Ludvigsson, Jonas F.

Journal of Pediatric Gastroenterology & Nutrition: April 2003 - Volume 36 - Issue 4 - pp 511-512
Book Review

Orebro University Hospital


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Teaching at University

Ramsden P. Learning to teach in higher education. New York: Routledge, 1992.

McKeachie W. McKeachie's Teaching Tips: Strategies, Research, and Theory for College and University Teachers, 11 ed. Boston: Houghton Mifflin Company, 2002.

Cannon R, Newble D. A Handbook for Teachers in Universities & College: A Guide to Improving Teaching Methods: Kogan Page Ltd, 2000.

Biggs J. Teaching for quality learning at university. Buckingham: Open University Press, 1999.

Medical teaching attracts more and more interest, especially in journals focusing on the subject (e.g., Medical Education: http://www.mededuc.com;Medical Teacher: http://www.tandf.co.uk/journals/titles/0142159X.html;Teaching and Learning in Medicine: http://www.tandf.co.uk/journals/titles/0142159X.html;Academic Medicine: http://intl.academicmedicine.org/). Journals dealing with general medicine, such as the BMJ, regularly publish research on medical education (http://www.bmj.com).

A recent editorial in Medical Teacher clearly illustrates that doctors studying medical education are keen to improve their teaching (1). Among the most requested articles online from December 2000 to December 2001 in Medical Teacher were “Twelve Tips for Potential Distance Learners”(2), “Simulation and New Learning Technologies”(3), “Rewarding Teaching Excellence . . .”(4), “AMEE Guide No 21: Curriculum Mapping . . .”(5) and “AMEE Guide no 22: Refreshing Lecturing: A Guide for Lecturers”(6). More and more, scientists are growing aware that teaching is not only about transmitting basic facts. We want students to learn. In his book Learning to Lead in Higher Education, Paul Ramsden (7) lists six key principles [page 96] of effective teaching:

1. Interest and explanation

2. Concern and respect for student and student learning

3. Appropriate assessment and feedback

4. Clear goals and intellectual challenge

5. Independence, control and active engagement

6. Learning from students.

Teaching is fun; reading a book about teaching may even make it hilarious! There are several teaching books on the market. The purpose of this article is to review four such books (Table 1).

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Learning to Teach in Higher Education is the gold standard of university teaching textbooks [with a focus on medicine] against which new books in this area should be measured (7). This book is divided into three parts:

1. Learning and teaching in higher education

2. Design for learning and evaluating

3. Improving the quality of teaching and learning.

Part I deals with different levels of learning and teaching. It is obvious that an improvement in teaching and learning requires changes at several different levels (in the student, the teacher, and the institution). Like Biggs (8), Ramsden is very clear on what he considers good teaching. It is less about various techniques of instruction (“. . . how to give a lecture, organise a laboratory class, or run a small group discussion . . .” [page 7]) and more about “understanding that teaching is about making it possible for students to learn . . .” [page 9]. It is about what the student does, not what the teacher does (focusing on what the student does is what Biggs calls “level III theory”—see following discussion).

However, Ramsden's book is not only about theory. He also presents raw data; in the “Course Experience Questionnaire (CEO)”, 4,500 students were tested in a range of areas. Medical students rated the quality of their education below average. In Chapter 5, he then lays the foundation for what can be done to alleviate the problems indicated by the medical students: We must always remember that learning is a student activity! Hence the focus should be on the students and not on the teachers. This may be one reason why Ramsden is negative toward lectures (more of a teacher activity than a student activity). Though he admits there is good lecturing, he would want most of us to employ other teaching methods. Many of these teaching methods are well described in Cannon-Newble's book (9).

We must also be aware of so-called contextual effects; student interests, their knowledge base, and also their previous experience will influence their learning strategy. Ramsden also underlines the importance of the type of assessment used. (Biggs makes even more of this topic when he talks of “aligned teaching” (8)).

In Part II, the many student examples and citations, one of the strengths of this book, becomes obvious:

Concerning students' interpretations of lecturers' behaviour and second guessing [about exams]: “I decided since X was setting the question, block diagrams were needed.”

Concerning the overload of the syllabus [in many medical schools]: “In very few lectures was I picking up the principles as we did them. It took me all my time to get the notes down. . . . You can't really follow what's going on. You can't do two things at once.”

In using these examples, Ramsden practices what he teaches. He draws on the experiences of the reader.

Chapter eight, “The Goals and Structure of a Course”, is my favorite chapter. Ramsden, himself, says it all: this chapter is about applying theory to practice: What do I want my students to learn, and how can I express my goals to them? How should I arrange teaching and learning so that students have the greatest chance of learning what I want them to learn? In this chapter it becomes clear that Ramsden approaches the subject of teaching methods from a different angle than Cannon-Newble. Ramsden writes: “They [other books about teaching in higher education] focus instead on methods of teaching and assessing students. . . . Naturally, there cannot be any meaningful discussion of teaching strategies without some reference to content: we always teach students something.”

Teaching and learning is originally a sub-discipline of Psychology. This is often evident in the citation lists of books about teaching but Ramsden has gone to great length to include references from various disciplines. So does he, for instance, address teaching in both history and medicine (10).

The index of the book is good and almost exhaustive! JPGN readers wishing to take a shortcut may head for “medicine” [pages 20,21,22,31,35,36,50, 53, 56, 130–31, etc.] or pharmacology [pages 22, 189]. A minor disadvantage with this book is that it is almost mandatory to read it from the start and onwards. Concepts explained in the first chapters of the book are frequently referred to in later chapters without explanation.

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1. Lilley P. Topics in Medical Teacher that most interest readers. Medical Teacher 2002; 24:237–8.
2. Hartley S, Gill D, Walters K, et al. Twelve tips for potential distance learners. Med Teach 2001; 23:12–15.
3. Issenberg SB, Gordon MS, Gordon DL, et al. Simulation and new learning technologies. Med Teach 2001; 23:16–23.
4. McLean M. Rewarding teaching excellence. Can we measure teaching `excellence'? Who should be the judge? Med Teach 2001; 23:6–11.
5. Harden RM. AMEE Guide No. 21: Curriculum mapping: a tool for transparent and authentic teaching and learning. Med Teach 2001; 23:123–37.
6. Brown G, Manogue M. AMEE Medical Education Guide No. 22: Refreshing lecturing: a guide for lecturers. Med Teach 2001; 23:231–44.
7. Ramsden P: Learning to teach in higher education. New York: Routledge, 1992.
8. Biggs J: Teaching for quality learning at university. Buckingham: Open University Press, 1999.
9. Cannon R, Newble D: A Handbook for Teachers in Universities & College: A Guide to Improving Teaching Methods: Kogan Page Ltd, 2000.
10. Balla JI, Biggs JB, Gibson M, et al. The application of basic science concepts to clinical problem-solving. Med Educ 1990; 24:137–47.
11. McKeachie W: McKeachie's Teaching Tips: Strategies, Research, and Theory for College and University Teachers, 11 ed. Boston: Houghton Mifflin Company, 2002.
12. Booth V: Communicating in Science, 2nd ed. Cambridge: Cambridge University Press, 1993.
13. Nordenstrom J, Dahllof G, Ekstrand J. [The merit profile–an instrument for the evaluation of academic achievement]. Nord Med 1998; 113:208–10.
14. Angelo TA, Cross KP: Classroom Assessment Techniques. A Handbook for College Teachers., 2nd ed. San Francisco: Jossey-Bass, 1993.
15. Marton F, Saljo R. On qualitative differences in learning—II: Outcome as a function of the learner's conception of the task. British Journal of Educational Psychology 1976:115–27.
16. Marton F, Saljo R. On qualitative differences in learning—I: Outcome and process. British Journal of Educational Psychology 1976:4–11.
© 2003 Lippincott Williams & Wilkins, Inc.