"The purpose of the AAP is to advance academic physiatry by providing leading edge programs, products, and services"

Speaker's Guide

Carolyn L. Braddom-Ritzler, EdD

PURPOSE:

The inclination of a speaker preparing for a scientific presentation is to concentrate on the subject matter, which is certainly of primary importance. However, if the participants do not "hear" the message little is accomplished.

Reaching the learner is of vital importance. This means that how the material is organized and presented is as important as the content.

The purpose of this information is to assist speakers in preparing and delivering the most effective presentations.

CONTENTS:

Andragogy: The Science of Adult Learning
Elements of an Effective Presentation
Objectives & Educational Methods

ANDRAGOGY: THE SCIENCE OF ADULT LEARNING

ADULT LEARNER CHARACTERISTICS

Learning for adults is the "means to an end," a way of solving a problem. Generally, knowledge is no longer viewed as an end in itself. Adults seek out learning experiences in order to cope with specific life change events, such as career goals.

Implication: Make "pay off" for learning obvious. Give learners a rationale for learning.
Adults tend to take errors personally and are more likely to let mistakes negatively affect their self-esteem.

Implication: The learning environment should be safe from ridicule. Humor is only funny when focused on the instructor, not the learner. More attention should be given to correct responses rather than incorrect responses.
Adult learners are likely to have more "fixed" points of view that make them closed to new ways of thinking and behaving. They tend to apply "tried and true" solutions known as reproductive thinking.

Implication: The learning environment should be safe enough for students to experiment with new ways of dealing with problems. Interpersonal feedback exercises and opportunities to experiment with problem-solving should be included in the learner's educational experience.

CURRICULUM DESIGN

Adults come to a classroom with specific expectations. It is critical for the teacher to state expectations before getting into content. (The teacher can assume responsibility for his/her own expectations, not those of the learners.)

Implication: State objectives at the beginning of each learning session. State an agenda for how time of learning session will be used. Begin with a needs assessment tool to show learners what they need to know.
Adults need to be able to integrate new ideas with what they already know. Linking information to experience and current knowledge is critical for the storage and retrieval of new information.

Implication: Sequence material so it builds on current knowledge. Use illustrations and examples to link to experiences. Design lectures to answer a question or solve a problem.
Information that has little "conceptual overlap" or conflicts with what is already known is acquired more slowly by the learner.

Implication: Allow more time for learners to process new unrelated material or material that conflicts with their current knowledge.
Adults prefer self-directed learning over group projects and group projects over lecture. They prefer materials be presented through the use of more than one medium; they prefer to control the pace, start and stop time.

Implication: Include other means of learning besides the lecture. Use visual aids, live demonstrations, case studies, etc. Be aware of student nonverbal messages about pace and length of presentation. (Adult learners have learned how to "student"-nodding and smiling at the teacher while thinking about other things.)
Adults prefer the instructor in the role of facilitator for learning, one who sees the learning/teaching transaction as a cooperative venture.

Implication: Change your class from an autocracy to a democracy. Be a guide, not a dictator.

CLASSROOM ENVIRONMENT

The learning environment should be physically and psychologically comfortable. Long lectures, periods of sitting with an absence of practice opportunities rate high on the learner irritation scale.

Implication: Students should feel comfortable in the learning environment. Shorten lectures and add times for questions or a quiz (include immediate feedback for correctness of answers). Do not teach the same way every time.
The teacher needs to help learners see the gap between performance goals (objectives for learning) and current level of performance. Identifying these differences is important in developing student readiness for learning.

Implication: Use evaluation frequently, including tools for learner self-assessment.
Adults benefit from being active participants in the learning process rather than passive recipients.

Implication: Utilize discussions, clinical practice, research seminars, etc. for interactive learning.
Key role of the teacher is one of facilitative-control. The teacher must balance the presentation of new material, the linkage of the material to the learner's current knowledge base, and provide opportunities for discussion or feedback all within the time available.

Implication: It is imperative that teachers plan and organize their material. Getting through only half the material in the allotted time is poor planning and does a disservice to your students.

ADULTS WANT THEIR LEARNING TO BE:

Problem oriented:

Personalized:

Self directed:

Be able to show learners "How this is going to help me."
Tie theory to practice.

Get to know your learners; recognize as individuals.

Provide a climate conducive to learning.

INSTRUCTIONAL MODELS

LECTURE:

Give teacher-prepared notes to learners as handout.

Be dramatic, novel, entertaining.

Use examples and illustrations.

Keep focused on major points-remember rules of 3's.

Bridge one concept to another and link to previous knowledge (important for memory retrieval)

Utilize 20 minute "lecture chunks."

Find alternatives to lectures such as video tape lectures or lecture scripts and use time saved for more small group interaction.

QUESTIONS:

Allow time for learners' questions.

The person asking the question is the one who remembers the answer; try to get more participants to interact.

Remember the value of "wait time" to allow learners the time to frame a question or response.

DISCUSSION:

Optimum number for discussion group is 5.

If size of group goes over 5, the most talkative member will dominate 40% of the time.

INQUIRY:

Least efficient in terms of time, but most effective for retention.

Structure research seminars, journal club or other means to encourage participants to get involved in the scientific method.

EVALUATION:

Evaluate learners in many ways-multiple data sources are better than single ones.

Adult learners prefer frequent, specific feedback.

Evaluation should be ongoing-not a single exam at the end of a semester.

Adult learners prefer and benefit from self-assessment opportunities.

A COMPARISON OF THE ASSUMPTIONS OF PEDAGOGY AND ANDRAGOGY

CONCEPT OF THE LEARNER

Pedagogy:
The role of the learner is a dependent one.
The teacher takes full responsibility for learning.

Andragogy:
As people mature, they move from dependency toward increasing self-directedness.
Teachers have the responsibility of encouraging this movement.

Implication:
The learning process is a cooperative venture in which both teacher and student share the responsibility.

ROLE OF LEARNER'S EXPERIENCE RESOURCE

Pedagogy:
Children have few experiences to bring to a learning situation.
Teachers bring experiences to their students.

Andragogy:
Adults have a reservoir of experiences that offer rich resources for learning.

Implication:
The primary educational techniques should be experiential-laboratory experiments, discussions, problem-solving cases, clinic experiences, etc.

READINESS TO LEARN

Pedagogy:
Most children go through developmental stages at similar ages. Therefore learning is organized into a fairly standardized curriculum, with a uniform step-by-step progression.

Andragogy:
Adults become ready to learn when they experience "a need to learn" in order to cope with a real life task or problem.

Implication:
The teacher has a responsibility to create conditions and provide tools and procedures for helping learners discover their "need to know."

ORIENTATION TO LEARNING

Pedagogy:
Children see education as a process of acquiring subject matter content, most of which will only be useful at a later time in life.
Curriculum is organized into subject matter units and moves from the simple to the complex.

Andragogy:
Adults see education as a process of developing competence. They want to be able to apply whatever knowledge they gain and put it to work immediately.

Implication:
Learning experiences should be organized around competency-development categories.

(Knowles)

SELECTED REFERENCES

Dannefer D, Perlmutter M. Development as a multidimensional process: Individual and social constituents. Human Development 1990; 33:108-137.

Galbraith MW. Adult learning methods. Malabar, FL: Krieger Publishing Co, 1990.

Knowles MS. The modern practice of adult education. New York, NY: Cambridge Books, 1980.

Knox AB. Helping adults learn. San Francisco, CA: Jossey-Bass, 1990.

Merriam SB, Caffarella RS. Learning in adulthood. San Francisco, CA: Jossey-Bass, 1990.

Mezirow J, et al. Fostering critical reflection in adulthood: A guide to transformative and emancipatory education. San Francisco, CA: Jossey-Bass, 1990.

Seaman DF, Fellenz RA. Effective strategies for teaching adults. Columbus, OH: Merrill, 1989.

Seldin P. How administration can improve teaching. San Francisco, CA: Jossey-Bass, 1990.

Tennant M. Life-span developmental psychology and adult development: Implications for adult learning. International Journal of Lifelong Education 1990; 9:223-236.

Weimer M. Improving college teaching. San Francisco, CA: Jossey-Bass, 1990.

Williams HY, Willie R. Research on adult development: Implications for adult education. International Journal of Lifelong Education 1990; 9:237-243.

THE ELEMENTS OF AN EFFECTIVE PRESENTATION

PREPARATION

It is important to update your information so that even if you are repeating the same presentation for ten years, each time additional information should be added to keep the content current and up-to-date.
Organize your material in a sequential, logical manner so that it will more easily make sense to the learners. Include information that demonstrates how it relates to the learners' experiences because we know that is how adults learn - by linking information to experience.
For whatever reason information is more easily learned if presented in threes. As much as possible plan your talk around three major points, three sub-points, etc. The concept of a "triad" is all around us - faith, hope, and charity; morning, noon, and night; Friends, Romans, and Countrymen lend me….. etc.
Meet the deadlines set up for you by the group for whom you are speaking. Do not become a problem by disregarding important deadlines, i.e. for handouts by procrastinating.
Practice you presentation in advance so you can check potential delivery, time, and content problems.
Make sure you have familiarized yourself with the audio/visual equipment ahead of time. It is embarrassing if you break the projector because of a defective slide tray, etc. or you waste valuable presentation time figuring out how to change slides. This is particularly important when using your computer. Make sure it is up front and ready before you are introduced.

HANDOUT

Most adult learners value handouts. Good quality handouts significantly increase the possibility for participants to review and retain the presented material, and offer increased opportunities for participants to pursue self-directed learning following the presentation.
A handout can be an outline of the presentation, copies of the projected material, charts, diagrams, reference list, articles from other publications, etc.
There is no general length requirement for handouts. However, the information should be presented as clearly and as concisely as possible. Figures and illustrations should REPLACE narrative and not duplicate information already presented. The handout should include "References."
If possible, conclude your handout with several questions and answers that participants could use for self-assessment.
Always submit an original for replication. Faxes do not duplicate well. Be careful to follow the submission deadline so your handout can be included in the course syllabus.
Include a cover sheet with the title of your presentation, date, your name and degree, and at least 1-3 objectives for your presentation.

VISUALS

Visuals provide additional stimuli that help learners grasp information. The most effective materials i.e. slides, overheads, etc. are those professionally prepared.
Type should be large enough to stand out against the background.
Keep the content on each slide concise. Too much visual information presented at a time causes learners to ignore the speaker while they try to read the visual.
Each slide should be on screen for 20-24 seconds. This means a speaker would expect to have approximately 30 slides for a 20-minute presentation.
Keep it simple - Don't be tempted to be so elaborate that it gets in the way of the message.

PRESENTATION

Be enthusiastic. Why should the learners be excited about the content if you are not excited about it.
Use humor if you are good at telling jokes. Be yourself and don't try for humor if it doesn't work for you. Human-interest stories and career experiences can be as engaging as joke telling. If you do use humor be careful never to insult another group. About the only person you can safely make fun of is yourself.
Never begin by apologizing. Participants want to see a confident speaker, not someone who is challenging his/her own credibility.
Begin by letting the audience in on your objectives. Why should they be spending their time listening to your presentation? Begin by telling them what you plan to tell them, tell them what you are telling them, and close by telling them what you told them. (The three concept again.)
STAY ON TIME. No matter how valuable your information is - you may be giving out nuclear secrets - STAY TO YOUR ALLOTTED TIME. Speakers who egotistically or neglectfully run overtime create problems for every speaker who comes behind them.
Never read from your slides. They should be there for the audience, not for you.
Make eye contact with the participants. Keep in mind that 85% of any message is delivered through nonverbal communication. It can be very helpful to watch a video tape of a presentation you have given. Sometimes we are not aware of distracting habits.
Try not to let the room be so dark, that participants can sleep undetected, and you can hide in the shadows of the lectern. Adult learners need active engagement, not passive listening.
For questions, repeat the question so that all participants can hear, and also so that it will be clearly picked up if the session is being audio taped.

PLAN, PRACTICE, PERFORM

OBJECTIVES

WHEN TO WRITE THEM:

Learning objectives should be written after:

The need is assessed and the target audience is determined.

But they should be written before:

The teaching methods are determined and the content is prepared.

HOW TO WRITE LEARNING OBJECTIVES

Developing the learning objectives should be the first step in planing a CME activity. Ask the question, "What do I want participants to be able to do as a result of participating in the activity being planned?" From a clear learning objective, it is easy to develop an outline and content for the learning activity. Ask yourself, "Is the learning objective an appropriate one for a practicing physiatrist and would I spend time and money to learn this?"

Being clear on the intended outcome for the learner may suggest a session with less didactic, basic lecture material and more interactive, up-date practical and experiential activities. Outcomes of objectives must be measurable. To assure that objectives may be measured, use action verbs such as demonstrate, differentiate, recall, identify, etc. Verbs that are generally not measurable and should be avoided include: understand, appreciate, believe, learn, etc.

Objectives should be achievable within the time allotted. For example, if an objective states that the participants will be able to demonstrate something, time must be allocated for each participant to demonstrate the skill. Likewise, if an objective states that a participant will be able to discuss something, the group must be small enough to allow each participant to discuss.

Objectives should be written at a level consistent with the professional, experience, and educational background of the target audience.

Writing learning objectives is not only an exercise in clear thinking about the desired results of education, but it is also an exercise in effective communication. One of the best ways to communicate effectively is to use specific action verbs in the statement of learning objectives. A list of good action verbs that have been found useful in writing objectives is shown [click here]. At the bottom are some words that should be avoided because they are vague, difficult to assess, and subject to multiple interpretations. The more specific the words are, the greater the chance will be that the evaluation process can assess whether the educational activity accomplished what was expected.

An important consideration in developing learning objectives is to consider Bloom's taxonomy (see Figure 1 below) which is a classification system that places every objective in on of the domains: cognitive, affective, and psychomotor. The program planner needs to determine which of these domains is being emphasized in the learning activity.

The cognitive domain (knowledge acquisition) addresses what a learner knows. The affective domain focuses on psychological learning or learner's feelings and opinions. The psychomotor domain emphasizes skills, techniques, and processes often appropriate for hands-on workshops.

Different verbs are better suited to each of Bloom's three domains. For example: appropriate actions words for outcomes in the cognitive domain would include analyze, compare, define, etc. Action verbs in the affective domain include advocate, challenge, criticize, defend, dispute and support. In the psychomotor domain some verbs of choice include diagnose, demonstrate, measure, differentiate, etc.

Learner outcomes are expressed as statements regarding what a participant can derive from the learning experience. Because they are vehicles of change, the outcome must be dynamic.

Outcomes must also assume a hierarchical order. The lowest level of learning outcomes requires only the learners remember or understand certain information. However, they may lay the framework for higher-level outcomes, which require learners to assimilate, extrapolate, differentiate, deliberate, analyze and reason.

Learning "outcomes" should state precisely what the learner will be able to do after taking part in a continuing educational offering.

Note that every action verb, regardless of its domain, defines behavior that can be both observed and measured. Writing an outcome is not unlike constructing a sentence; it states who is to do something, what is to be done, what variables are at work and how it is to be done. Used properly, written outcomes become a contract between group communicators and the potential participants. That new accountability improves, advances, upgrades, elevates, fosters and enriches lifelong continuing education.

A wise person once said. "If you're not sure where you're going, you might end up someplace else."

An excellent way to introduce the statement of objectives is: "Upon completion of this (session, course, workshop, activity, etc.) participants will be able to. . . ."

The choice of the verb will depend in some degree on the material being presented. If the purpose of an activity is to refresh the memory of the participants on basic information, the objective can begin: "Physician will reinforce their knowledge. . . ." If much of the material is new or is expected to be unfamiliar, the objective might state: "Physicians will increase their ability to . . . ." If a training workshop is being held with the purpose of teaching a specific skill, the objective should state the performance level expected. For an activity that provides both new learning and review, the statement of objectives should cover both aims.

EDUCATIONAL METHODS FOR SPEAKERS TO CONSIDER

The following are descriptions of possible teaching/learning methods:

LECTURE - a carefully prepared presentation, usually followed by group discussion.
CASE PRESENTATION - detailed information covering a situation, an event, or a series of related events, followed by group discussion.
SYMPOSIUM - 2-5 successive lectures on various components of a major topic area, followed by group discussion.
PANEL DISCUSSION - 3-6 faculty members engaged in an interactive dialogue on an assigned content area, followed by group discussion.
SEMINAR - an interactive learning activity led by an expert in a specialized area of study, followed by group discussion.
FORUM - open dialogue and discussion among all participants.
DEMONSTRATION - a carefully planned and prepared presentation showing how to perform or apply a procedure.
WORKSHOP - a carefully planned and supervised practice oriented activity providing "hands-on" experience opportunities, usually following a demonstration.

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