September 9, 2020, by mszrm4

Online teaching as an educational method

September’s N.A.M.E. blog is written by Dr Rakesh Patel – Medical Education Course Director at UoN.

The purpose of this blog is to prompt you to reflect about some of your held beliefs and assumptions about medical or healthcare professions education. Now, more than ever, there is a real need as medical educators to step back and critically reflect upon the teaching we deliver; given the current expectations that as much as possible that can be done online, should be done online.

For healthcare professions educators this presents a significant challenge; not least because the development of “practitioners” requires not only knowledge, but also skills and behaviours usually developed through practise. But we can use this challenge as an opportunity to highlight some commonly held assumptions among teachers about the learning process that may be relevant when designing online teaching activities or curricula more broadly.

Firstly, consciously or unconsciously, some teachers still appear to be designing activities as though the process of education involves transferring information from head of the teacher into the heads of the learners (in the case of online teaching – via the computer screen). This belief about education as a process of “information transfer” appears to underlie the perception that all teaching can be simply moved online.

Learners have been conditioned into “receiving the teaching” and both teachers and learners assume that the desired outcome is the ability to recall knowledge or reproduce skills at the next time of asking. Evidence from cognitive science suggests at best, approximately 40-50% of what is taught gets learnt, and which 40-50% that is, varies tremendously from one individual to another. Also, there is a fairly predictable rate of forgetting new knowledge over time, so in the end very little may be retained.

Given this evidence, clinical teachers should beware the temptation to simply move teaching content online and assume learners will learn it. The design of online teaching activities should be carefully crafted to the specific learning outcomes of the module or programme, especially given that there are so many variables that may affect the learning process (e.g. baseline knowledge and motivation levels of learners).

Secondly, the move to online teaching is likely to drive a number of teachers towards using post-teaching testing for ‘assessing learning’. The problem with this tactic is that learning (which is what teachers are really interested in) and performance (which is what they are measuring and then using as a proxy of learning) are not the same thing. Whilst performance is observable, learning is not observable, but inferred from the (performance) testing.

At first glance, this may not appear to be a problem, however in the online teaching environment, it may expose another issue with learning and that is the illusion of knowledge. If testing occurs immediately after the teaching, and learners ‘perform’ well on the test, there is a likelihood they will feel they ‘know’ it, when in reality, the optimum way to demonstrate learning is to apply knowledge or skills on different tasks, in different contexts, over time.

Finally, the move to online teaching is likely to cause significant problems with information overload. In-person classroom environments allow for teachers to sense whether individuals have picked up key concepts before moving onto new or more complex material. In the online environment, there may be a tendency to assume that because all the teaching material is available online, learners will have constructed the relevant basic knowledge appropriately before moving onto more complicated concepts or tasks.

Through the eyes of the learner, what is online is merely information until it is transformed into knowledge through the process of learning. If there is too much information, without some signposting to what is relevant or critically important, there is a risk that each learner will choose what to learn and what not to learn indiscriminately. Adding more and more information about concepts which require understanding of some fundamental knowledge beforehand may in fact be counter-productive, leading to information overload.

So now what?

I’m going to resist the temptation to share with teachers (who are intelligent and experienced educators) ‘Top Tips’ or a list of recommendations on ‘Do’s & Don’ts’ when it comes to online teaching. Why? Because, simply following a checklist as one would do a recipe, will not result in teachers knowing why they are doing what they are doing, and therefore how to do it best for their cohort of students.

Instead, I want to share a list of key concepts, that educators can take their time to read and reflect upon, and make sense of them in relation to what they already know about teaching, learning and assessment.

The concepts implicit in the post above include:
• the difference between learning and performance
• instructional design
• working memory and long-term memory
• cognitive load theory
• scaffolding

I’d like to invite readers of this blog to start a conversation about some of these key concepts and what they mean in everyone’s own teaching contexts. By continuing the conversation, sharing key references and reflecting on practice, there is a chance the teaching of learners may be improved by not just applying what works based on sound evidence from research, but knowing why it may work in our own personal teaching, for whom and in what context.


Dr Rakesh Patel is the Course Director of the PGCert/ PGDip/ MMedSci in Medical Education, University of Nottingham. Dr Patel is also Academic Programme Director (Medical Education) & Honorary Consultant Nephrologist, Nottingham University Hospitals.

If you want to read more about some of the concepts discussed:

Posted in Uncategorized

Previous Post

Through the looking glass: studying medical education as a medical student

Next Post

CONGRATULATIONS Nottingham MedEd Scholars!