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Good teaching is not a race to cover content: Less can be more

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November 3, 2017
by Kenneth D. Royal, PhD, MSEd; Todd Zakrajsek, PhD

All otolaryngologists are involved in teaching, whether they are faculty, teaching medical students and residents, or private practitioners, teaching colleagues, nurses, physician assistants, staff, and the public. A challenge these medical educators face is that there is much to teach but only a finite amount of time. This challenge is increasing, as new knowledge continues to be generated and caring physicians want to make sure learners are receiving comprehensive exposure to relevant content.

Without specific training in teaching techniques, many physicians rely on the lecture, perhaps interspersed with a few discussion points. Unfortunately, research has shown that sticking to the content-rich lecture method provides only low to moderate gains in learning.

A common pitfall for educators is cramming too much information into a course or presentation. Although educators know that students cannot learn everything presented to them, the past teaching concept of “If it isn't covered, it wasn't taught” drives educators to impart too much material.

Unfortunately, cramming extra content rarely results in a positive learning experience for the student. It takes longer for a novice to process information than for an expert. A lot of information for an expert is an exponentially greater amount of information for a student. Learners are quickly overwhelmed by all the content, which causes a ripple effect into other areas (e.g., students make negative faculty/course evaluations and put forth less effort in other classes, thereby indirectly sabotaging fellow faculty). Clearly, more content does not lead to more effective teaching, learning, and later recall of information.

Educators who have reached a supersaturated amount of content often simply cut material, frustrated with the perceived lack of adequate time to cover the material properly. However, this approach rarely results in anything fruitful. In medical schools, many courses are team-taught or have material that is built on previously presented information, so quick content reduction in one area often results in territorial disputes, hurt feelings, bruised egos, animosity with colleagues, and other negative outcomes.

So, what is a better alternative to reconciling knowledge abundance and finite instructional time? One recommendation is to reconsider the challenge. Instead of trying to eliminate existing material to fit it into a specific period of instruction, consider building the session from the ground up. Following are a few considerations in building an effective teaching session, or course, with a focus on learning rather than covering content within the time allotted.

First, before building your course material, consider the time available and determine how many concepts the learners may be able to process in the time allotted. A common consideration is two to three major points per hour. Better outcomes have been demonstrated if those are really learned, rather than simply being presented quickly.1 Of course, there may be many minor points to support each major point, so obviously, more than two or three concepts may be presented in an hour.

Second, recognize how much knowledge the students have of the subject matter being taught. It is easier to learn something new if you have some prior understanding of the concept. Students are not peers, nor are they experts in your field. So obviously, they cannot learn information as fast as the person teaching. New learners can process much less than more experienced learners. Check periodically to see if students are bored (which results when toolittle new information is presented) or frustrated (which results when too much new information is presented). This can be done by asking questions about material just presented.

Third, take time for engaged learning opportunities. Research consistently shows that having learners do something significantly increases their long-term retention of information.1,2 These activities3 can take only a few minutes to complete (e.g., lecture check, teach back, think-pair-share).

Fourth, recognize which materials students can learn on their own. Not everything needs to be taught by an educator. Save instructional time for particularly challenging concepts or processes and focus on those.

Finally, research has shown that students tend to learn more at the beginning and end of a session or presentation; this is known as the primacy/recency effect.1 Therefore, it is good to leave a bit of time at the end of any teaching for a quick summary. If it looks like time is running out, instead of cramming in the last few bits of information, take a second to slow down and summarize what was learned. It may well mean that something is not covered, but it also increases the probability something meaningful will be retained.

Teaching in any field is challenging. There is so much information and so little time. Therefore, it is imperative that instructional time be used as effectively as possible. This often boils down to thinking seriously not about how much is taught, but how the information can best be learned. Educators who accept that there is only so much material that can be covered, and realize that students are capable of (and should be held responsible for) learning some things on their own, usually experience positive results. Perhaps the best summary is a paraphrased quote by Linus Pauling: Good teaching is more about uncovering material than it is about covering material.



References

  1. Doyle T. Learning-Centered Teaching: Putting the Research on Learning into Practice. Sterling, Va.:Stylus Publishing; 2011.
  2. Doyle T, Zakrajsek T. The New Science of Learning: How to Learn in Harmony with Your Brain. Sterling, Va.:Stylus Publishing; 2013.
  3. Major CH, Harris MS, Zakrajsek T. Teaching for Learning: 101 Intentionally Designed Educational Activities to Put Students on the Path to Success. New York:Routledge, 2016.
Department of Clinical Sciences, North Carolina State University, Raleigh, Department of Family Medicine, University of North Carolina at Chapel Hill
Department of Family Medicine, University of North Carolina at Chapel Hill
Ear Nose Throat J. 2017 October-November;96(10-11):402-404