Viewing by month: February 2011

Feb 26 2011

L is for Learning by Doing

Health economics is just one of many areas that is taught in a school of public health that is highly conceptual and is associated with a specific set of tools that then need to be applied when analyzing problems and trying to plan for the solutions to the problems.  Once a student becomes an expert in economics, she will be called upon to consider an issues, think about the economic intuition in the issue, apply the logic of economics to assess how a change in the system will likely lead to changes in behavior, and finally to be able to demonstrate this to others or to show just how big of a difference the change is likely to make, the public health professional using economics will eventually need to demonstrate via graphs or equations how a change in incentives will lead to a projected set of changes in behaviors.

However, the ability to make all those logical links does not come quickly to all students.  In some cases, students will be able to perform each of the necessary tasks in isolation but will find it difficult to implement the sequence of steps together.  For this reason, there needs to be a process of learning by doing prior to assessing the students and the process needs to demonstrate for students now just how to perform each of the task individually but how to tie them all together.

Thus, when I am thinking about learning by doing, I am thinking that I need to demonstrate an example of how to use the tools associated with the main idea that I have taught the students to solve a problem that has been posed in the context that I have provided.  Thus, the learning by doing step begins to draw in many of the prior elements of VARIABLES before assessment.  Specifically, the aspects of understanding students’ motivations, providing good instructions, and providing a clear application to a real world setting all play into the learning by doing experience.

When I provide such an example, it should involve all of the tools that are available.  These include the basic logic, a link between the logic and the math, and a link between the logic and the graphs.  Each of the three elements—logic, math, and graphs has its place in the discussion. In some settings, the primary goal is to emphasize and build up an ability to use the logic.  Students in classes like these will never necessarily do a demand analysis or estimate a cost function, but definitely need to know how to interpret changes in incentives and how to ask questions of those who are performing the more sophisticated economic evaluations if the results of such evaluations to not match up intuitively with what would be expected.  Thus, the basic logic is useful for initiating a discussion and for engaging those involved in deeper analysis in finer points about interpretation later on.

The graphical tools are usually a second step as these can help to provide some additional insight into the interpretation.  The graphical interpretation helps in most cases to demonstrate two dimensional relationships in ways that most can readily understand.  The two dimensional nature forces students to think about direct relationships that are of the greatest interest.  It can also illustrate whether further mathematical analysis would be particularly useful.  Sometimes the graphic analysis can make it more clear than simply the logical analysis that there is an ambiguity in the results. 

Finally, the mathematical analysis for students in an entry-level overview class is not usually terribly detailed or terribly complicated.  However, for some students for whom they are not accustomed to the manipulation of numbers or symbols in equations, the analysis can be a challenge.  Students often seem to feel challenged by the capacity to link the logic with a picture with a mathematical interpretation of the picture.  These three elements together are like a complex machine with many interlocking moving parts that need to be considered together.  If one part is not aligned properly it can make the entire machine function improperly.  Non-experts may feel intimated by the need to understand the entire machine and to make certain that all the pieces are functioning properly together.

More than any other reason, the notion of economics being a series of interlocking steps where a fault in any one can lead to an incorrect interpretation leads to the need for a clear demonstration prior to the actual assessment.  Students need to be shown how to make all the links.  Students need to be able to ask questions when they see the links presented the first time.  Students need to be reassured that the links are complex but manageable.  Students should be challenged to make the links themselves as part of this presentation, but generally this is a time for instruction.

A recently developed online course provides a quintessential example of learning by doing. Students first listen to an online lecture that describes a calculation in a very basic way. Then, they are asked to work through a practice set of spreadsheets in which they are given the information and intuition for each step and then asked to perform the step before they are supposed to move on. This type of practice provides them with a chance to learn by doing. Even in an asynchronous learning experience, they are able to ask questions about the process and learn from this exercise that is already done for them.

Posted by Kevin Frick at 11:04 PM - Categories:

Feb 20 2011

B is for Big Ideas—Teach Them First

In many fields there are a lot of concepts with a lot of nuances.  Economics is no exception.  The basics of economics are fairly intuitive.  People generally respond to incentives.  When prices go down, people consumer more of something.  When prices go up, people consumer less of something.  When it comes to businesses, when the price of an input goes up, less is used.  And to get businesses to produce more of something the price must be higher.  We can talk about generalities and how the incentives are very straightforward and extend it to equilibrium and risk without too much effort. 

Then comes graphing and equations.  Those tend to trip people up a bit more.  People also tend to get tripped up by the need to consider more than one incentive at a time, although as long as we keep the conversation in terms of directions of change things work pretty well. 

So, how does this relate to the concept of big ideas.  The big idea is that incentives are important.  In a public health context, there may be plenty of things that public health professionals think that people should do.  The first through may be that simply making something more available will mean that people will use it.  What is forgotten in some cases is that people tend to do things when they make economic sense.  Or, when the incentives point in the right direction.  When we plan for how much of a service to make available, we should not base our planning on how much we think will e used because people should use something, but on how much we predict will be used because people respond to incentives that they have been given.  In a first health economics class (particularly when I have only eight weeks to teach students) if a student comes away with the idea that incentives matter when making decisions about medical care and public health and leaves behind the idea that people will just do something because it is recommended or right that is a  major accomplishment.

Once a student has learned that, they can then learn equations and graphing and nuances.  Learning these can take an entire career—or at least an entire course of PhD level graduate study.

The key for me is to structure learning opportunities—including lectures, readings, practice assignments with constructive feedback, and graded assignments to provide the opportunity to learn the big ideas first and then to learn the finer points.  This should permeate the planning process, the expectations that are set, the way that feedback is given, and the eventual assessment of the students.

Posted by Kevin Frick at 5:04 AM - Categories: VARIABLES before Assessment

Feb 18 2011

A is for Application

Students in a school of public health usually want to know how what they are learning can be applied in the real world.  When I discuss an application of the material, I like to be able to point students to an example not just of the way in which the material MIGHT be used but to an example of the way that the material IS being used.  This is how we make things real.  Students are looking for a reality.

I recently received a comment in a course evaluation that demonstrated that at least one student had not been convinced of the applicability of the material.  Many other students have commented that they could not understand how someone would not realize the application, but even having one person not get it suggests that there is room for improvement.

In the course, students were asked to evaluate the quality of several cost-effectiveness articles.  The comment in the course evaluation was that the evaluation of quality criteria seemed like a rote exercise.  The next time I teach this, I will make sure to mention the following: in students' professional lives they may be asked (1) to review grants that include proposed cost-effectiveness analyses and will need to understand what makes  a high quality approach;  (2) to act as a peer reviewed for a manuscript submitted for publication, where they will also need to know what makes a high quality piece; (3) to participate as part of a research team to plan for a cost-effectiveness analysis so that they will need to understand what makes a high quality study; or (4) to use papers that have already been published to motivate policy change and they will need to asses the quality of articles that might drive quality change.  

I am considering asking students to offer a final thought at the end of each assignment in which they draw a conclusion about quality combining the multiple points they have assessed rather than simply assessing the quality criterion by criterion.  This would help to make students more aware of the need to go beyond simply reporting on individual criteria and to make the assignments feel like it is closer to a real world setting.

Posted by Kevin Frick at 10:19 AM - Categories: VARIABLES before Assessment

Feb 15 2011

I is for Instructions

Students have a right to expect instructions that are clear and that are not changed during the course.  I know that I and my TA's have tried many times to write questions for my health economics class that can be interpreted only one way.  Try as we might, it turns out that they can often be interpreted more than one way.  When students are working through the problem and not facing a multiple choice test, they have no problem telling me about the alternative interpretation of my instructions.  The students with the alternative interpretation, their classmates, and the instructors all find this difficult and time consuming to deal with.  This is just on illustration of the need for and value of clear instructions.  

Students like to know due dates.  They rarely complain when the due dates are moved to a later date.  I don't think I have ever shifted a due date to an earlier date.  Still, students in the setting in which I teach are taking classes in eight week segments during which they are often facing 20 hours a week of contact with faculty.  This is a huge time investment and needs to be planned for.  Thus, making sure that the instructions are as clear as possible on day one of a course is particularly helpful in my case, but this is certainly generalizable.

I think that the giving of instructions can also be used to set expectations.  A constant struggle at this point in time is students in class with laptops.  I know that many students like to take notes directly on their laptops.  Some schools have even invested in software that facilitates direct annotation on pdf files.  However, some students when given the choice between paying attention or using the wireless Internet will choose to use the wireless internet for non-class-related purposes.  On the one hand, students paying a lot of money for their education have the choice of how to spend their class time.  On the other hand, and here it is particularly useful to teach economics, there is an externality that is associated with non-class-related use of the Internet.  It does not affect only the student who is using the Internet but the student's classmates as well.  This would be a great way to introduce the concept of externalities on day one of class (which is also particularly relevant in public health) and then to set the expectation that students not do this.

What other expectations should be set?  I like to set expectations about participation and taking advantage of the learning opportunities that are presented.  I am a long distance runner who is now training for my third half marathon with an eye toward my second full marathon this October.  In the 13-20 week training programs for such events there are plans for running and fitness opportunities for every day. Including, on some days, resting.  If the runners follow the directions of the coach, it maximizes the probability of success for the runners.  If we think of the students as analogous to the runners and the instructor as analogous to the coach, the instructor plans a series of learning opportunities.  The students need to be encouraged to do them all--to take advantage of them all--so that they will understand the bigger picture in which the set of activities fits.  Then, the students will maximize their chances of learning and of deep understanding.

In economics and economic evaluation, I particularly focus on giving students instructions on how to use the practice examples that they are given, questioning and discussing the premises of economics and the applications of economics, and using opportunities for group learning appropriately to help with understanding the material.  Just a few comments on those.  I try to give students two practice examples.  One that they will most likely do on their own.  A second in a group. Then they get assessed.  I'll discuss this more later.  Some students don't find the time to do the practice.  If they don't they will miss an important learning opportunity.

I don't teach economics as dogma.  I want students to question it and I want them to question its application.  Putting it to the test is the only way to really understand it.

Finally, I encourage students to work together but complete assignments on their own.  There is a time and a place for group learning as long as the final product is each student's.  Again, setting clear expectations about the appropriate use of group learning opportunities is a great thing to include in the instructions I give to the class each time.

There are many creative ways in which instructions can shape the entire learning experience rather than simply being a drag to read through a syllabus on day one or rather than foregoing the opportunity to give instructions and jumping right into the class.

Posted by Kevin Frick at 8:46 AM - Categories: VARIABLES before Assessment

Feb 14 2011

Remaking the BBS: Category and Topic Options

This entry in the "Remaking the BBS" series is going to look at features in the BBS only available to faculty and TAs in a course. All of the major features for students have been covered in previous entries.

One of the major features of this new BBS is the ability for faculty and TAs to have a lot more control over the access to and posting in categories and topics in a class BBS. Faculty and TAs will now be able to set controls at the category level which then get applied to every topic in that category, but which can be overridden at the topic level. You can keep the control loose at the category level, but more finely control specific topics within a given category.

Let's first take a look at some of the new category options:

BBS Category Options

With these new controls, you'll be able to do the following:

  • Only allow faculty, TAs, and staff to create new topics in the category. Students can post in those topics (if you want), but they can't create new topics on their own.
  • Set a date and time on which the category becomes read-only, meaning that students can no longer post in the category after that time. This could be useful for a BBS exercise.
  • Set up a category where students can't see anyone else's post in the category until they post themselves. Again, BBS exercises could benefit from this feature.
  • Restrict students to editing their posts for only 15 minutes after they make a post. This is how posting in the BBS currently functions, but in the new BBS, that restriction has been removed. This option allows you to reinstate it.
  • Link a category to lecture or activity pages within the class website (more on this in a future post).
  • Limit who can access the category. This is normally done through the Course Groups tool, where you set up a private category that can only be seen and accessed by that group, but we're giving you the option of limiting access outside the Course Groups tool. This could be useful for setting up a category that only faculty, guest faculty, and TAs could access.
Whatever options you select at the category level cascade down to the topics within that category. For example, if you select the option to only allow students to see other posts in a topic once they post in that topic themselves, that applies to every topic in the category.

You will be able to override most of these options at the topic level. Here are the options for configuring a specific topic in a category:

BBS Topic Options

A couple of notes about these options:

  • You can make a topic "sticky." That is, it will always appear at the top of the list of topics in a category. This could be useful for an instruction topic in a BBS exercise category.
  • Whatever option you set here overrides the option set at the category level. For example, if you set the status of a topic to "Read Only" but the category in which the category resides has a status of "Post + Reply," then students can only read the messages in that topic. They cannot post new messages themselves in that topic.
We think that these new category and topic options will provide faculty and TAs a lot of control over the activity in the BBS in their courses. If you have questions or comments about these new options, we'd love to hear them!


Posted by Brian Klaas at 9:20 AM - Categories: Online Courses | Course Tools

Feb 12 2011

R is for Realities

When I begin a new class, I find it useful to understand students’ realities.  In other words, to understand how they might use the information from the class in their professional lives.  If I were teaching in an undergraduate setting, it would not necessarily be clear how students might use the information in their professional lives because very few would be certain of what their professional lives would be.  In contrast, in a graduate setting in which many students view life through a very applied lens, like a school of public health or most of the entire medical campus, many students are returning professionals or otherwise have a pretty good idea of what their professional lives will be. Students rightfully want to know how what I am teaching them can be directly applied to what they are already doing or are going to be doing in their jobs in public health and medical care.  Gathering information about students’ motivations for learning in general was part of understanding general variation that I discussed in an earlier entry.  Gathering information about students’ motivations for a specific class is part of this step on realities.  If a student has a direct application of the material to their professional activities, then, even if the student is generally looking to pass tests and earn a credential, the student may be more willing to engage.  In contrast, if a student is generally a person who loves to learn but sees no way in which he or she would ever use the information from a particular class, the student would be less engaged.

Understanding student realities can also facilitate providing examples.  I don’t use only nursing examples when I am addressing nurses in a classroom, but I am certainly more inclined to do so.  I don’t use only health administration examples in classes in which I have a lot of students who are earning Masters of Health Administration degrees, but I am more inclined to discuss a hospital or health insurance example.  Similarly, when I have a large group of MPH students, I’ll make sure to include examples of public health economics or economic evaluations in public health settings. 

Beyond professional activity differences, what are other areas of realities that are of concern to me?  Some students are not from the United States.  While they may find applications from the United States health care system to be interesting, they are also interested in knowing things that are specific to their own countries or at least to countries that are more like theirs.  Even within the United States the reality has changed greatly over time.  Lecturing about a chapter in a text book that describes an out of date reality may be an interesting historical use of economics but does not provide students with direct insight about the world today. 

In addition to planning for the course in the first place having an awareness of students’ realities allows me to better plan for questions that may be asked.

Finally, there is the question of how to apply this information.  One example came from a health economics class.  I shared with students some information on how a particular health care system had responded to a shortage of some pharmaceuticals for pain control and anesthesia.  The article seemed rather concerning, so I thought that an interesting reality application would be to use economics to interpret the events in a letter to the editor.  I gave students the opportunity to structure their letter in ways that would reflect their reality.  The students were allowed to choose from a number of different perspectives (e.g. physician leadership, patient advocacy, or hospital administration) and then were asked to discuss the most relevant economic points.  I’m not sure whether each student chose the perspective closest to his or her own reality or tried a bit of role playing in their response, but it gave the students an opportunity to shape the assignment to their own realities and that is the best I think I could do in that situation.


Posted by Kevin Frick at 5:32 AM - Categories: VARIABLES before Assessment

Feb 11 2011

A is for Awareness

The second step in preparing to teach is Awareness.  As a practical matter, this means:             

·     understanding the students' priors about the material in a course. How well prepared are they?  Do they have misconceptions?

 So, the first question is whether there is a prerequisite for the course?  If there is, how is the prerequisite structured?  Is it structured to get students to memorize a lot of facts so that they should be familiar with the vocabulary of a course but may not understand the concepts deeply enough to use them in new and creative ways?  What is the variation in the grades in the prerequisite?  Have students practiced using the concepts before? Have they worked with the concepts at the level of explaining them and writing about them?  Have they just done problems but not had to explain their work?  There are so many things that will vary about students "priors" with respect to the course materials.  A pre-test could be given, although this is not something that I am a fan of doing.

However, the pre-test concept does have the value of indicating whether the students have an existing mastery and may help to turn up misconceptions.  There are other ways to get at misconceptions.  In the process of having students introduce themselves, they could be asked about impressions.  

When I work with students in the Doctor of Nursing Practice program, I like to ask them what they thought of economics before I have the read a book called The Economic Naturalist by Robert Frank.   The students in such a program are bright students.  They usually have day jobs in which they are managing departments or otherwise in leadership positions that require a lot of thinking.  However, they consistently indicate that their priors are that economics is highly mathematical, or very abstract, or has lots of jargon.  Few have ever taken more than a single economics course.  They think largely about macroeconomics and all sorts of confusing things that they hear about monetary and fiscal policy on TV or on the radio when it comes to economics.  They do not think about economics as a basic motivation for decisions in our lives.  They don't think about basic incentives that firms face every day.  When they have read the book by Frank, they comment that economics can be creative, or that they find it down to earth, or that the concepts really aren't all that hard, or that it actually makes a lot of sense.  This process of re-orienting their awareness prior to trying to lecture them about health economics is key to my working with them over the next several weeks.  It is also rather painless and opens them to the learning experience.

I have another great example of my "Aha!" moment when it comes to awareness and priors and nurses.  I was speaking at a local Sigma Theta Tau research conference in 2005.  ??? is the nursing honor society. On that particular day in 2005, I was the second of two plenary speakers in a row.  I listened carefully to the speaker before me and found a way to link what she was saying to my presentation.  I spent about 5 minutes at the start of my presentation making this linkage.  I had not planned to do that but it worked.  As I then went on to describe economic evaluation, the attendees facial expressions and body language suggested that they were understanding me in ways that other audiences (of nurses or otherwise) had not when I had tried to make similar presentations before.  That was the moment at which I realized just how important starting from what the audience knew and building a bridge was so important.  It was ironic as I had been working with nurse researchers for six years by that point, but every time I tried to explain what I did I used lots of graphs and calculus and tried to explain things but never really tried to build a bridge piece by piece.  My approach had been more like throwing a rope wildly that the nurses on the other side of the knowledge gap were supposed to catch and hang on to rather than building a solid bridge from what they knew already to what I wanted them to know.   

Looking at my own teaching, I may be taking for granted that students have a higher level of understanding of microeconomics when I try to teach health economics.  I may need to go back and reassess how I am teaching so that I can help to solidify the basic microeconomic concepts.  Then, I could put my own approach into practice in all the courses I teach and not just in some of them.  


Posted by Kevin Frick at 9:30 PM - Categories: VARIABLES before Assessment

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