Yocheved Bensinger-Brody, PT, PhD, PCS
School of Health Sciences, Touro College
I was recently honored with receiving the Presidential Faculty Excellence in Teaching Award, and because of this was asked to describe some of the teaching strategies I use in this blog forum. Considering that I don’t have an advanced degree in education, I don’t feel qualified to pontificate about best practice teaching strategies, but I can share about my motivations, the resources and strategies I’ve found helpful, and reflect about what I think is really working in my classroom.
Soon after graduating with my BS in Physical Therapy in 1999, I attended a continuing education course about neuroplasticity and how clinicians can potentially help drive this process. This course was perhaps the most formative of my entire career. Not only was the new-to-me concept of a plastic brain mind-blowing, but I have a distinct memory of feeling offended that my entry-level clinical education had not introduced me to this concept. To be fair, at that time, this was still a relatively new science that had not yet influenced standard of care. However, this offense I felt, in knowing that the current state of basic science and my clinical education did not match, has since motivated all of my clinical work, further education, and teaching. In my current role as a faculty member in Touro’s Doctor of Physical Therapy Program, I am responsible for the pediatrics curriculum, which includes typical development, atypical development, diagnoses, evaluation, and intervention. While I address each of these topics from the lens of a physical therapist, I also address each of these topics from the perspective of multiple scientific disciplines, including developmental psychology, developmental orthopedics and neuroscience. In addition to integrating this information into my lectures and assigned readings, I provide extra credit for students who engage with the scientific community at large, by attending scientific talks on related areas, or by visiting a scientific lab. With my encouragement, each year a number of my students attend lectures about Autism at the Simons Foundation, a NYC foundation dedicated to science and math research. The feedback from students is always consistent; they don’t necessarily understand everything presented, but they have a new appreciation for the complexities of the diagnosis and are excited that scientists from multiple disciplines are working to understand the clinical problems, as this will ultimately inform our practice as physical therapists. The students start to see themselves as part of a broader scientific community working towards solutions for optimal developmental outcome.
While this sets the tone for the courses I teach, most of the topic areas are physical therapy-centric and clinically oriented. Like many of my colleagues in clinical education, I use a multi-modal teaching approach. In addition to skill-based labs during which the students learn and practice skills, I have been able to bring children into the classroom for the students to practice standardized testing skills, and for evaluation and treatment demonstrations. While bringing ‘patients’ into the classroom provides a unique opportunity for learning, it is when entering the clinical environments that classroom concepts become real. I have been fortunate to partner with hospital and community based pediatric centers that allow me to bring my students for day-long trips. At these sites, the students are able to learn firsthand about the different environments of care, to meet children with varied diagnoses and in varied stages of rehabilitation, and to observe physical therapy treatment sessions.
For the didactic content of my course, I integrate power-point presentations with the use of the smartboard to draw complex concepts. In addition, videos of typically and atypically developing children allow us to engage in movement analysis, and videos of me treating select pediatric patients at varied ages and developmental stages provide yet another tool for learning. I invite content experts as guest speakers, to teach specific clinical skills, and among them are two occupational therapists. My hope is that students will understand the value and relevance of other disciplines’ expertise the way I do, and that this models ways to work in an interdisciplinary fashion. During my doctoral training in psychology at the Graduate Center of CUNY, I was fortunate to take a semester long seminar about teaching with Dr. Louise Hainline, a renowned professor of psychology whose research interests are partially focused on learning in higher education. In this evidence-based course we learned numerous strategies for encouraging active learning during the presentation of didactic material, as this keeps students engaged, and facilitates active processing as opposed to passive hearing. Teaching in a clinical program lends itself to active learning strategies, as we often ask the students to work on case studies or to consider clinical problems while working in dyads or small groups. However, one of the most helpful and unique strategies that I’ve implemented from the seminar is the 2-minute-paper. At the start of each class I project 2-3 questions on the board relating the most important topics that were covered in the last session. Students are instructed to take 2 minutes to write as much as they can remember about the topics/questions without consulting their notes. After 2 minutes, they are able to turn to the student next to them to elaborate and help one another fill in the blanks, and then we come together as a class to discuss. In this way, within 7-10 minutes, all students have been able to review key concepts, and as a class, we are ready to build. Students have told me on many occasions that this strategy is helpful. It could be that they like this strategy as it helps them guide their studying. I find the strategy helpful because from the first minutes of class, the students are actively and dynamically engaged in the conversation.
Above all of the content and skills that I teach, I try to infuse a sense of the human factor that is essential when working with children and their families. Each year I wrap up my clinical pediatrics course with concluding ‘soapbox’ remarks, summarizing the messages I had tried to convey throughout the curriculum. A sample of these ‘really need to know’ ideas are that:
- You need a good eye – In simple terms this refers to a clinician’s observation skills that are perhaps the most important skill we have. I elaborate and explain that in Hebrew, a good eye, or ‘ayin tov’ takes on another meaning as well. It means to see others with rose-colored glasses on, as perception drives response. Children are not ‘manipulative’, rather they are finding strategies for survival and adaptation; their behavior communicates this to us. Parents of our pediatric patients are not ‘difficult to deal with’, rather they are doing their best to advocate for their child, are often overwhelmed, and could use support. I encourage my students to see and appreciate the often-untestable brilliance and potential that each child presents with. When you approach a child and his/her family with an ayin tov, the relationship is one of trust, and a true partnership develops.
- You need to stick your neck out – Often as allied health care professionals, physical therapists will leave the difficult conversations for the physician or will rely on the physician’s expertise to catch medical flags. I encourage my students to be ready and willing to have the hard conversations with parents and to put their own reputation on the line to push for additional testing if clinical symptoms are not adding up to the diagnosis provided. Working with children lends itself to unique opportunities and unique responsibilities, as our level of investment can truly impact a child’s trajectory of development.
- As often as we can, you need to say yes – Unfortunately, it is easy to say no; to say that a child is unable to achieve a skill level or is not able to learn how to navigate a certain piece of equipment. It is harder to say yes, and to problem solve how to make skills and opportunities accessible to children and their families. There are enough naysayers; I encourage my students that whenever they are able, they should be the ones who say yes.
This past year while attending the American Physical Therapy Association’s national conference I had the opportunity to meet and talk to faculty from other DPT departments who teach the pediatrics curriculum. Interestingly, a number of programs are choosing hybrid or fully online classroom formats for their pediatrics curriculum. When I returned, I informally polled a number of students who had just completed my clinical pediatrics course and asked them what they thought about this. The response was unanimous; every single student said they would not want this class to be online, and they couldn’t even conceive how this could be done. I am sure that much of the pediatric didactic content can effectively be taught in an online format; in fact, others are doing just this. However, I think the opportunities to engage the students in active learning, and to drive home the important messages that we are part of a scientific community, that we are part of a multidisciplinary team, and that above all we value the partnerships we develop with children and their families, would get lost. Perhaps more importantly, in the classroom I can model for my students the attributes that I hope they will emulate as clinicians. I am grateful for the human connection I am able to establish with my students in the live classroom, and I am convinced that it is our humanity in the classroom that helps us learn the lessons of humanity that we must demonstrate with the children and families that we serve.