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Teaching & Learning

The good (effective) teacher or teaching. What does the evidence say?


path: EFFECTIVE TEACHER/TEACHING – based on research and evidence

The Cognitive Principles of Effective Teaching

These are simply excellent.  Presented by Professor Chew of Samford University.  Although the videos are short, there’s a lot in each one – so think about replaying them or mind-mapping them out.  

1: Beliefs about Teaching

2: The 9 Cognitive Factors to Learning

3: Prior knowledge, misconceptions, ineffective learning strategies and transfer

4: Constraints of Selective Attention, Mental Effort, and Working Memory 

5: Teachable Moments, Formative Assessment, and Conceptual Change

There are so many myths out there....

A lot of medical teachers (and others in general) hang onto teaching ideas that have been “sold” to them rather than being evidence based.   For example, many of us will have been taught that trainees only remember 10% of what they read, 20% of what they hear, 30% of what they see and a whopping 90% of what they do (e.g. if they teach others).  Another example is the idea that trainees should be taught according to their learning style.   Both seem logical don’t they and we therefore don’t question them if they “make sense”.  But the truth of the matter is that there isn’t any research that says there is any truth in either of these two things.   We just assume them to hold true because they make logical sense.  In fact, Edgar’s Cone of Experience (read, hear, see, do) was initially presented as a theoretical framework that made no mention of learning but soon took on a life of its own, as the learning pyramid!!!  As for learning styles, medical teachers have never been told to stop teaching different learning styles – it’s just not as widely mentioned anymore.  So, its use has died out, but not necessarily the underlying belief.

Although this video talks a lot about effective teaching in schools, many of the findings are transferable to the world of teaching in primary care.

So, it is not surprising that more and more educational institutions, schools and teachers are beginning to focus on what the EVIDENCE and RESEARCH actually says about what sorts of things help with effective teaching rather than relying purely on old teachings – some of which are true but many have little evidence behind them.   And some of these old teachings, even when exposed as untrue, are so ingraned into our educational societies that they continue to hold form.    As a medical educator, you do need to become more research informed with respect to teaching so that you don’t get caught up in the masses of misinformation presented to you.  But the pressure of your workload often means that you don’t have the time to keep track of it all, hence the reason for these pages.

Please note: Some of the videos on this page refer to teaching children in schools.  Do not be put off by this.  Many of the underlying principles still apply to teaching adults like our GP trainees.  Try and tease out the key points that you think are transferable to adult teaching.

What is effective teaching?

  • Effective teaching is that which leads to high achievement by students in valued outcomes.
  • The effective teacher is the teacher who can employ a range of different skills to enable effective teaching to happen.

Pedagogy Revisited

Today, pedagogy refers to the theories and methods used in teaching; how knowledge and skills are imparted in an educational context. However, in the past, pedagogy referred specifically to the methods used to educate children. Andragogy was coined to focus on the practices used to teach adults.   I mention this here because in the educational literature you will often come across the word pedagogy – as in “how can we improve our pedagogical methods”.    Pedagogy in this sense means the theories and methods used in teaching, and not the art of teaching children in a formal teacher-centred way.

Teachers with the highest qualifications are not automatically the 'best' teachers

So, what does the research say about THE EFFECTIVE TEACHER?

  1. As a teacher, you must have good knowledge about what you are teaching and some awareness of how different learners might interpret that knowledge.  Also be familiar with resources available to help support you and your learners. (HIGH IMPACT)
  2. Your teaching methods should review and build on previous knowledge (scaffolding).  Teaching methods should include active practice and time for reflection to help embed the learning.  (HIGH IMPACT)
  3. Create a classroom or educational climate that is conducive to learning.  An environment which shows respect to learners, values everyone’s opinions and where the teacher and learner are on the same level.  Show warmth, respect, enjoyment, and enthusiasm.  Teacher sensitivity to student needs.  Regard for student perspectives – respect for student autonomy, interests, and motivations.  The educational environment should be safe enough to enable learners to express their honest feelings and thoughts.  Both teachers and learners need to feel trusted and value.   Build respect and rapport.   Organise the physical space.  Establish a culture for learning. (MODERATE IMPACT)
  4. Championing love, passion, enthusiasm and dynamism for a subject is perhaps one of the best ways of engaging learners and thus enhancing the effectiveness of learning.  That enthusiasm and passion rubs off onto the learners.  It results in a confirmation bias – learners see how “wonderfully exciting” this teacher is and therefore expect the lesson will be too.  This knowledge of a teacher’s reputation can strongly influence how a new class feels about them, regardless of their teaching practice.

  5. Periodically reflect on your own teacher behaviour and skills.  Engaging in teaching skills courses, expanding your repertoire of skills, videoing and reviewing self performance helps teachers to develop new skills, build on what they have which in turn results in more effective teaching as the teacher adopts greater teaching style flexibility.   This is aided by the teacher to collects evaluation about him or herself after some teaching sessions. Participate in your professional educational community. (SOME IMPACT)

So, what does the research say about EFFECTIVE TEACHING?

The question of what teaching practices are shown by research to be effective remains contested.  We are therefore left with the conclusion that the behaviour of effective teachers and less effective teachers are not easily characterised; much depends on the particular way that teachers and classes as people relate together. There are signs that certain types of behaviour may often lead to higher gains, but there are always exceptions in both directions (Brown, 2001).

The list of examples beloware all supported by robust evidence of positive impact on student learning, so may be seen as offering at least a ‘starter kit’ for  thinking about effective pedagogy.

HOWEVER, some important caveats are required reading these to be indicators of ‘effective practice’.  All of them are open to interpretation. All of them could be done well or done badly. All of them could be inappropriate in some contexts and  appropriate in others.   So, try not to treat these as a “recipe or formula” for effective teaching.

Key Points from Cognitive Psychology

Paradoxically, some of these things might make make learning harder in the short term, and less satisfying for learners,  BUT actually result in better long-term retention.

  • Varying the Conditions of Practice: Varying the learning context, types of task or practice, rather than keeping them constant and predictable, improves later retention, even though it makes learning harder in the short term.   Focus on higher order thinking skills.
  • Spacing Study or Practice Sessions: The same amount of time spent reviewing or practising leads to much greater long-term retention if it isspread out, with gaps in between to allow forgetting.
  • Interleaving versus Blocking Instruction on Separate To-Be-Learned Tasks: Learning in a single block can create better immediate performance and higher confidence, but interleaving with other tasks or topics leads to better long-term retention and transfer of skills.
  • Generation Effects and Using Tests (Rather Than Presentations) as Learning Events: Having to generate an answer or procedure, or having to retrieve information – even if no feedback is given – leads to better longterm recall than simply studying, though not necessarily in the short-term. Testing can also support self-monitoring and focus subsequent study more effectively. “Basically, any time that you, as a learner, look up an answer or have somebody tell or show you something that you could, drawing on current cues and your past knowledge, generate instead, you rob yourself of a powerful learning opportunity” (Bjork and Bjork, 2011, p61).

As for the teaching session itself…

  • Hook the learners into the subject.  Simply put, if we like a topic a lot then we are more likely to rate the person teaching it as very good. The opposite is also true: most students won’t like the person who makes them work hard at a subject they don’t like.
  • Engage students in Learning.    Be interactive.   Create activities.  Think about questioning and discussion techniques.
  • Be flexibile and responsive in your teaching style.  Engage a variety of teaching methods – vary it – match it to what you are trying to teach.  Be prepared to go off our lesson plan if the new direction is still relevant for learning.
  • Use some sort of Assessment in Instruction.   If the learners know they are going to be tested and think something will come up in the test, they WILL learn it.   A well-known phrase amongst educationalists is “assessment always drives the learning”.

Rosenshine's 17 Principles for Effective Teaching

Rosenshine (2010, 2012) summarised 40 years of research on effective instruction with a key set of principles that maximise its impact.   Training teachers to adopt these behaviours can result in improvements in learner outcomes.

  1. Begin a lesson with a short review of previous learning
  2. Present new material in small steps, with student practice after each step
  3. Limit the amount of material the student(s) receive at time
  4. Give clear and detailed instructions and explanations
  5. Ask a large number of questions and check the responses of all students for understanding
  6. Provide a high level of active practice for all students
  7. Guide students as they begin to practice
  8. Think aloud and model steps (provide scaffolds for difficult tasks)
  9. Provide models for problem solving and worked examples
  10. Ask students to explain what they learned
  11. Check the responses of all students
  12. Provide systematic feedback and corrections
  13. Use more time to provide explanations
  14. Provide many examples
  15. Re-teach material when necessary
  16. Prepare students for independent practice (review & review)
  17. Monitor students when they begin independent practice (weekly/monthly reviews)

The Dynamic Model (Creemers & Kyriakides, 2006, 2011) is empirically grounded in lots of past research.   It focuses on the characteristics of schools and teachers that are associated with high learning.  The model identifies 21 particular teaching practices, grouped under eight headings. 

  1. Orientation
      • Providing the objectives for which a specific task/lesson/series of lessons take(s) place
      • Challenging students to identify the reason why an activity is taking place in the lesson.
  2. Structuring
      • Beginning with overviews and/or review of objectives
      • Outlining the content to be covered and signalling transitions between lesson parts
      • Drawing attention to and reviewing main ideas.
  3. Questioning
      • Raising different types of questions (i.e., process and product) at appropriate difficulty level
      • Giving time for students to respond
      • Dealing with student responses.
  4. Teaching modelling
      • Encouraging students to use problem-solving strategies presented by the teacher or other classmates
      • Inviting students to develop strategies
      • Promoting the idea of modelling
  5. Application
      • Using seatwork or small-group tasks in order to provide needed practice and application opportunities
      • Using application tasks as starting points for the next step of teaching and learning.
  6. The classroom as a learning environment
      • Establishing on-task behaviour through the interactions they promote (i.e., teacher–student and student–student interactions)
      • Dealing with classroom disorder and student competition through establishing rules, persuading students to respect them and using the rules.
  7. Management of time
      • Organizing the classroom environment
      • Maximizing engagement rates.
  8. Assessment
      • Using appropriate techniques to collect data on student knowledge and skills
      • Analysing data in order to identify student needs and report the results to students
      • Teachers evaluating their own practices

So what DOESN'T have much evidence behind it?

As well as telling us ‘what works’, an important contribution of research is to tell us  what doesn’t work. By stopping doing things that are either ineffective or inefficient, we should allow more time to focus on thing that will make more  difference.  The following are examples of practices whose use is not supported by research evidence yet they continue to be done because educators have a hard time in letting go of what was previously all the rage!

Praise for students may be seen as affirming and positive, but a number of studies suggest that the wrong kinds of praise can be very harmful to learning. For example, Dweck (1999), Hattie & Timperley (2007) and Stipek (2010) argues that Praise that is meant to be encouraging and protective of low attaining students actually conveys a message of the teacher’s low expectations.   “Praise for successful performance on an easy task can be interpreted by a student as evidence that the teacher has a low perception of his or her ability. As a consequence, it can actually lower rather than enhance self-confidence. Criticism following poor performance can, under some circumstances, be interpreted as an indication of the teacher’s high perception of the student’s ability.”

Enthusiasm for ‘discovery learning’ is not supported by research evidence, which broadly favours direct instruction (Kirschner et al, 2006). Although learners do need to build new understanding on what they already know, if teachers want them to learn new ideas, knowledge or methods they need to teach them directly.

Evidence on the effects of grouping by ability, either by allocating students to different classes, or to within-class groups, suggests that it makes very little difference to learning outcomes (Higgins et al, 2014). Although ability grouping can in theory allow teachers to target a narrower range of pace and content of lessons, it can also create an exaggerated sense of within-group homogeneity and between-group heterogeneity in the teacher’s mind (Stipek, 2010). This can result in teachers failing to make necessary accommodations for the range of different needs within a supposedly homogeneous ‘ability’ group, and over-doing their accommodations for different groups, going too fast with the high-ability groups and too slow with the low.

Dunlosky et al (2013): Re-reading and highlighting are among the commonest and apparently most obvious ways to memorise or revise material. They also give a satisfying – but deceptive – feeling of fluency and familiarity with the material (Brown et al, 2014). However, a range of studies have shown that testing yourself, trying to generate answers, and deliberately creating intervals between study to allow forgetting, are all more effective approaches.

Teachers who are confronted with the poor motivation and confidence of low attaining students may interpret this as the cause of their low attainment and assume that it is both necessary and possible to address their motivation before attempting to teach them new material. In fact, the evidence shows that attempts to enhance motivation in this way are unlikely to achieve that end. Even if they do, the impact on subsequent learning is close to zero (Gorard, See & Davies, 2012). In fact the poor motivation of low attainers is a logical response to repeated
failure. Start getting them to succeed and their motivation and confidence should increase.

A belief in the importance of learning styles seems persistent, despite the prominence of critiques of this kind of advice. A recent survey found that over 90% of teachers in several countries (including the UK) agreed with the claim that “Individuals learn better when they receive information in their preferred learning style (for example, visual, auditory or kinaesthetic)” (Howard-Jones, 2014). A number of writers have tried to account for its enduring popularity (see, for example, a clear and accessible debunking of the value of learning styles by Riener and Willingham, 2010), but the psychological evidence is clear that there are no benefits for learning from trying to present information to learners in their preferred learning style (Pashler et al, 2008; Geake, 2008; Riener and Willingham, 2010; Howard-Jones, 2014).

This claim is commonly presented in the form of a ‘learning pyramid’ which shows precise percentages of material that will be retained when different levels of activity are employed. You know the thing – We remember 10% of what we read, 20% of what we hear, 30% of what we hear and see etc.   These percentages have no empirical basis and are pure fiction. Memory is the residue of thought (Willingham, 2008), so if you want students to remember something you have to get them to think about it. This might be achieved by being ‘active’ or ‘passive’.

More videos

Beware of Cognitive Overload

Cognitive Principles of Effective Teaching 2



Cognitive Principles of Effective Teaching 5

Here's an ide: an educational research lead

As we said earlier, Medical Teachers do need to be research-informed but the pressure of the workload means that they don’t have the time to keep track of it all.   But how about this?  Ask your Deanery, GP school, or TPDs for someone being appointed the role of adesignated research lead  who can filter what’s out there and share the most robust evidence for their colleagues on a periodic basis.   Perhaps once a year? Think about it…  educators would stay up to date and learners would hopefully be exposed to teaching methods that result in succesfful learning outcomes.  Some high schools already do this…  where a designated research lead creates a newsletter periodically to summarise a range of educational research and discuss its application in the classroom. And perhaps this could then extend into hands-on training in Trainers’ Workshops and help them reflect on their own practice.

A few final words from Ram

Always ask yourself, what am I trying to do?

For me, it’s all about Transformative Learning.  In other words, not just imparting some new knowledge and making me or the people I am teaching look clever.  For me, it is about created fundamental changes to peoples thoughts, feelings, attitudes and behaviour.    A change to their paradigms of reference.  Helping them learning things which help fundamentally change their working practices in a positive way.   That to me is TRANSFORMATIVE learning as opposed to feeding them with a spoon of knowledge.

If it leads to compassion,
you know it's knowledge
Otherwise. it's just more information

Teacher or Facilitaor or Something Else?

I prefer the term facilitator rather than teacher.   For me, the word teacher kind of implies that I am an oracle of wisdom and that I have a lot of knowledge to impart and my recipients are there to sit, listen and absorb it.    However, the word facilitator suggests that I am here to help (or facilitate) the learning process.  In other words, help a learner or a group of learners discover something new for themselves.    New stuff that is yet to be identified.  New stuff that will only emerge through honest and open dialogue and discussion.   New stuff that makes a real different in the real world of people.  

Of course, it depends on what you’re trying to teach.  If it’s some expertise area then, yes, you need to have some good knowledge of the subject matter.   But what I am saying is that there is more than one way of imparting that knowledge than just through talking and slides.   For instance, showing your passion for the subject matter will help inspire interest in the learners who will pick up this enthusiasm.    The way you do it and your passion for the subject matter is what evokes transformative change. 

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Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

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