- MIRRORS, SENSES AND LIMITS TO KNOWLEDGE
- SCHOLARSHIP OF TEACHING & LEARNING
- COURSE DESIGN AND PLANS
- FEEDBACK ON TEACHING
- FACILITATING OUTREACH, EXHIBITIONS AND MEDIA
Mirrors, senses and limits to knowledge
Teaching history of medicine is to act as a mirror for students to reflect on their role as future health professionals, to instill identity, to give tools for professional agency, and to prepare students for working with patients and colleagues from other backgrounds. I try to achieve this goal through a philosophy of making the familiar unfamiliar, through showing how similar issues have been solved differently at different points in time, through revealing how everyday objects or practices have fascinating and often surprising genesis, and through sharing anecdotes the students can share with their friends and family. Ideally, my teaching creates memorable experiences that force the students to think, that inspire them to learn more, and that can be recalled in future key decision moments.
My teaching philosophy has developed through three distinct stages. When I began as a teachers’ assistant at the history department in 2006, I was quite narrowly text- and feedback oriented. The courses used portfolio assessment. The students wrote several essays throughout the semester, gave written feedback to their classmates, received written feedback from the teacher, and finally handed in revised versions for assessment. While I still believe in learning by doing to master a craft, there were also drawbacks. Individual feedback is time consuming and does not scale well, I spent disproportionate time on students who were struggling at the expense of those who did well, and the students ended up experts in a narrow topic rather than achieving a broader overview. A lasting lesson is that students learn more as active participants than passive audiences, and that the activities must be tailored to the intended learning outcomes. Letting one of the tasks be students giving feedback on other’s work, might be one way solve the problem of scale.
My second phase started in 2011 when I began lecturing in a large introductory course at the faculty of humanities. My focus became self-centered and content oriented. Preparing classes, I wrote full manuscripts to be read verbatim. They included when to pause and when to change slides, as I was nervously trying to cover as much content as efficiently as possible. My teaching philosophy was simply to try to be enthusiastic in my delivery of the manuscript. I still believe enthusiasm is a necessary component in learning, still use manuscripts when delivering papers at conferences, and the manuscripts are helpful in ensuring preparation time is spent on improvement rather than reinventing. On the other hand, preparing a manuscript is time consuming, leads to lecturer-centered detail orientation, and leaves out the most important part of the teaching – student learning. From this, I learned the value of preparation (albeit with a better focus), documentation, and continuous striving to improve student learning.
My third and current phase started as I began teaching at the medical faculty in 2018, and no longer had future historians as my main audiences. I quickly realized medical students think differently, and that I needed a better understanding of what motivates them in order to make my teaching relevant. Through informal discussions, lunches, and a feedback seminar, I learned that their primary focus is on fulfilling their professional roles towards patients, and on achieving good grades on their final standardized multiple-choice exams. This makes the students solution-oriented and excellent memorizers. However, Bildung (dannelse) and reflection are less of a priority. In order to motivate the students to learn about history, I now put more emphasis on making the relevance of the learning outcomes obvious, explicit and applicable – for instance what health system reforms older patients have experienced, and how that might have shaped expectations.
Relevance also means being aware of the students’ context. I now check what other topics students cover the same week and relate to recent announcements made in MittUiB. In order to make my teaching relevant, I relate to present events and possible applications whenever possible. My most recent lectures on the history of the health system, for instance, have started with the corona virus outbreak and how the health system developed in response to similar threats in the past. When relating to current events seems too forced, I try to start my classes with a memorable but surprising case that I then return to from different angles throughout. Teaching source criticism, for instance, I found “fake news” an overused cliché. Instead, I started with the Donation of Constantine, and details on how Emperor Constantine allegedly was told that to cure his leprosy he needed to take a bath in a fountain filled with the still warm blood of children. That the donation itself was a forgery, and how this was uncovered, becomes the starting point for how critical thinking has developed over time. The case, which I then return to, gives the students both a memorable anecdote, a tool to remember the content for the rest of the lesson, and help them grasp how the core concept of source criticism has developed over time.
Although storytelling remains at the core of my discipline and how I teach, my focus on student learning now goes beyond what is told with words. An important insight is Dugan Laird’s argument that learning occurs when more senses are stimulated (Approaches to teaching and development, 1985). During the opening week for new medical and dentistry students, I arrange a walking tour to the leprosy museum. This is based on the idea that visiting venues for medical breakthroughs and patient experiences is a more memorable introduction to Bergen than simply being told these places exist. Similarly, for my course on the history of psychiatry I moved some of the teaching to a psychiatric hospital, and during the covid-19 pandemic I arranged historical walking tours for exchange students who are otherwise isolated.
Another expression of the conviction that students learn through experiences is teaching using historical objects. I believe students remember the birth of the Norwegian health system better when presented with a plague mask from the period, and that a syringe and a soap bar is more evocative way of making students reflect on what medical technologies save lives, compared to a diagram. I have also used this approach in outreach for school children (video).
An extension of teaching through objects is to shape the physical surroundings in which learning takes place. I am currently involved in organizing the faculty’s medical collections, and a long-term goal is getting students involved in creating exhibitions to shape the physical context for learning (and research). Whether teaching online or in lecture halls, the setting is part of the learning experience. Although this will take years, if not decades, the work must begin sooner rather than later.
Instead of a singular approach, I see my continued growth as an educator as a matter of expanding my toolbox. Some classroom strategies are straightforward, such as making sure my Prezi- and PowerPoint presentations are varied and include video clips, figures, historical photos and artworks, poetry, bullet-points, and quotes. Increasingly, my emphasis has been on tools for student activities. Students learn more when guided to tease out lessons from the past, compared to simply being told. As values and ideologies have changed over time, history invites the students to identify their own meanings. In larger classes (50+ students), I use think-pair-share. Smaller classes (>20 students) invite more advanced group discussions. A tool that has worked in both settings, is to bring pencils and printouts for students to take guided notes throughout the lecture, instructing them to review these and the slides for their final exam (examples).
Finally, I believe it is important that medical students see the limits of their own expertise. Not all questions have a single correct answer. When making strategic decisions with long-term implications, perspectives and expertise from different fields – including, but not limited to, patients and their relatives – must be represented. Although this is difficult, I hope to teach my students to recognize key strategic moments with long-term implications, and that they develop an instinct for when to invite necessary expertise. One approach to this, inspired by my convictions on Bildung, is to include at least one recommendation for further reading from literature or poetry. To grasp the last Norwegian famine, I recommend Henrik Ibsen’s poem Terje Vigen; to grasp epidemics, I recommend Albert Camus’ The Plague. These texts approach complex issues from different angles than students get familiarized with during the rest of their education, and hopefully invite reflection on their own practices.
To me, student learning is not the ability to memorize details – for this they have Google. Instead, my discipline offers an opportunity to take a step back and reflect on the bigger picture: How have issues we face today been faced before, and what lessons are learned? To summarize, my teaching philosophy centers on creating memorable and authentic experiences relevant to the specific audience, contextualized and tailored to the constraints given. My role is to present the past as a mirror to the present, and a guide to the future.