How do we choose what to assess?

Assessing content (facts) for the sake of it – for the most part – is a useless activity because it tells us almost nothing about how students can use the facts to achieve meaningful objectives. On the other hand, how do you assess students’ ability to apply what they’ve learned? The first is easy (i.e. assessing content and recall), while the second is very difficult (i.e. assessing how students work with ideas). If we’re honest with ourselves, we have a tendency to assess what is easy to assess, rather than what we should assess.

You can argue that your assessment is valid i.e. that you are, in fact, assessing what you say you’re assessing. However, even if the assessment is valid, it may not be appropriate. In other words, your assessment tasks might match your learning outcomes (i.e. they are valid) but are you questioning your outcomes to make sure that they’re the right outcomes?

Are we assessing the things that matter?

SAAHE 2016 conference

I usually post my notes after a conference but this year at SAAHE I mainly used Twitter to keep track of my thoughts during the sessions, which was great because we probably saw more activity on Twitter in PE than ever before. Here is the conference feed using the #saahe2016 hashtag.

Note : While it’s great that Twitter gives you the ability to embed a conference feed in a post like this, I always wonder what will happen when Twitter goes away?

Where does the path of least resistance lead?

Human beings are psychologically predisposed to do the easiest thing because thinking is hard and energy intensive. We are geared through evolution to take short cuts in our decision making and there is little that we can do to overcome this natural predisposition to take the path of least resistance (see System 1 and System 2 thinking patterns in Kahneman, 2011). The problem with learning is that the easy choice is often the least effective. In order to get students to do the hard work – overcome the resistance – we should encourage them to strive towards a higher purpose in their learning, as opposed to simply aiming for a pass. Students – and lecturers for that matter – almost always default to the path of least resistance unless they have a higher purpose that they are working towards. If we want students to achieve at high levels, then the path of least resistance must lead to failure to complete the task. Making the easy choice must lead to poorer outcomes than doing the hard work, but so often students can pass without doing the hard work. We must therefore create tasks that are very difficult to pass without doing hard cognitive work.

Kahneman, D. (2011). Thinking Fast and Slow.

Providing students with audio feedback

I’ve started providing my students with audio feedback on a set of about 60 clinical case studies that they recently submitted. I was depressed at the thought of having to write out my feedback; I tend to provide a lot of detail because I almost always try to provide a rationale for the comments I’ve made. I want the students to understand why I’m suggesting the changes, which can be really time consuming when I have a lot of documents.

This semester I decided to try audio feedback (Cavanaugh & Song, 2010) as a method of providing input on the students’ drafts and I have to say, it’s been fantastic. I take about the same amount of time per document (10 – 15 minutes) because I find that I give a more detail in my spoken feedback, compared to the written feedback, so this is not about saving time. I realised that when I write / type comments there are some points I don’t make because in order to explain the reason for the comment would take more space than the margin allows.

In addition, I’ve found that I use a more conversational tone – which the students really appreciate – and because I’m actually speaking to the student, I pay less attention to line items e.g. spelling corrections and punctuation issues. In other words, I give more global comments instead of local comments, and obviously don’t use Track Changes. As I mentioned earlier, I provide more detail, explaining the reasons behind certain points I make, going into the reasons for why it’s important that they address the comment.

Students’ have given me feedback on this process and 100% of those who responded to my request for comment have suggested that this method of receiving feedback is preferable for them. One of them reported that hearing my comments on his draft allowed him to “hear how I think”. This comment reminded me of the thinking aloud protocol, which is a way for experts to model thinking practices to novices (Durning et al. 2014). This insight led to a slight change in how I structured the feedback, where I now “think” my way through the piece, even pausing to tell the student that I’m struggling to put into words an impression or feeling that I experienced while reading. I try to make it as “real time” as possible, imagining that I’m speaking to the student directly.

I record to .mp3 at a sample rate of 44 K/Hz and a bit rate of 128 kbit/s, which offers decent audio quality at a low enough file size to make emailing feasible. This is my basic process for recording audio feedback:

  1. Read through the entire document, making mental notes of the most important points I want to make
  2. Go back to the beginning of the document and start the recorder
  3. Greet the student and identify the piece I’m commenting on
  4. Provide an overview of my thoughts on the document in it’s entirety (structure, headings, logical flow, etc.)
  5. Work through the different sections of the document (e.g. Introduction, Method, Results, etc.), providing more detailed thoughts on the section, pausing the recorder between sections to give myself time to identify specific points I want to make
  6. End with a summing up of what was done well and the 3-5 major points that need to be addressed
  7. Stop the recorder, rename the audio file (student name – course code – title) and email it to the student


Open online courses in health professionals education – A scoping review

I’ve been working with Stephen Maloney and Christian Osadnik at Monash University on a scoping review of open online courses in health professionals education, which we submitted to ER-WCPT. We’ve since changed the protocol to a systematic review (the main difference being the lack of critical appraisal in the scoping review) but I’ve left the protocol as is for this post. Here’s the abstract that was accepted for presentation at the conference in Liverpool later this year.

Despite increasing calls to integrate technology into health professions education, evidence to guide its effective implementation is lacking. Open online courses (OOCs) have emerged in the higher education space and may offer promise for health professions education. However, the uncritical nature of current discourse around OOCs means informed choices regarding the pedagogical value of this approach are difficult to make. The aim of this scoping review was to identify the current landscape of OOCs in health professions education, placing emphasis on issues regarding implementation and evaluation.

The study protocol followed the framework proposed by Arksey & O’Malley (2005). Electronic database searches were conducted in Ebscohost, PubMed, PloS One, PloS Medicine and Embase to identify publications from years 2008 – 2015. A comprehensive list of keywords and synonyms associated with allied health disciplines and “open online course” was used for searching. Grey literature was identified via Google Scholar. Eligibility criteria were applied independently by two study authors to determine study inclusion. Data were extracted using standardised templates and synthesised according to a framework of: economic value, pedagogical value, feasibility and acceptability, and measures of effectiveness.

From 104 citations, 33 articles were included in the review and were analysed using the following themes: feasibility and acceptability, effectiveness, economic value, and pedagogy. Most of the articles reviewed simply accepted OOCs as an inherent good in HPE, with few adopting a critical stance. This was especially evident when looking for evidence of effectiveness and economic value of OOCs. In addition, health professions educators have varying interpretations of the meaning of ‘open’ in OOCs, with few mentioning issues of licensing. Few of the articles described course design, and none reported on the use of learning theory to inform the design. In addition, there was almost no attempt by any of the authors to determine if any actual learning took place in the courses. There is an emerging acceptance of OOC in HPE, as seen by the increase in publications in this area in recent years. In general, findings were most often presented in the form of analytics that were gathered during participant engagement in the online environment.

There is a wide variety of interpretations among health professions educators on the meanings of “open” in the context of OOCs, with very few articles making any reference to the licensing issues inherent in the method. In addition, the lack of theoretical framework underpinning the OOCs considered in this review highlights significant pedagogical weaknesses limiting their application to the evidence-based clinical education setting. Most authors in this area seem to regard OOCs as having economic and pedogogical value, but few provide evidence to support the claim.

Health professions educators who want to integrate OOCs in their curricula should be wary of informing their decisions with the current research in the domain. We suggest that there is a need for more rigorous research into the use of OOC in HPE and recommend that educators using this approach pay particular attention to the effectiveness and pedagogical impact of OOCs.


Psychology’s top 20 principles for enhancing teaching and learning

Every once in a while an article is published that you know is Important and that you should take Note of, and in this post I’m going to summarise a paper that I think fits into that category. It’s a recent publication in Mind, Brain and Education that attempts to summarise and explain the Top 20 principles of teaching and learning, as determined by the last few decades of psychological research. The article is called Science Supports Education: The behavioural research base for Psychology’s top 20 principles for enhancing Teaching and Learning, and it’s by Lucariello, Nastasi, Anderman, Dwyer, Ormiston, and Skiba. See the bottom of this post for the abstract and citation information.

After a brief introduction and description of the Methods the article gets stuck into the principles, which I’ll list and describe below. For some reason, Principle 8 – on the development of student creativity – is not included in the paper and no explanation is given for the omission.

Principles 1-8: How do students learn?

1. Students’ beliefs or perceptions about intelligence and ability affect their cognitive functioning and learning: If students believe that intelligence has a fixed value, they are less likely to learn than if they believe that intelligence can be changed. Teachers should communicate to students that “…failure at a task is not due to lack of ability and that performance can be enhanced, particularly with added effort or through the use of different strategies.”

2. What students already know affects their learning: Students prior knowledge influences how they incorporate new ideas because what they already know interacts with the new material being learned. This is an especially important concept when considering students’ misconceptions and how those misconceptions impede new learning. Teachers could create tasks that give students an active role in confronting and then reducing their cognitive dissonance.

3. Students’ cognitive development and learning is not limited by general stages of development: Cognitive growth is uneven and not linked to stages. Therefore, teachers’ ideas around how, and what new material should be presented, are more effective when they can take into consideration the domain-relevant and contextual knowledge of their students.

4. Learning is based on context, so generalizing learning to new contexts is not spontaneous, but rather needs to be facilitated: In order for learning to be effective, it should generalise to new or different contexts and situations. However, student transfer of knowledge and skills is not spontaneous or automatic. Teachers could therefore teach concepts in multiple contexts so that students can recognise contextual similarities, and focus on the application of their knowledge to the real world.

5. Acquiring long-term knowledge and skill is largely dependent on practice: What people know is laid down in long-term memory and information must be processed before it can move from short-term to long-term memory. This processing is accomplished through different strategies, and practice is key. Teachers should consider a variety of frequent assessment tasks given at spaced intervals (distributive practice). In addition, interleaved practice (a schedule of repeated opportunities) to rehearse and transfer skills or content by practicing with tasks that are similar to the target task, or using several methods for the same task, is also recommended.

6. Clear, explanatory, and timely feedback to students is important for learning: Students should receive regular, specific, explanatory, and timely feedback on their work. Feedback is more effective when it includes specific information that is linked to current knowledge and performance to clear learning goals. Teachers should consider providing feedback on assessment tasks – particularly after incorrect responses – in order to improve classroom performance in the future.

7. Students’ self-regulation assists learning and self-regulatory skills can be taught: Self-regulatory skills include setting goals for learning; such as planning, and monitoring progress; and self-reflection, which consists of making judgements about performance and self-efficacy in reaching goals. Self-regulatory skills include the regulation of motivation, which consists of students’ knowledge, monitoring, and active management of their motivation or motivational processing. Teachers can teach these skills directly to learners, by modelling strategies or coaching on their effectiveness. Teachers can also provide opportunities for learners to set goals and manage their attainment and for self-appraisal. A reflective community also can be established by teachers.

8. Missing from this paper

Principles 9-12: What motivates students?

9. Students tend to enjoy learning and perform better when they are more intrinsically than extrinsically motivated: Learners who are intrinsically motivated engage in academic tasks for the pure enjoyment of such engagement, and are more likely to achieve at higher levels and to continue engaging with activities in the future. Intrinsic motivation is linked to effective learning because students persist longer at tasks, experience lower levels of anxiety and develop positive competence beliefs. Learners who are extrinsically motivated engage in tasks in order to receive a reward or avoid a punishment, and are at risk for a number of problematic long term outcomes. Teachers can facilitate intrinsic motivation by de-emphasising high-stakes assessment, by allowing students to engage in projects they are interested in, encouraging students to take academic risks and by ensuring that students have enough time to engage with tasks.

10: Students persist in the face of challenging tasks and process information more deeply when they adopt mastery goals rather than performance goals: When teachers emphasise test scores, ability differences, and competition, students are more likely to adopt performance goals. Moreover, when test scores and grades are presented publicly, students are encouraged to focus on performance goals. In contrast, when teachers emphasise effort, self-improvement, and taking on challenges, students are more likely to adopt mastery goals. At the same time, they are likely to use effective and more complex cognitive strategies, to persist at challenging tasks, to report being intrinsically motivated, and to report feeling efficacious. Mastery goals are therefore more likely to be adopted when grades and test scores are shared privately and not compared across individuals.

11. Teachers’ expectations about their students affect students’ opportunities to learn, their motivation, and their learning outcomes: In classroom settings, teachers’ expectations for students’ successes and failures influence student achievement and motivation. When educators hold high expectations for their students, they often rise to the occasion and achieve at high levels (provided that the necessary support structures are in place). In contrast, when teachers hold low expectations for student success, students may come to believe that they lack skills and abilities, and thus confirm the teachers’ expectations. It is important to understand that teachers may interact differently with students, and provide differential instruction, based on their expectations for each student’s success or failure, regardless of how accurate those expectations are.

12. Setting goals that are short term (proximal), specific, and moderately challenging enhances motivation more than establishing goals that are long term (distal), general, and overly challenging: Goal setting is the process by which an individual sets a standard of performance and is important for motivation because students with a goal and adequate self-efficacy are likely to engage in the activities that lead to achievement of that goal. Three properties of goal setting are important for motivation. First, short-term goals are more motivating than long-term goals because it is easier to assess progress toward short-term goals. Students tend to be less adept at thinking concretely with respect to the distant future. Second, specific goals are preferable to more general goals because it is easier to quantify and monitor specific goals. Third, moderately difficult goals are the most likely to motivate students because they will be perceived as challenging but also attainable.

Principles 13–15: Why are social context, interpersonal relationships, and emotional well-being important to student learning?

13. Learning is situated within multiple social contexts.

14. Interpersonal relationships and interpersonal communication are critical to both the teaching–learning process and the social–emotional development of students.

15. Emotional well-being influences educational performance, learning, and development.

These principles are interrelated and are represented in theory and research relevant to schools as systems that support psychological (social and emotional) well-being as well as cognitive development and academic learning. According to developmental–ecological theory, the child or learner is best viewed as embedded within multiple social contexts or ecosystems (e.g., school, family, neighbourhood, peer group), that influence learning:

  • Microsystem: student-teacher and student-student interactions influence learning
  • Ecosystem: microsystem interactions occur within a school where policies and norms (teaching and learning practices and organisational structure) influence learning
  • Macrosystem: ecosystems interact (e.g. school and families) within a society which reflects culture, values and norms

These interactions within and between systems influence students’ learning significantly, and are documented more extensively in the article (pg. 61-62).

Principles 16–17. How can the classroom best be managed?

16. Expectations for classroom conduct and social interaction are learned and can be taught using proven principles of behaviour and effective classroom instruction.

17. Effective classroom management is based on (1) setting and communicating high expectations, (2) consistently nurturing positive relationships, and (3) providing a high level of student support.

Classroom management is a fundamental, bedrock set of
procedures and skills that establish a climate for instruction and learning. Class and school rules must be positively stated, concrete, observable, posted, explicitly taught, frequently reviewed, and positively reinforced. This allows students to learn the social curriculum in each classroom and enables teachers to develop classroom climates that maximise student engagement and minimises conflict and disruption.

Classrooms that are structured to offer multiple opportunities for students to respond facilitate the development of quality teacher–student relationships, which in turn lead to fewer behavioural problems and increased academic performance. Students who are at risk for classroom disruption may need more attention to relationship-building in order to develop and maintain connections in the classroom.

Culturally responsive classroom management is an approach that aims to actively engage students by offering a curriculum that is relevant to their lives. Teachers demonstrate a willingness to learn about important aspects of their students’ lives and create a physical environment that is reflective of students’ cultural heritage. Culturally responsive teachers understand the ways in which schools reflect and perpetuate discriminatory practices of the larger society and are characterised as “warm demanders”; “strong yet compassionate, authoritative yet loving, firm yet respectful”.

Finally, a high ratio of positive statements / rewards to negative consequences, and nurturing an atmosphere of respect for all students and their heritage, builds trust in the classroom that can prevent behavioural conflict.

Principles 18–20: how to assess student progress?

18. Formative and summative assessments are both useful, but they require different approaches: Formative assessments are carried out during instruction and are aimed at improving learning in the classroom setting. Summative assessments measure learning at a given point in time, usually at the end of some period of instruction where they are used to provide a judgement about student learning. The goal of both formative and summative assessments is to produce valid, fair, useful, and reliable information for decision making. Teachers can also use their understanding of assessment information to decide whether they covered the material that they intended to cover, or to judge how effectively they met the objectives for student learning.

19. Students’ skill and knowledge should be assessed with processes that are grounded in psychological science and that have provided well-defined standards for quality and fairness: Valid and reliable assessments enable teachers to make inferences about what students are learning. To understand the validity of an assessment, there are four question that need to be considered:

  1. How much of what you intended to measure is actually being measured?
  2. How much of what you did not intend to measure actually ended up being measured?
  3. What consequences, either intended or unintended, occurred with the assessment?
  4. Do you have solid evidence to support your answers to the first three questions?

Validity is a judgement, over time and across a variety of situations, about what inferences can be drawn from the test data, and the consequences of using the test. Valid assessment entails specifying what an assessment is supposed to measure. Teachers can improve assessment quality by aligning teaching and testing. However, they should also:

  • Be mindful that valid tests in one context may not be valid for another
  • Ensure that high-stakes decisions be based on multiple measures, not on a single test
  • Examine outcomes for any discrepancies in performance among different cultural groups

20. Good use of assessment data depends on clear, appropriate, and fair interpretation: Effective teaching depends heavily on teachers being informed consumers of educational research, effective interpreters of data for classroom use, and good communicators to students and their families about assessment data and decisions that affect them. The interpretation of assessments involves addressing the following questions:

  1. What was the assessment intended to measure?
  2. On what are comparisons of the assessment data based? Are students being compared to one another? Or, are responses being directly compared to samples of acceptable and unacceptable responses?
  3. Are scores being classified using a standard or cut point, such as letter grades, or another indicator of satisfactory/unsatisfactory performance?How were these standards set?

Awareness of the strengths and limitations of any assessment is critical. Such awareness enables teachers to make others aware of important caveats, such as the imperfect reliability of scores and the importance of using multiple sources of evidence for high-stakes decisions.

And there you have it. Twenty principles (19 without the one on fostering student creativity) on how best to go about enhancing teaching and learning practices in the classroom. While I don’t think it’s feasible to try and incorporate all of these principles in every classroom session, it’s definitely worthwhile having these at the back of your mind when planning assessment tasks, assignments, lectures and activities in class. I also recommend reading the whole paper which provides additional insight and links to further reading that would be useful to dig into.


Psychological science has much to contribute to preK-12 education because substantial psychological research exists on the processes of learning, teaching, motivation, classroom management, social interaction, communication, and assessment. This article details the psychological science that led to the identification, by the American Psychological Association’s Coalition for Psychology in Schools and Education, of the “Top 20 Principles from Psychology for PreK-12 Teaching and Learning.” Also noted are the major implications for educational practice that follow from the principles.

Citation: Lucariello, J. M., Nastasi, B. K., Anderman, E. M., Dwyer, C., Ormiston, H., & Skiba, R. (2016). Science Supports Education: The behavioural research base for Psychology’s top 20 principles for enhancing Teaching and Learning. Mind, Brain and Education, 10(1), 55–67.

Teaching physiotherapy in Kenya

A few weeks ago I visited colleagues in the Physiotherapy Department at Jomo Kenyatta University in Nairobi. I was invited as an external examiner and also to give advice on their developing MSc programme, which they are going to offer with both online and face-to-face components. This is just a short post of a few things that struck me about what it’s like trying to teach physiotherapy in Kenya.

Until recently, Kenya, like most other African countries, did not offer a 4 year Bachelor’s degree in Physiotherapy. Many countries on the continent still only offer physiotherapy as a 3 year diploma. Over the past decade or so my university has been one of the few institutions in Africa that has worked with our international colleagues to upgrade their degrees from Hon to MSc – and sometimes to PhD. Those colleagues have then gone back to their own countries and developed their local programmes to offer both the BSc (Physiotherapy) degree, as well as to upgrade local colleagues from their Diploma to BSc (Hon).

What this means is that the four members of staff in this department run two curricula in parallel – one for the new BSc students and another for the Diploma upgrade students. There obviously isn’t enough time in the week for them to do this, which is why the Diploma upgrade programme runs on Friday evenings and weekends. Think about that. They’re so committed to improving the profession in their country that they work seven days a week. I wonder how that notion would be taken up by academic physiotherapists in South Africa.

Now, also consider the fact that they’re working on developing a new MSc programme. It’s not enough that they’re already working with two separate cohorts of students (BSc and Diploma-upgrade); they also want a group of postgraduate students…just to keep themselves busy in those few moments of the day when they’re not already teaching. And this is why they need to offer the course partly online; not be trendy or because “flipped classrooms” are in but because there simply isn’t enough space in the normal day for them to pack in more classes.

On one of the days I was there I spent an hour or so with their 3rd year class because the lecturers were still busy with a practical test that had gone on for more than 4 hours. The reason that it had gone on for so long is that there were only 2 lecturers available to do the test. They finished at 18:30. The attitude of the teachers in the department is that the work has to get done and that they’re the only ones to do it, so there’s no point in complaining because complaining just takes up more time. There simply is no other option. And this is not unusual in the African context. There is one other university in the country that offers physiotherapy, and their situation is no different to JKUAT. And, from what I understand, these two departments are better off than many others on the continent.

What really struck me when I left Kenya was the fact that, no matter what challenges we might face in my own department, we cannot really understand the difficulties that our colleagues across Africa are dealing with in their physiotherapy programmes. While we complain about the fact that our air conditioning unit is broken, they don’t have lights in some parts of the building. It really reminded me, in a very physical way, that teaching is not about the equipment or access to resources. Yes, those things are important but what matters most of all is the commitment of the teachers to the students, and their passion for the profession.

All in all, I had a wonderful time in Nairobi. Everyone was incredibly friendly and welcoming and made we feel so very welcome. But most of all I was impressed at the level of professionalism and motivation shown by my colleagues in the Physiotherapy Department at JKUAT. I look forward to going back next year.

Some thoughts on education from two interviews

I spend a lot of time listening to podcasts on my hour long commute to work every day. One of my favourite series is the Tim Ferriss Show, because I get a lot of insight into my own academic practices from listening to these high performers from other domains. Earlier this week I listened to Tim interview Chris Sacca and Eric Weinstein. The quotes from the interviews that resonated with me are presented below (note: listening to a few minutes of audio is very different to transcribing and reading that audio…this took much longer than expected).

Chris Sacca on Shark Tank, Building Your Business, and Startup Mistakes:

Question: If you were to start your own school to educate youth, how would you do it? What would you concentrate on? How much would you pay the teachers? Is education the answer to the world’s problems?

Answer: Presuppose that you weren’t using schools to just train your kids to be “successful”. Think about how the purpose of education up to this point has always been: Do well in school and you can get into a great college. Get into a great college and you can get into a great grad school and then you can get a great job. And that has been the baseline underlying assumption for our education system for at least a generation now…probably two.

And yet, imagine if that weren’t the case. I was lucky. I went to one of the most competitive schools in the country. Among my peers were kids who went to all the fanciest boarding schools, all the best prep schools, all the best high schools. I went to a public high school. I went there with trepidation, assuming that I would get trampled by these kids. And, while their life experiences were certainly more diverse and exciting than mine because they had money to do all kinds of cool things, and they had AP classes that I didn’t necessarily have, spending time with them I realised that their world views were incredibly narrow. Most of them had never lived or worked among poor people. Most of them hadn’t actually volunteered. Most of them hadn’t had service jobs, tipping jobs. They hadn’t worked manual labour. The same went on when I worked out in Silicon Valley with top Harvard and Stanford grads at Google and beyond, all across the valley. The same kind of thing…I found people who were incredibly “successful” and yet had very uni-dimensional lives.

So, back to your question: if I were to start my own school…What if you started a school that pre-supposed the goal was: Happy kids. And I mean Happy with a capital H. Balanced. Thoughtful. Compassionate. Do-ers. What if their resume would never matter. Some of you have heard me say before, that the only people who care about your GPA are people who you’ve given no other basis to evaluate you.

What if, instead you wanted to build an education that fostered: Interesting. Understanding. Action. Experience. I don’t know what that school looks like but that’s how my wife, Crystelle and I have been approaching raising our three daughters. I’ve yet to see test scores correlate with happiness. I’ve yet to even see test scores correlate with Learning, with a capital L. So I don’t know what I would do to re-invent the education system or any particular school, but it’s certainly top of mind for me.


Eric Weinstein on Challenging “Reality,” Working with Peter Thiel, and Destroying Education to Save It:

Question: If you had to create a class for any grade level from 9th grade to the end of college, what would the class be and when would you teach it?

Answer: Part of the problem surrounds, where would I be allowed to teach this class? The first question is: Are you really allowed to deeply question your teacher, or your school?…What you’re always looking for, is an education that makes students unteachable by standard methods. And this is where we get into the trouble, which is…we don’t talk about teaching disabilities, we talk about learning disabilities. And a lot of the kids that I want are kids that have been labelled learning disabled but they’re actually super-learners.

They’re like learners on steroids that have some deficits to pay for their super-power. When teachers can’t deal with this, we label those kids “learning disabled” to cover up for the fact that the economics of teaching require that one central actor – the teacher – be able to lead a room of 20 or more people in lock step. Well, that’s not a good model.

What I want, is to get as many of my dangerous kids out of that idiom, whether it requires dropping out of high school, dropping out of college…not for no purpose. Drop into something. Start creating. Build it. Join a lab. Skip college.

Note: Eric Weinstein works at Thiel Capital, which is linked to the Thiel Foundation that provides a fellowship for students to drop out of college and work on projects they care about. So, his point about dropping out of, or skipping college, needs to be considered in that light.

Introducing the Humanities into physiotherapy education

This post has been modified and published on The Conversation: Africa as Physiotherapy students have much to learn from the humanities.

Selection_018I’m increasingly drawn to the idea of integrating some aspect of the Humanities into undergraduate physiotherapy education. We focus (almost) all of the curriculum on the basic sciences and then the clinical sciences, which has a certain pragmatic appeal but ignores the fact that a person is more than an assemblage of body parts. We spend a lot of time time teaching anatomy and biomechanics (i.e. bodies as machines), and then exploring what we can do to bodies in order to “fix” them. While we pay lip service to the holistic management of the patient, there is little in our curriculum that signals to the student that this is something that we really care about.

“Science is the foundation of an excellent medical education, but a well-rounded humanist is best suited to make the most of that education.”

Empathy is critical to the development of professionalism in medical students, and the humanities – particularly literature – have been touted as an effective tool for increasing student empathy. In addition, there is some evidence that training in the Humanities and liberal arts results in health professionals with improved professionalism and self-care. In other words, health professionals who are exposed to the arts as part of their undergraduate education may demonstrate an increased ability to manage themselves and their patients with more care.

Hilary Allen_Artist in Residence 2015_1000

The relationship between emotion and learning has also been explored, with findings from multiple disciplines supporting the idea that emotion is intimately and inseparably intertwined with cognition in guiding learning, behaviour and decision making. The introduction of the Humanities in health professions education therefore has another potential impact; by using the arts to develop an awareness of emotional response, educators and students may find that exposure to the Humanities might lead to improvements in learning.

As I started looking into these ideas in a bit more detail, I realised that there are several examples of how art and literature are being explored formally by some very prominent medical schools.

dancingwheelsI was disappointed – although not surprised – not to find any good examples of physiotherapy departments who have formally integrated the Humanities into their curricula. However, I did find several papers (all by the same author with various colleagues) that describe a process of integrating these concepts into an undergraduate physiotherapy programme over a period of time, and these are listed in the references below.

avery_hosp_ward_low_resOver the past year or so, I’ve tried to bring some of these ideas into my Professional Ethics module, using the assignments for students to explore the Humanities (art, literature, theatre, music, dance, etc.) as a process of developing a sense of awareness of empathy in the context of clinical education. They can interpret the assignment in any way they want, for example, by writing a poem, drawing a picture, taking a photo, or re-interpreting a song. However, the important part is the reflection that they attach to the piece. Here are some examples of previous student work in this module, without the more personal reflections that accompany them.

  • Eleven hundred hours – poem by a student
  • The mind of the innocent – poem by a student
  • I’ve had two students provide videos of interpretive dance sessions used as methods to try and present an embodied experience of what it might be like to live with a disability.
  • Photovoice assignments (see below for examples): in these assignments students took photos of people and places and then reflected on how those experiences had informed their personal and professional development as ethical practitioners.



I’m hoping to get some experience with this process as part of these little experiments I’m running in the classroom, and that over time we can start building something more formal into the curriculum. Watch this space.

Additional readings