Whatever you’re teaching, this is the one thing every student wants to know. It can be frustrating to hear this question over and over, but students are likely asking because they’ve been burned in previous courses that had bad alignment.
Consider the following scenario: An instructor begins a first aid program with a compelling story about how they saved the life of a lady choking in a restaurant. They proceed with statistics on the frequency of the need for first aid and the positive outcomes students can produce by being in the right place at the right time. The students are highly motivated to learn their first aid skills and do well as they enthusiastically practice splinting, bandaging, CPR, etc.
For their written assessment, students are given an exam that asks them to recall compression and ventilation ratios that were mentioned, but nothing about the incidence of cardiac arrest the instructor was so passionate about. For their practical assessment, students are presented with a scenario of a pedestrian struck by a bicyclist. Focusing on performing their individual skills, almost every student fails by walking straight into “traffic,” not having had decision-making scenarios as part of the program.
These are examples of students being taught things they are told are important, but apparently not important enough to be tested on, and being tested in a way that doesn’t match how they were taught. The results are poor assessment grades and frustrated students and instructors. Some learning may have occurred in class, but any enthusiasm and ability to apply that learning was killed in the assessment process. But was the assessment completely to blame?
The Teaching Triangle
The solution to this is more than just “teach to the test.” The educators must strive for better alignment of the three basic components of instruction. This “teaching triangle” consists of the learning objectives, the instructional strategies, and the assessments. You can think of these as your targets, teaching, and testing. While students and instructors are often frustrated by exams, the source of frustration usually has more to do with these three components not aligning rather than just problems with the testing.
While not every educator can choose the learning objectives, instructional strategies, and assessments for the classes they teach, every educator does have the responsibility to try to align these three as best they can. Better alignment produces better performance and happier students. This is a big part of what is meant when it’s said that educators must do more than simply teach what is on the page (or screen).
In short, the learning objectives are what you want students to be able to do as a result of your instruction. Think of the capabilities you want students to have as a result of your class. Objectives are often framed in the ABCD format to specify the audience (type of students), behavior (what you want them to do), conditions (the circumstances under which it will be done), and degree (how much or how well they will have to do it). Each of these must be specific and measurable to keep the teaching focused on what is important and the testing (assessment) relevant. Even though a good objective will specify all the ABCD components, they don’t necessarily have to be worded in exactly the ABCD order. If the objectives are constructed properly, they should explain who should do what, where, and how much/well.
How do you know if the students have achieved the learning objectives? Build an assessment that follows the objectives exactly. This may mean implementing assessments beyond classic multiple-choice questions. For example, if your objective is for EMT students, given a bag-mask device and oral airway, to effectively ventilate an apneic patient to chest rise, then this is exactly what your assessment should test. If this is the case, then the learning objectives and assessments align! That may seem simple, but wait—we’re not done yet.
Focus on Alignment
The third leg of the teaching triangle, instructional strategies, has to bridge the learning objectives to the assessments. Instructional strategies include both the content and the way it is taught. In the early days of EMS education, instructional strategies often looked something like “Talk about this topic for this long and make sure you mention this, this, and this.” Today’s EMS education allows the use of an almost infinite variety of instructional strategies that can be customized based on topic, teacher, student, and program resources.
So many choices are available that it can be overwhelming, and so this is where instructors must focus on alignment. Should I modify the slide deck that came with the textbook teaching package? Should I tell that tell that war story about that difficulty breathing call in the snowstorm? Should I do a hands-on session using turkey tracheas? When considering your options, ask yourself, “Is this strategy the best choice to help the students achieve the educational objectives I’m going to assess?” There may be many things you want a student to know, appreciate, and be able to do, but if they aren’t in the objectives and on the test, then maybe they should be in another class. If you think they should be in the class you’re teaching, then update the objectives and assessments to align.
Alignment of learning objectives, instructional strategies, and assessments is crucial for every class an EMS educator teaches. Effective alignment will be evident bit by bit throughout class. At the beginning all students and instructors should be clear on the measurable ABCDs of the learning objectives. Through class the instructional strategies should be focused specifically on helping students become capable of meeting the measurable ABCDs of the learning objectives, and at the end of class the summative assessments should test students’ ability to meet those the measurable ABCDs. Work on aligning your targets, teaching, and testing, and you’ll be amazed at your results.
Rommie L. Duckworth, LP, is a dedicated emergency responder and award-winning educator with more than 25 years working in career and volunteer fire departments, hospital healthcare systems, and public and private emergency medical services. He is currently a career fire captain and paramedic EMS coordinator.