Teachers have three loves:
Love of learning, love of learners, and
Love of bringing the first two loves together.
Scott Hayden

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THERE IS NO UNIVERSAL recipe for the ideal teaching method. Yet, anyone who has stood in front of students for decades tends to develop what he or she deems as the key principles of effective teaching. While the recipe will vary from teacher to teacher, there will be common principles on critical aspects.

After teaching over four decades, I too have come to formulate what I consider to be the fundamental principles of good teaching. Six in number, I lay them down in this chapter. I do not expect universal agreement with them, or with the relative stress I put on them. I simply offer them as my contribution to the dialog about teaching and teachers that continually goes on among educators, students, parents and citizens. Teaching, it must be said, is an ever evolving profession.

LOVE YOUR SUBJECT

A teacher who is fondly remembered usually has a strong attraction towards his or her subject. Students can easily sense whether you teach because you have to or because you really want to. Your demeanor in the classroom will reveal to them how enamored you are with the topic. And that spirit will also infect your students.

The love of what you teach will keep you learning about it for as long as you teach, and later on as well. It will lead you to avoid teaching in a routine fashion. You will be driven to introduce fresh perspectives as you go along. And occasionally you will point to material beyond the curriculum and stray into novel realms.

I always strove to keep up with the developments in the field of theoretical and applied medical statistics and, during the long vacation every year, upgraded my lecture notes and changed the reading material. It never seemed like a burden but just a part of who I was. I can thereby confidently affirm that:

I was still learning when I taught my last class.
Claude Moore Fuess

RESPECT YOUR STUDENTS

As a teacher, you have a grave responsibility to play your part in the process of the development of your students as human beings. Your noble job is to shape their knowledge base and skills and mold their attitudes towards their profession and the world at large.

Your students are your second family. You have to be attentive to their educational and personal problems, and be flexible when it is warranted. They should know that you care, and are always willing to listen and act appropriately. A teacher who just comes to class, says what he has to say and disappears neglects a basic part of his job, namely, to engage with the students after class. It is only through such interaction that you can come to know your students well, monitor their progress and modify your pace and style accordingly. Each group of students has its own characteristics and you should not assume that what worked last year will suffice this year as well.

I told my students that I was there to facilitate their learning and designated two hours every week when they could come to my office for individual or group consultation. Those who could not make it during those times because of clinical duties or other reasons made separate appointments. It was an unusual thing at MUHAS. Because of the large class size, a line of students would form at my door. If a student was unable to do a test because of family emergency or illness, I would set a separate test for him or her. Overall, I agree that:

The secret in education lies
In respecting the student.
Ralph Waldo Emerson

ADHERE TO HIGH ACADEMIC STANDARDS

Being helpful to the students as much as possible does not, however, imply compromising on the academic standards. While you go the extra mile, at the end of the day, they have to demonstrate that they have put in the effort needed to learn the subject. If they have not, they have to bear the consequences. There can be no exceptions on this issue.

At MUHAS, there was a distinct long term effect in not setting easy tests and exams. After the initial year, students began to realize that in my course, it was possible to fail the second supplementary final exam, and be disbarred from the degree program. It was an unheard of phenomenon at MUHAS. Word filtered down to the incoming batches. Attendance in lectures in the following years rose to 100%, and the students took the course material much more seriously than in the past when passing this course was a guaranteed thing. A few lecturers were heard complaining that the students were paying excessive attention to my course and neglecting other courses.

At the outset, many students, at UCLA as well as MUHAS tended to be unhappy at my demanding requirements. They would complain but to no avail! But once the course was over, quite a number would thank me for making them go through the arduous drill: ‘Professor, we really learned something.’

At both universities, I saw instructors who only taught the easier material and gave substandard exams. It lessened their work and earned them cheap popularity. Because of the breakdown of the system of external examiners at MUHAS, they got away with doing a poor job. Many of today’s students prefer such instructors, and those who make them sweat become unpopular.

Once a group of students approached me to complain about the final exam given for a course I was not involved in. They claimed that it did not reflect the material that was taught and wanted me to raise the issue in the meeting of the Examiner’s Board. My reply was:

I know that nearly a third of the lectures in this course were not given. At that time, none of you complained. Now that the exam was not to your liking, you are upset. I am doubtful about your seriousness towards education. Sorry, I cannot help you.

In comparison, the issue of standard of instruction was a critical one at UDSM in the 1960s and 1970s. In all the faculties and disciplines, the instructors demanded a lot from their students. It was the norm. There was no grade inflation. Though the pass level was just 40%, getting a passing mark required hours of backbreaking work on a daily basis. A first class pass was a rare event. With a bachelor’s degree from UDSM, you could compete with graduates from the best global universities. Sadly, that is no more. Today even a person with a doctoral degree from UDSM or MUHAS generally demonstrates a level of intellectual attainment and maturity that is more deficient than an honors level undergraduate of the earlier era. I thereby strongly concur that:

What all good teachers have in common, however,
is that they set high standards for their students
and do not settle for anything less.
Marva Collins

PRACTICE AND REQUIRE ETHICAL CONDUCT

It is your fundamental obligation to advocate and practice the highest standards of ethical behavior. You should never engage in favoritism for financial, personal or other reasons. And you should never cut corners or misrepresent your work. Your conduct inside and out of class has to be guided by uncompromising intellectual integrity.

Sad to say, breakdown of ethical norms is a common affliction in the modern academy. Not just the students but the academic staff too fall prey to that pernicious bug. I have given some examples earlier. I note one more.

In the year 2000, a student in the Master of Public Health program approached me to help in relation to her research project. It concerned people receiving anti-retroviral drugs for HIV infection. I do not lecture in this program and was not her supervisor. But I usually do not decline to help a student. I soon realized that though she was one of the top students in her cohort, her knowledge of research methods and data analysis was poor. Given the number and type of lectures they had been given, one could not expect more. Thus I spent many hours instructing her on the basics and improving her research proposal. Of course, there was no bahasha for this work; that would go to her designated supervisor.

Then she went off into the field to do the research. Three months later, she was back in my office, now with a thick research report in hand. She wanted me to look it over and give comments before it was finalized. As I perused it, I was astonished. It was a first class, well organized report on a fairly large number of subjects. Data analysis, illustration and interpretation had all been done in an appropriate manner. A novice had accomplished in three months what it would take a team of qualified professionals a year or more to do so.

I was not fooled. It was not her work. She had obtained outside help. Perhaps the data were in large measure manufactured. So I politely told her that I had already provided sufficient assistance and it was the responsibility of her supervisor to comment on and approve her report. She passed with flying colors and I never heard from her again. As for myself, I was quite demoralized and dejected. All that effort ground to dust. As I walked home that evening, I wondered if the leadership of public health efforts in our nation is coming under the hands of experts who have been educated in this style. Where are we going?

INTEGRATE THEORY WITH PRACTICE

When teaching any subject at any level, it is essential to maintain a balance between ideas and facts, between the general and the specific, between theory and practice. This precept applies whether you are teaching carpentry or surgery, mathematics, history or biology. And the balance has to be maintained in a dynamic fashion from beginning to end.

The manner in which a discipline or craft is visualized or practiced by professionals in the field does not represent the ideal way through which newcomers should be taught. Both for slow learners and the bright students, a one-sided emphasis on one aspect or the other of the subject interferes with the learning process. It can even be counterproductive.

Applied statistics (medical statistics, transport statistics, education statistics, agriculture statistics, etc.) is typically taught as a series of techniques for handling a set of numbers. The instructor demonstrates a procedure with an example, and then goes on to another. You waddle through one form of drudgery to another. Most examples are routine and contrived. Your job is to memorize the procedures and apply them when needed. For most students, the subject is banished from the mind as soon as the exams are over.

Unfortunately, this is the alienating approach by which medical statistics is taught in all the study programs at MUHAS, and in general, across the world. Alternatively, it can be taught by organically integrating it into the applied field. Both at UCLA and MUHAS, I taught this subject using a content article based approach. Each lecture took off from one or two health related papers, electronic copies of which had been distributed to the students beforehand. These required readings had reports of research on conditions like polio, malaria, childhood diarrhea, ear infection and so on. A key criterion for selecting an article was that it had in some fashion utilized the statistical tool or method I wanted to cover in class on that day.

I did not begin a lecture with formulas or numbers but would start discussing the substantive issues in the article. With their medical or health related background, the students would be readily drawn into the discourse. The statistical issues and numbers would naturally arise in the process, with the students hopefully realizing that they were essential for a complete understanding of the article and the health questions at hand. And often I would critically analyze it to indicate how the study and data interpretation could be improved. My ultimate goal in the course was to convince the class that a basic grasp of the major principles of statistical thinking is a prerequisite for the sound and effective practice of their respective professions. On this matter, most students were skeptical at the outset. But, by the end of the course, I felt that many had changed their attitude towards statistics.

INJECT EXTRANEOUS MATERIAL

While study subjects are taught separately, reality is not compartmentalized. The biological and physical realms, including human life at the individual and social levels, exist and develop as integrated processes. Human health also embodies physics, chemistry, biology, numbers, psychology, economics and sociology as a complex, dynamic entity.

When teaching any subject, especially at the university level, it is imperative to make the students aware of its wider ramifications, even though doing so may entail stepping beyond the formal curriculum. I firmly hold that such digressions are a necessary part of understanding the subject and it contributes towards their evolution as socially responsible and competent professionals.

My courses on medical statistics at UCLA and MUHAS integrated the actuality of statistics in the real world. I would inform the class about the numerous instances of the misuse and abuse of statistics in medical research and published papers, how conflict of interest, drive for promotion and commercial motivation contributed to compromising the quality of research even in the industrialized nations. I would tell them that statistics focuses on uncovering the truth about a usually complex reality. Without strict adherence to the ethical norms in research and reporting, the ensuing numbers are not just worthless but potentially harmful to human health too. Dealing with such issues tends to engage the students in a more solid manner in the course and improve their critical thinking skills. Quite a number of students I meet years later thank me for making them aware of the deeper realities of health research.

In addition, I would talk about the history of medical research and the contribution of statisticians to the development and refinement of the methodology and dealing with ethical matters like fairness, balancing risk and benefit and consent. The central role played by statisticians in uncovering the importance of the placebo effect in medicine was covered. Once in a while doses of humor and fascinating episodes from the history of medicine would punctuate a technical presentation. Well selected and timed digressions contribute to a richer learning process. I enjoyed them and the students did too.

The best teachers are the best story tellers.
We learn in the form of stories.
Frank Smith