Evoking a rhythm for learning in Health ​and Development ​

This story is written by Kausar S. Khan, Senior Lecturer, Community Health Sciences, Medical College, Aga Khan University, Karachi.

I teach the program of Community Health Sciences to undergraduate and graduate medical students at AKU. I also teach short courses to people from non-governmental and government organizations. My teaching is inspired by Paolo Freire and Carl Rogers, whereby the learner is 'engaged' in the subject to be learnt. I strongly believe that 'people remember what they discover' and, therefore, while teaching I engage learners in making meaning of the subjects/ideas introduced. In short, I follow the maxim, that learners are not empty vessels that have to be filled by some expert.

The following is an example of a very specific teaching strategy that I developed and used with the first-year undergraduate medical students (80+ students), while teaching the topic of health and development. My aim was to help them comprehend the complex and evolving relationship between health, poverty and development; identify determinants of health in Pakistan; discuss factors affecting determinants and propose ways to eradicate elements that negatively affect health. The students sit in rows after rows in a large hall; the average age is 17 years. I used a PowerPoint presentation to flash the topic and introduce the content of the topic. I distributed what I call 'Students – Worksheets', which have seven sections that correspond with the questions raised during my presentation.  In the worksheets, each student is requested to write his/her responses to questions raised. A short (5 min) video clip on health issues in Karachi is shown, and students write down the salient health issues raised by the film. After every section filled in the Worksheet, students share what they have written. Students at one point are asked: "For better health outcomes of the most vulnerable and marginalized, who should define development?" (Question displayed on a slide of the power-point presentation). This is the rhythm of the classroom session – questions raised, students write their response on the Worksheet, share their response, and power presentation moves on. For example, section 6 on the worksheet required students to write what they learnt from the session and in section 7 they write their reflexive note (reflexivity is introduced to the students in an earlier session). Worksheets are collected at the end of the session.

It is quite striking that the majority of students successfully write the reflexive notes and, barring a few, are able to separate their thoughts and feelings. In my experience, the process of separating feelings and thoughts is often not easy for learners. An example from students' reflexive notes, reads: "Empathy leads to a will to change things. I thought about how to help the poor after I graduate. I understood the importance of community health, I felt empathy for my community." It was also very striking that the learning (section 6) went beyond the stated objectives of the session.

Having experienced the efficacy of Student-worksheets in my classroom, I believe that the worksheet provides the students with the opportunity to first access their own understanding/opinions before listening to other views while remaining focused on the learning task. When the students shared what they wrote, they were open to hearing and appreciated the diverse point of views and were not disrespectful towards each other. For me, worksheets have always worked – they stimulate students to think and share their thoughts with others. My role in teaching is simply appreciating students' thoughts and validating them. The student-worksheets are taylor made for every session, however, section 6 and 7 i.e. what have you learnt; and reflexive note remains the same all across.​​