What makes an effective teacher?

What makes an effective teacher? David Camerons Conservative Party recently stated that the Tories will be brazenly elitist about candidates entering the teaching profession as they believe that qualifications make a good teacher. [REF]. However, research shows that a teachers personal characteristics and teaching styles can also be attributed to effective teaching. In 1992, Professor Caroline Gipps, Vice-Chancellor at the University of Wolverhampton and leading expert in educational assessment and learning, published What We Know About effective Primary Teaching. The document suggests that a successful primary teacher: Focuses on the whole class rather than individuals Teaches the whole class while offering help to individuals, or co-operative work where children help each other Teach one subject at a time Praise children as much as possible Have high expectations Encourage challenging talk rather than quiet busy work Use a variety of teaching styles Allow children some independence and be democratic rather than autocratic about work and discipline Matches work to a childs ability Effective teaching is a subject that is repeatedly researched and studied. More recent research shows that good teachers demonstrate a number of characteristics, but there are certain characteristics that underlie the effectiveness of teachers such as empathy and a willingness to work hard. Some people are described as being born to teach, but the personal and moral characteristics needed to be an effective teacher can be developed through practice, watching other effective teachers and learning from their technique. A study carried out by Santrock [2001] identified the main characteristics of effective teachers: CHARACTERISTICS OF EFFECTIVE TEACHERS Characteristic Total % 1. Has a sense of humour 79 2. Makes the class interesting 73 3. Has knowledge of their subject 70 4. Explains things clearly 66 5. Spends time to help students 65 6. Are fair to their students 61 7. Treats students like adults 54 8. Relates well to students 54 9. Are considerate of students feelings 51 10. Dont show favouritism towards students 46 Santrock, J. (2001) An Introduction to Educational Psychology, London: McGraw Hill, (p.10) Although subject knowledge is ranked third, the study overall shows that personal characteristics are key to effective teaching rather than qualifications. Classroom management is also an important factor as an average school week only provides 25 hours of teaching time with students. An effective teacher organises their students, time, environment and resources in a way that maximises learning opportunities. Effective teachers also motivate and encourage their students to work hard. Through regular assessment and looking closely as what a student is learning and what has been learnt, lessons can be planned accordingly. Teachers need to cater for the skills, abilities and interests of each student by matching work to the needs of the individual. This avoids giving tasks that are impossible to complete and to avoid giving tasks so easy that students learn nothing. Pedagogy: shared working atmosphere; awareness of the needs of each pupil; purposeful well organised classroom; celebration of successes. Need to know the needs of individuals and groups as well as how children learn. Most teachers teach facts, good teachers teach ideas, great teachers teach how to think. (Jonathon Pool). Teachers have to be facilitators: they cannot do the learning for the student. (Carl Rogers). A teacher who likes to explore a subject by using lots of activities can achieve the same success as one who prefers one activityà ¢Ã¢â€š ¬Ã‚ ¦ There is one aspect of personality that no teacher can do without: a willingness to learn and to reflect on teaching. (The Effective Teacher, p.10). Failing teachers often lack self awareness and do not quite know what they are doing or if what they are doing is right or wrong. They are defensive about their teaching methods and cannot take criticism, however constructive it is. [Ref] Define learning 250 Learning can be defined as The process of accumulation and change that marks our growing sense of knowledge. (p.14 The Effective Teacher). Different factors can affect learning and these include the child, the family, society, economy and social structure. Brofenbrenner looked at how children grow up and how that affects the learning process, then linked all of these factors together into his Ecological Systems Theory [1979]. His theory suggests that a childs development is influenced by the social contexts in which they live, with the three main contexts being a childs family, peers and school. The parent and child are placed at the centre of learning. 2. 1.Who the child spends most of their time with is identified and what positive and negative factors that has. 3. The general external factors that influence the learning environment are looked at. Constructivist approach to learning Recall; ability to remember information Understand the information Use or apply knowledge in new situations Break down and interpret information Putting things together; developing new ideas Assess effectiveness of whole concepts; critical thinkingBlooms Taxonomy is a classification of the levels of learning. The cognitive process identifies 6 levels of thought. Based on this theory, the learner has to reach one level before moving on to the next. When used correctly, Blooms Taxonomy can accelerate learning and elevate student interest and achievement, especially for slower learners. [Sousa, D. 2001] How the brain learns What makes an effective learner? 500 Understanding and thinking about how a person learns can enhance motivation and increase achievement. [REF ] A persons learning style is the way he or she concentrates on, processes, internalises and remembers new and difficult academic information or skills. Styles often vary with age, achievement level, culture, global versus analytic processing preference, and gender. [Shaughnessy, 1998]. It is often looked at in terms of a learners preference for visual, auditory and kinaesthetic ways of working. [Burton, 2007]. Encourages a learner to think about how he or she learns. Novice learner: Do not evaluate their comprehension Do not examine their comprehension Do not examine the quality of their work Do not make connections Expert learner: What is the relationship between teaching and learning? 500 Consider which is more important. Actual learning or actual teaching? Support argument with literature and wider reading. 500 There have been many arguments as to which side of the teaching and learning processes are more important. Child centred education the teacher gives the child opportunities to learn. Teacher centred stand and present what they know. Teacher centred education is a traditional approach to teaching where the teacher presents facts to the student by direct instruction. The teacher is at the centre and in charge. Student centred education is a more modern approach where the learner is at the centre of learning and the teacher acts as a facilitator, guiding the student and giving opportunities to learn. Bennett, 1976 Clinical Reasoning Case Study: Knee Osteoarthritis Clinical Reasoning Case Study: Knee Osteoarthritis Abstract Clinical reasoning is the thinking process that escorts clinical practice, it is a multifaceted skill. The aim of this report is to use clinical reasoning to comment on a case of medial compartment one-sided knee osteoarthritis. Using clinical reasoning, an outline of management and manual therapy are designed. Introduction Mendez and Neufeld (2003) defined clinical reasoning as a cognitive process aiming to understand the implications of patient data. It also aims to recognize and diagnose present concrete or latent patient problems, to make clinical well-judged choices to help in problem solving, and to result in encouraging patient outcomes. Factors affecting the outcomes of clinical reasoning can be internal factors linked to health professionals (knowledge, acquaintance with a particular case and their reasoning skills). Patient factors need skills to transfer facts, and explanation of disease condition and treatment alternatives. External factors include health institution potentials, profession-specific structure of treatment, and intricacy of the case (Mendez and Neufeld, 2003). Edwards and others (2004) suggested the following practices of clinical reasoning for a physiotherapist. Diagnostic reasoning, developing a diagnosis based on disability and its impact considering accompanying pain, pathological changes, and contributing factors to the disease. Descriptive reasoning is to understand the patients description and experiences about the disease. Procedural reasoning involves treatment decision making, while communication collaborative reasoning involves setting up a patient-therapist relationship and setting goals for treatment based on interpretation of investigations results. Predictive reasoning is foreseeing the treatment results, and ethical reasoning which needs understanding of the ethical questions about the conduct and goals of treatment. Possible causes and processes of the patients recent complaint: Based on the patients occupation, and history, knee Joint injury herald osteoarthritis in individuals who are in their 30s or 40s, osteoarthritis becomes obvious nearly in every other subject with a previous history of knee injury. A proper interpretation of the existing data infers that at 10 years after suffering an injury to the knee, an average of one third of patients display joint space narrowing on x-ray examination. Twenty years post injury, about half the individuals with history of injury shows similar changes (Roos, 2005). Arthroscopic procedures may cause postoperative knee pain and swelling enough to delay rehabilitative physiotherapy. This should not persist more than two weeks otherwise the patient will be at risk of complications mainly prolonged knee stiffness. (Reuben and Sklar, 2000). Many believe that changes in the knee joint in osteoarthritis reproduce the collective effects of mechanical stress rather than senile degeneration alone. Therefore, it is an occupational disease (Radin, 2004). Patients occupation activities are aggravating factors to develop knee osteoarthritis (Loomis, 2008). Based on the patients symptoms and physical examination findings, the patient may have had a cruciate ligament rupture or added meniscal injury. Because of negative ligament tests, tenderness over medial TFJ joint line, no tenderness of patella tendon, quads tendon, hams tendons insertions, MCL attachments or LCL attachments, and data suggesting positive McMurray manoeuvre. Besides the presence of mild effusion, it is most likely the patient suffers a meniscal injury (Dascola, 2005). Roos (2005) provided a model for the processes responsible for pain and development of osteoarthritis. He assumed the disease needs, being mechanically determined, increased or altered joint load as a precondition to its development. Therefore, joint injury, occupation and aging lead to development and progression of osteoarthritis in one of two possible pathways. First, deconditioning of the musculoskeletal, increased joint loads occur with pain and progression of osteoarthritis. Alternatively, joint instability, misalignment and defective proprioception result joint related changes leading to increased joint loads with pain and disease progression. The patients irritability: At this point, the patient anxiety is because of worsening of pain and movement limitation and worry that he will not be able to continue working or doing everyday activities without significant discomfort. Jinks and others (2007) suggested that a therapist should look at the first onset of joint pain as sign to try preventing future disability. Reasoned identification of need for caution and need for adjustments: Three cardinal patients findings call for caution and adjustment of assessment as they may need change in the plan of manual therapy. These are persistent pain for four months, reduced right knee extension in standing with slight varus deformity. Besides pain limiting knee movement in active and passive flexion and extension with pain and stiffness limiting lateral rotation and stiffness without pain limiting medial rotation. Plain radiography was done following Ottawa knee rules (Jackson and others, 2003) and showed the same findings as the one done two years earlier. The use of MRI in addition provides better prediction of the need for added treatment. Indication of MRI, in this case, is to evaluate pain as it persisted for more than 3-6 weeks (Oel and others 2005). In case MRI is not available, or not covered by insurance, knee ultrasonography can be helpful to assess knee effusion, integrity of tendon and MCL injuries and to rule out minimally displaced patellar cracks (Lin and o thers, 2000). Arthroscopy can be diagnostic and therapeutic for meniscal or ligaments injuries, removal of loose pieces of cartilage or bone. Besides intra-articular steroid injection can be given to manage pain, viscous supplementation, and arthroscopic debridement and washout can ease the mechanical symptoms (Gidwani and Fairbank, 2004). Factors that may be contributing to the patients presenting problems: The slowly developing knee swelling is matching with meniscal injury however, the therapist must consider associated mild ligament sprain. The absence of locking is against meniscal injury, but the giving way points to possible ligament injury or patellar sublaxation. The presence of anterior crepitus may point to ligament injury or patellar problems, however, the active and passive limited range of movement suggest an intra-articular problem (Smith, 2004). This calls to consider the possibility of having combined lesions on top of osteoarthritis. Three more points need communication with the patient, adjusting occupational activities (Loomis, 2008), return to swimming sport practice or perform water exercise being a low knee load exercise (Grainger and Cicuttini, 2004). Also, tell the patient with the potential side effects of NSAID and advice to use topical preparations with safer analgesics as paracetamol (Derbyshire County NHS, 2008). Developing a working hypothesis: According to the patients current situation, expectations, worries and good general health, and knowing the case is most likely to be knee medial compartment osteoarthritis the objectives of manual therapy should be (Technical Committee Physiotherapy Profession, 2003): Minimize pain Decrease disability and enhance functional ability, muscle strength, joint flexibility. Patient education to encourage better work activities, and regain interest in swimming sport. When to start manual treatment and what is the plane: Manual therapy portrays the physical therapist applying passive movements aiming to enhance joint motion and minimize stiffness. It includes passive range of movements, and muscle stretching techniques (Fitzgerald and Oatis, 2004).As this particular case needs a multidisciplinary approach that may involve surgery, manual therapy should start once the process of diagnosis and possible surgical interference finish. It may start in conjunction with pain relief physical therapies as thermotherapy, cryotherapy and transcutaneous electrical nerve stimulation. The general rules of static stretching range of motion manual therapy are (Technical Committee Physiotherapy Profession, 2003): Twice weekly when pain and stiffness are least in 20-30 minutes sessions (Hoeksma and others, 2005). Better to be preceded by warm compresses. To be performed slowly and the range of motion extended to the limit of least subjective pain and resistance. Advice the patient to breath slowly during passive exercise. Hold the terminal stretch for 10-30 seconds. Passive exercises are continuously adjusted according to pain and the duration of holding the static position. Measuring the outcome: The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) test is a self-report specific measure to assess pain and physical function. Validity of the test was investigated in many studies and showed high levels of consistency and test-retest reliability consistent with clinical practice (Stratford and Kennedy, 2004). The 6-minutes walk test is primarily endurance test originally developed to measure exercise capacity in cardiac and pulmonary patients. Test-retest reliability and responsiveness index (measures improvement after therapy) have been examined and found highly reliable (King and others, 2000). Patients perform these tests at baseline, on the 5th week, and later every 12 weeks of therapy (Hoeksma and others, 2005). Prognosis and expected improvement rate: Jinks and others (2007) stated the outcomes of osteoarthritis are poor quality of life, limited daily activities and disability. However, we know little about the primary influence of joint pain on disability in the older population; also we know little about if such influence is reversible if the pain improves. According to their results, Jinks and others (2007) inferred that decreased physical functions among knee osteoarthritis patients with pain shows how important this symptom is as a possible launching cause to decline of physical activities. Even those whose pain improves are occasionally able to regain their experienced levels of physical activities. The Ottawa Panel (2005) advised the combination of manual therapy and therapeutic exercises especially muscle strengthening exercises to achieve better improvement of pain and function in patients with osteoarthritis knee. Conclusion Clinical reasoning is on of the methods of applying evidence based practice in physiotherapy. A case of medial compartment right knee osteoarthritis presented with pain after minor exercise is subjected to clinical reasoning critical thinking. The case turned to be a multidisciplinary case that needs further investigation and possibly orthopaedic surgeon interference before manual physiotherapy begins. Using clinical reasoning skills and principles, the patients history and clinical findings were analysed, designing principles of a plane of manual therapy, measuring the outcome, and foreseeing prognosis and improvement rate were explained. References Dascola J S, 2005. Injury-related causes of acute knee pain. JAAPA, 18(7), 34-40. Derbyshire County NHS Primary Care Trust, Medicine Management Update, February 2008. Reviewing Non Steroidal Anti-Inflammatory Drug (NSAID) Prescribing-an update on current issues [Online]. No 3. 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