alderfer
- Existence (E) needs: physiological, safety, and
other elements necessary to support existence
- Relatedness (R) needs: interpersonal relationship,
acceptance, and belonging
- Growth (G) needs: creativity, challenge, and
personal growth.
Needs frustration- the less a need is satisfied, the
more the desire for it increases.
Frustration regression- the less successful an
individual is in satisfying a higher level need, the
greater the importance of fulfilling the previous
level
Satisfaction progression- as a person satisfies one
level of needs, the desire for higher level needs
increases proportionately
Growth progression- the more growth level needs
are fulfilled, the more intense the desire for
additional growth.
3. Herzberg two-factor theory
4. McClelland’s achievement motivation
David C. McClelland
1. The need for achievement (job, career, and
success)
2. The need for power (control and influence)
3. The need for affiliation (warm, friends,
relationships)
Aroused motivation= strength of motive +
perceived possibility of achieving the objective +
expected value of the objective
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MAJOR THEORIES OF MOTIVATION “Other
MAJOR THEORIES OF MOTIVATION “PROCESS MOTIVATIONAL THEORIES”
MOTIVATIONAL THEORIES”
1. Theory of X and Y (Douglas Mc Gregor) and
Vroom’s Expectancy Theory Theory of Z (W. Ouchi)

- Victor H. Vroom 2. Role of money in worker satisfaction (EE

- Explains behavior as a process of making choices
in direct response to the expected potential for
reward.
1. effort will bring reward
2. the effort expended will be related to the
perceived value of the reward as a person.
Vroom’s Expectancy Theory
5 variables that influence the selection decision:
1. Expectancy- the belief that effort brings
performance and leads to rewards
2. Outcome- the perceived expectancy that he
outcome from the effort will actually realized
3. Instrumentality- the degree of faith in the belief
in the belief that current efforts may make possible
achieving even larger or more long-term rewards.
Lawler)
3. Relationship of maturity and motivation (Erik
Erikson and Chris Argyris)
APPLICATION OF MOTIVATION THEORIES TO THE
WORKPLACE
Pay- material pay (tangible and monetary),
psychic pay (intrinsic rewards) = total motivational
paycheck
Goal Setting- MBO (management by objectives)
and TQM (total quality management)
Leadership, work and job satisfaction
Job satisfaction- the degree to which
employees feel their jobs meet their needs
and wants

4. Valence- the value placed on the available

rewards

5. Choices- a quantified model, called VIE

equation (motivation= Valence +I nstrumentality +
expectancies)

Adam’s Equity Theory

- J. Stacy Adams

- Employees are motivated by the degree of equity

perceived in their work situation. Comparison and
Perception.

Skinner’s Reinforcement Theory

- BF Skinner

- We tend to behave to the way on how we are

treated

1. law of effect
2. Stimulus
3. response
4. Reinforcement
5. Behavior modification