Farewell UWSOM

Dear Friends,

I am now in my last hour as Director of Currculum at UWSOM, and this is my final post. I know I haven’t posted in a long time, and I wish I had been able to keep up this blog a little more assiduously. Things got busy in A300…..

Thank you all for your contributions to the school of medicine and to medical education. As I move into my new role I just might begin to wrap my mind around all the things I’ve learned in the past couple of years and how much I’ve gained from my time here. Thank you all for your patience as I learned, as I stumbled, and as we worked together to improve our curriculum.

I have in various posts included links to other blogs, articles and video clips – not always with the best insight, it turns out.

I’d like to leave you with one that is maybe a little too sentimental, but oh well, it’s the New Year and I’m going to miss you all, so why not. It’s what we’re here for, after all, to spend a little time as teachers and as physicians, getting into the experiences of our students and our patients, so that we can better serve them, and better learn and heal ourselves.

Keep in touch! I am eager to follow the progress of the new curriculum!

If we could see inside others’ hearts.

With regards and signing off the Blog of Curriculum Renewal (at least for now),


Active Learning Classrooms

This spring I was lucky to be a part of a faculty professional learning community (FPLC). Once a week I got to walk up campus to Odegaard Library and spend an hour with other faculty and staff from across the university, to talk deeply about active learning classrooms. The impetus for this FPLC was the brand new pair of active learning classrooms that have been created as part of the remodeling of Odegaard. Each week for spring quarter, one of us led the discussion and focused on a different aspect of teaching in an active learning classroom – what is needed? How do we do it? What have we already experimented with? What are the successes and challenges we’ve seen or experienced ourselves? How will we use these new spaces in the library? We brought in examples of lesson plans that could be adapted to the new spaces and offered each other tips on how to make them stronger. Once the rooms were nearly finished, we got to tour them and do some pretend teaching using the equipment and practicing being in the space.

The classrooms are amazing – they were designed and created specifically to enhance student learning in small and large groups, using the most current technology and allowing for flexible leadership among students and faculty. The teacher is not tied to the front, students are arranged in tables of nine that can also be used as three sets of three, there are monitors all around and the person at the controls can toggle all sorts of configurations of what is on the screens. There are glass boards at arm’s reach of each table for writing, and alcove booths for even smaller groups of students to work together away from the main group.

One member of our FPLC will be teaching in the ALC this autumn quarter. He was at first unsure of how he would be able to make some of his materials work for this space.  He teaches geography, and he uses actual maps that he hangs on the white board in a traditional classroom. Once he saw the room take shape his imagination got started and together our group brainstormed some ways for him to adapt what he does plus try some new approaches.  He realized that he could actually allow students to work in smaller groups on the maps if he figured out how to project them – and then came up with several ways to try that, while still having the physical maps up on one of the walls. He plans to take it slowly and not hold every session in the ALC for the first quarter. Making this shift means changes in his lesson plans and some of his materials, so doing it all at once is a huge endeavor.

Even if you don’t have access to the ALCs in Odegaard, you can start slowly, make a few changes, and brainstorm some new approaches. There are lots of resources available to help make your lesson plans more active. Some are on the Odegaard ALC web site linked above. Some you can get from me if you let me know. In A-300 we are here to help – for the UW SOM faculty in Seattle and across WWAMI, let me know if there is anything I can do to support your efforts to promote active learning in your classroom.

Sharing learning on learning


Last week I was fortunate to attend a Teaching and Learning Symposium that was held in the (beautiful new) HUB on campus. The symposium was a poster session of research that UW faculty have conducted on teaching and learning in their classrooms. There was also a brief panel session where four faculty described their efforts to incorporate technology into their teaching in innovative ways. It was so much fun to walk around and listen to all the chatter about students, assumptions about learning, discoveries about teaching, and what it meant to do research in the classroom.

Since most of you, I think, were not able to attend this symposium I am delighted to share with you the link to this report produced by the UW provost on learning. Take a look – you can see all the fascinating ways that UW faculty are engaging in evidence-based teaching and find some resources for more information at the end.

If you’re a faculty member at UWSOM and some of these things appeal to you – let me know and we can talk about how we in curriculum can help you get started. Look closely at this report – you can find our own Robert Steiner there! Enjoy –

Putting Learning First


Musings from a former PTA president

Yes, I was PTA president for two years at my kids’ elementary school and for one year at the middle school. I was also on the board of the preschool, worked as “yard duty” for a year, and taught and volunteered in the classroom. All before I earned a PhD in education. Which is a way of saying that I’ve seen education from a lot of angles – and I’ve heard a lot from parents who want the best education for their kids. If you have kids you probably know exactly what that means to you. What I’ve seen is that parents want deep, enriching experiences with teachers who know their child and care about their child’s progress. They want their kid surrounded by other kids who are eager to learn so that together they can all grow. They appreciate it when teachers provide complex, structured learning experiences that build on one another. They want to know that the teachers have planned thoughtfully crafted lessons with plenty of variety of activities. If they think their child should be in the gifted program, they want those things even more. Smart kids, parents say, should be challenged to think deeply, not just memorize rote information or fill out worksheets, sitting still all day and listening to a teacher talk from the front of the classroom. Smart kids should be up and about, doing, thinking, experimenting, creating, practicing working in teams.

What’s interesting to me is how different that  is from what our students sometimes experience in medical school. People who choose to become physicians are some of the smartest, most engaged and eager students in the entire universe of learners, yet we sometimes provide them a learning environment that all my fellow PTA parents would squak like crazy over if it were the standard for their kids. We ask our students to sit in lecture halls for hours at a time and absorb masses of facts with little opportunity to synthesize, analyze and create new ideas.

I am not suggesting that there is no need to learn facts. Remember the phonics vs. whole language battle about reading instruction back in the 1970s? Or how about the current “math wars” in which parents and school districts are arguing about learning rote math facts vs. students discovering how formulas work in a more organic way? To me those are incredibly stupid arguments because we need BOTH the facts and the critical thinking opportunities. Think of it this way: the more words you know, the better sentences you can make, right? So more facts (words) leads to more higher order thinking (complex sentences with lots of variety). Facts are needed.

BUT – if no one ever helps you learn to create those complex sentences then it doesn’t matter how many words you actually know. Like in logic: necessary but not sufficient. Facts are necessary but not sufficient to higher order thinking. You still need practice with using the facts and constructing ideas and synthesizing and evaluating and all that…with supervision and support from someone who can shape your efforts and provide feedback about how you’re doing (say, a teacher!).

When our students are subjected only to fact-learning they, and we, are missing opportunities to help them create complex medical sentences. When we talk about encouraging our faculty to “flip” their classes and provide more time for working on those complex sentences, we are not asking them to abandon facts and the learning of facts. However, we ARE asking faculty to carefully consider which facts are most important and what is the best proportion of time spent on facts vs. complex thinking practice. There is a limited amount of time to use, and we need to use it wisely for both facts and higher order skills.

Back to K12 education – people with high school students in Seattle may be aware that Nathan Hale High School is a member of the Coalition of Essential Schools. CES is a group started by Ted Sizer, one of the great thinkers in American education in the 20th century. CES schools believe in “depth not breadth” and have 10 principles that guide their educational endeavors. They are, learning to use one’s mind well; depth over coverage; goals apply to all students; personalization; student-as-worker, teacher-as-coach; demonstration of mastery; a tone of decency and trust; commitment to the entire school; resources dedicated to teaching and learning; and democracy and equity. I have to say, if my future physician could be educated with those principles I would be very happy to know I had a hand in making it happen. My PTA days are over, but I’m eager to help UWSOM be the kind of school my fellow PTA parents would have wanted for their kids – some of whom are now medical students.

Curriculum renewal and genome sequencing…which is harder?

A friend shared this post with me today and I wanted to pass it along to you. Dr. Francis Collins is the director of the NIH – and I learned from this interview that he went to high school in Virginia just down the road from my own home town.

The article is about genomic sequencing and analysis, and is in interview format. Dr. Collins answers one question about medical education, and here’s what I thought you might find interesting:

“Dr. Reed: The importance of taking a good family history is something that you and I and every other medical student learned about in medical school. What do you think, in a genomic era, the medical school of the future will look like?

Dr. Collins: I wish I could predict. I know it shouldn’t look like what it is now, and I know how hard it is to change medical school curricula. When I was a medical school professor in Ann Arbor a few years ago, I often scratched my head about how difficult changing just 1 hour of the curriculum could be, because there were all of these entrenched views about what the curriculum should look like. At one point, I think I said it was easier to sequence the human genome than to change an hour of medical school training, and it’s still a challenge to do that.

There are some medical schools, though, that have taken this on in a pretty thoughtful, creative way and tried to build medical school education around a holistic view of how biology works from the genome all the way up to the whole organism and to the environment, instead of having things pigeonholed by discipline.”

And WE are on our way to being one of those medical schools that are taking on the curriculum in a thoughtful, creative way!




Pearls for small group teaching

Bruce Silverstein is the course chair for our GI course, which runs in April for our second year students. Bruce runs the course entirely in small groups, with almost no large lectures. Each day of the course (there are about 10 course sessions over three weeks) Bruce meets in the morning with all the small group leaders for what he calls “skull sessions.” In the skull sessions, the faculty discuss the day’s lesson and challenge each other to remain current on the latest research and clinical approaches to the material. Then in the afternoon, they meet with the students. Students are expected to prepare ahead of time using a carefully outlined and annotated syllabus that provides foundational information. At the start of each session, in the large lecture hall, students meet a patient and listen to a very short (five minute) presentation. Then they move to their small group rooms and spend the next couple of hours discussing the day’s material. Bruce has been refining the Gut course for many years, and has developed some “pearls” for small group teaching.

Pearl #1: What matters is what you learn, not what you know.

  • The most important thing to get the student to believe.  Make it safe to learn. They will not be punished for not knowing.  We are not born with knowledge, we all learn it.

Pearl #2: Make it intimate.

  • In an intimate learning environment you become approachable. Use a horse-shoe or chevron seating pattern so you can walk around, and use name-cards so you can learn their names quickly.

Pearl #3: Students must prepare beforehand.

  • Encourage preparation by picking on students who are not prepared in a soft, fun way.

Pearl #4: Keep things in small bites.

  • Take the material for the session and divide it up into small, somewhat self-contained bites. This allows you to keep things moving and go bite to bite.

Pearl #5: Incentives.

  • Incentives make a difference. Food is a good motivator – and works for the GI experience. Students who answer questions get a cookie or a small food treat.

Pearl #6: Content must be relevant.

  • This is crucial. If they don’t understand why they will think they are wasting their time. Clinical examples of relevance are the best – they want to think of themselves as physicians. 

Pearl #7: Don’t lecture.

  • This is the kiss of death.  Students are moving away from in-person lectures. If you lecture there is no point in having a small group. If you lecture you could just do a podcast.

Pearl #8: Change the pace q 5 minutes.

  • Change exercises, cases.  Keep it moving.  Today attention spans are shorter. Students are used to everything in small bites.

Pearl #9: Skull sessions = consistency.

  • Gut Course instructors meet every day for 1.5 hours to review the material and I teach them how to teach it. This means every student gets the best possible experience in any small group.

Pearl #10: Take breaks.

  • When to take breaks? When things start dragging, when you need a break, when you come to an impasse.  Breaks are a good way to reset where you were. But – only 5 minutes, and guard the treats!

Pearl #11: Reference patients you’ve seen.

  • Students really want to be taking care of patients.  It’s why went into medicine.  Any relevant experience is welcome.  Ask questions about what would they do with a similar case.

Pearl #12: Make it FUN!

  • Learning should be fun.  Think of whatever you can – contests, game shows, anything that is out of the norm.  Don’t worry about not being professional.  I once did a total professional talk as a Jeopardy-type exercise.  It was hard to do but it worked.

Pearl #13: Socratic is best.

  • Never answer the question but ask another question that leads the students to an answer.

Pearl #14: Enthusiasm sells!

  • Excitement is infectious.  Show you care and have energy for what you are teaching.

Pearl #15: Nothing beats praise.

  • Students spend a lot of time feeling under the gun – offering praise for the thinking they are doing is easy and goes a long way to keeping them motivated and involved.

Pearl #16: 90 second rule.

  • Don’t stay on a student for longer than 90 seconds.  Too much time on an individual can cause them to get more flustered or confused.  Allow the student to get a consult from a classmate, or call on someone else.

Pearl #17: Never embarrass a student.

  • Never. And if you happen to do so by accident, apologize later.

Pearl #18: Review and reinforce.

  • Sometimes it takes hearing something 5 times to ensure it sticks.

Pearl #19: If you are hoarse you talked too much.

  • This sometimes happens with faculty who are new to leading small groups!

Pearl #20: Here is they key to small group teaching: make the students do the work!

Active Learning meets Universal Design

Anyone already know what universal design is? [pause while students consider this]

If you don’t already know, and you had to guess, what would you guess? [take a minute to brainstorm with a neighbor]

What did you come up with? [offer a few students a chance to state their ideas]

Well, if you were thinking about ways to make things accessible to a wide range of users, you are on the right track. Universal design (UD) is a set of principles that encourages the creation of objects, tools, spaces, really anything – including teaching materials – in ways that make them effectively usable to the widest range of people. There are seven principles, and they are:

  1. Equitable use.
  2. Flexibility in Use.
  3. Simple and intuitive.
  4. Perceptible information.
  5. Tolerance for error.
  6. Low physical effort.
  7. Size and space for approach and use.

Considering the principles of UD as you develop your teaching materials means that you are contributing to equitable access for all students, undeniably a positive thing to do. So how does that connect to active learning?

In an active learning classroom students take on some of the work, rather than sitting there passively, waiting for it all to be over. Learning becomes a shared experience between the instructor and the students. PowerPoints that are chock full of information do not offer much room for students to do any thinking. All the information is there in front of them and they sit passively while the presenter does all the thinking. It’s even more pacifying if the presenter then reads the slides!

Developing UD PowerPoint slides not only provides for equitable access, but it sets you up for creating an active learning environment, just by being thoughtful about how much you put into each slide. Since I arrived in the world of medical education from the K-12 world I have learned that doctors value having a LOT of slides in a presentation. I’ve heard one doctor, in preparing for a talk, say, “But I only have 40 slides done for my 60 minute talk!” I’ve also seen PowerPoint decks for 60 minute classes that were 120 slides long. It’s as if having more information on more slides is the only way to prove you know what you’re talking about.

Instead, think of your slides as prompts for conversations, as ways to illuminate the most difficult aspect of an idea, not as your own notes or as storage for all possible information you could convey on a topic. Your learners will still recognize that you know what you’re talking about because you will prompt them to think deeply and guide them down the right path, so that they too know what you know.

Good slides that promote UD and active learning have many features in common:

  1. Use a clear font such as Ariel or Times
  2. Maintain high value contrast, for example black type on a plain white background
  3. Avoid fly-ins and dissolves
  4. Convey one idea per slide
  5. Include only what you need to prompt yourself and the learners (you can print out your own notes to use to do your presentation)
  6. If you use figures, keep them simple and focus on the most important information

You can learn more about UD, and read descriptors for the seven principles, at the DO-IT  center at the University of Washington.

Here’s a good resource for thinking about effective PowerPoint. It’s called Really Bad PowerPoint (and how to avoid it).

Marco Rolandi of the UW (Dept of Materials Science and Engineering) has an excellent article on designing figures for presentations. Rolandi, Marco, Karen Cheng and Sarah Perez-Kriz. 2011. A brief guide to designing effective figures for the scientific paper. Adv. Mater. 23: 4343-4346.  You’ll need a UW log in to reach the paper.

If you are interested in trying this – if you’d like to pare down your slides to increase UD and active learning, but you’re concerned about how to go about it – how to think about what to leave in and what to take out…give me a call! I’d be happy to help or to point you to other resources. We can start small – one presentation maybe. See how it goes. I’ll be waiting to hear from you!

Are you “so busted?”

Did you see the article in the Seattle Times this week about Washington college faculty flipping the curriculum? Our own Scott Freeman (who presented at our school of medicine faculty retreat last June) comments in the article that he was “so busted” by a student who told him he wasn’t doing enough to help her learn.

What about you?  Are you doing enough to help your students learn? How do you know? Note that Freeman consistently earned “great reviews” from his students – so how well your students like you as a lecturer isn’t necessarily a good measure of how well you are reaching them. You could be the best lecturer ever and still your students might not be learning as much as they could.

There is evidence that active learning works, and even evidence specifically in STEM (science, technology, engineering and mathematics). Check out the article by Joel Michael from Rush Medical College to see an analysis of some research. Med students are sharp and dedicated, so they are going to wring all the learning they can out of anything we present to them, but even so, we have an obligation (and an honor, I believe) to provide our students with the best learning opportunities we can.

When I was a grad student one of my mentor professors talked to me about professional humility. He said it was the recognition that as smart and as dedicated a researcher as I might eventually become, I would only contribute a drop in the bucket of human knowledge and understanding. To have professional humility was to recognize that my expertise would only take me so far, and to value the contributions of others too. Scott Freeman demonstrated professional humility when, in spite of positive student feedback and years of experience teaching a lecture format, he acknowledged his own limitations and tried a new approach.

Are you “so busted?” Are you willing to try another approach?

Michael, Joel. Where’s the evidence that active learning works? Adv Physiol Educ 30:159-167. 2006. doi:10.1152/advan.00053.2006.

New year, new quarter, new changes in teaching and learning

Greetings! It has been a few weeks since the last post – Thanksgiving and other events intervening. The end of autumn quarter is fast approaching, and winter quarter will begin in the new year.

Here in A300 we have started a new activity called the “WYN” meeting (WYN stands for What You Need). The WYN team consists of staff from Curriculum and Academic and Learning Technologies (ALT). We have been arranging to meet with the course chairs in the weeks before the start of the quarter to hear about any changes planned for the course and find out what each chair needs to effectively deliver the course. We also let the chairs know what’s going on in curriculum and technology and how we can support their work.

So far we’ve met with two course chairs ahead of winter quarter, and learned about some wonderful changes they have planned. One chair, after noticing that a lecture she was at was pretty darn dull, has decided to overhaul the way she presents some of the information in her course, “flipping” some parts of her curriculum. Now, students will have reading to do outside of class and spend more of their course time in small groups working on problems related to the preparation – rather than listening to all of the content delivered in a lecture.

The other chair we’ve met with has plans to pare down his syllabus, continually refining what is the most important information for students to focus on, and including bullet points. He also plans to add more audience response questions to his lectures, and provide formative feedback opportunities at the beginning of small groups.

Today we heard an excellent presentation by Geoff Norman, of McMaster University, who spoke about cognitive psychology. One of his key points was the importance to learning of transfer – the way we apply information or understanding from one context to another. Norman argues that this is one of the most important elements of learning and requires a lot of practice yet one of the least emphasized in class. It strikes me that some of the changes that our course chairs are making increase the opportunities to practice transfer by freeing up time in small groups to work through problems and see “deep structures” – the elements that actually transfer.

I look forward to meeting with more course chairs and hearing about their plans for their courses. Students – keep your eyes open for opportunities to practice transfer – and plan to prep more outside of class so you can look for deep structures as you work through problems in your small groups!

Effective Interactive Techniques for Lectures

I just got off the phone with a faculty member.  He was talking about ways to make his lectures more engaging, and he mentioned being at a CME lecture recently and how boring and dull it was. He pointed out that in a traditional lecture, it’s the presenter who is having all the fun, thinking and being engaged, but the audience just sits there. We remember better and more easily when we are engaged and thinking – and if it doesn’t happen during the lecture then we have to go home and redo it later to prepare for assessments. Why not find ways to help students learn more deeply DURING class time?

Here at UWSOM we are working to support our faculty who want to do that. Whether you’re interested in doing Khan Academy style “nuggets” and using class time for cases, projects or problem-solving, or if you just want some tips on how to make large group lectures more engaging, we can help.

In fact, there is a workshop coming up in a few weeks that you might be interested in. Here is the information from the flyer:

Low-Risk and High-Tech Approaches to Making Your Lectures More Interactive

Tuesday, December 11, 2012

8:30 a.m. to Noon

 Are you interested in learning effective interactive lecturing techniques that will engage learners and optimally stimulate learning? This workshop is designed to introduce participants to a variety of easy to implement “low-risk, high-yield” strategies to increase interactivity and learning in large-group, “lecture” type settings. The workshop will also present several technology-enabled methods that can be used during large-group sessions to prompt learners to apply their knowledge of the subject.

 Objectives for Workshop Exercises

 After this session participants will:

  • Describe several low-risk, high impact interactive teaching/learning strategies to incorporate into lecture-type teaching sessions.
  • Describe technologies that can assist in making learners more active participants during large-group sessions
  • Select a strategy to implement and outline plans for incorporating these strategies into a recently presented or planned lecture or series of lectures consistent with objectives.
  • Identify 2-3 data markers that would inform the evaluation of strategy’s success.


Michael Campion, MEd & Lynne Robins, PhD

 All workshops are free to all University of Washington School of Medicine faculty and Health Sciences faculty members.  Enrollment in each workshop is limited, and registration is required. TO REGISTER please visit Catalyst:


If you are an eligible faculty member please consider attending!