Teaching through Stories

Have you ever been listening to a teacher and getting a bit bored as they drone on. Then they start telling a story about something that happened to them, and you perk up and listen? From a young age, we have been listening to stories. Stories can be interesting, exciting, strange, or ordinary. But since people are used to listening to stories, it can be a very effective teaching technique and can aid in retention of your subject.

So let me tell you a story.

A student was once having trouble distinguishing the terms Crural ( the front or anterior side of the lower leg, the shins) and Sural (The back of the leg, calf area). So I told her, “Imagine that a little boy comes up to you and kicks you in the shins. That’s Cru-el!” (Cruel/Crural). Matching the pun with the image of the boy kicking her gave her the hook she needed to remember that Crural was on the front of the leg. Knowing that, she could deduce that Sural must be the back.

I’ve taught the importance of washing hands by telling a story about Childbed Fever: There was a hospital with two maternity wards. One was staffed by Doctors, and one by midwives. The ward with Doctors had many women who were dying of childbed fever after the birth of their children. The ward with the midwives did not have as many cases. The Doctor Ignaz Semmelweis theorized that the doctors themselves carried the contagious elements on their hands transferring it from woman to woman in the ward when they did vaginal examinations. He instituted a policy of washing hands with chlorine, and the death rate dropped.

Now I used this to tell students how washing hands can save lives. But I can also use it to tell how pride can cause deaths. Midwives had long washed hands before births and examinations, but doctors at the time discounted these rituals as “old wives tales” and superstition. Even when Semmelweis showed that washing hands reduced the death rate by 90%, most doctors did not accept or follow his advice. He was fired from the hospital, his ideas were mostly discredited, and he died in an asylum for the insane.

Stories stick in the mind. They encourage empathy. They more fully engage the brain giving facts context and making them easier to remember. So take a hard point in your subject and try to find stories that will illustrate that point. Try picking an exercise from the list below and watch as your students perk up and hopefully become more enlightened.

EXERCISE: Write a story that…

  1. Introduces a controversial topic.
  2. Teaches a vocabulary word.
  3. Helps remember an equation.
  4. Illustrates how you learned something.
  5. Tells the relevance of a topic to the larger world.
  6. Illustrates the historical context of a subject.
  7. Introduces a hard to understand topic.
  8. Tells a little known detail.
  9. Adds depth to a subject that is normally taught in a straightforward manner.
  10. Helps prevent the wrong interpretation of a topic.
  11. Gives context to an ethical problem.
  12. Helps one remember the order of a process.

in a hospital where the patients in the midwife’s ward were doing well, but the ones in the doctor’s ward were not.

Don’t be afraid to teach beginning lessons to advanced students

One of the fears that many teachers have is to bore their students by teaching lessons that they already know. This is a particular problem when you have mixed classrooms where students are at different levels. Having advanced students can make a teacher talk faster in an effort to keep the attention of the advanced students. This can make a lesson that both bores the advanced students and loses the beginning students.

What I have found is that just because a student has passed a lesson by, that is no reason not to go over beginning lessons again. The teacher of beginning students has a special talent. They can explain the how and why of a new topic. Advanced students may have long forgotten why they needed to study some topics. And although they have often mastered how to do very specific instances of a topic, they may have only glossed over some of the concepts.

For example, today I taught beginning chemistry to a person with a chemistry degree. Although they had covered most all of the topics long ago, there were still things she learned from my lesson.

First, I found that she had the same misconception about isotopes that was mentioned in one of the previous blogs about definitions. It is possible to get quite far without understanding isotopes in chemistry, but you can’t get past first year physics that way. Beginning lessons can correct misconceptions that students have had for years.

Another thing she didn’t know were the origins of certain concepts. I was able to tell her that the word “atom” means “that which can not be cut”. And it comes from ancient Greek. I also was able to teach her the true definition of pH. She had a vague understanding of the values of acids and bases, but didn’t understand that pH meant the charge of Hydrogen and was a measure of the hydrogen ion concentration.

I also taught people who had studied phlebotomy about blood typing, and two separate people said they had not covered it in their jobs. I have taught EMS people how blood pressure works, and learned that knowing how to do a thing doesn’t necessarily mean understanding it.

There is a talent to teaching beginning topics. It is not enough to read the textbook or the notes out loud. You have to go back into the history of it. You have to go deep into the why of it. You have to listen for confusion and aim people toward the truth.

There is a special skill to teaching lessons to people whom have had it before. Don’t be afraid to try it. Use your advanced students as resources. Ask them about their experiences. Ask them what techniques they used to remember these facts. You may find that having advanced students in your class enriches your lectures and makes them better. So don’t be afraid to teach.

The importance of definitions – part 3

In this series, I talk about definitions. We use them to introduce someone to a new subject, and yet if done poorly it can lead to misunderstandings that can setback a student’s learning. What is worse is how even instructors can fall prey to making definitional questions on tests that are inaccurate, and actually penalize students for understanding a subject too well.

The three isotopes of Hydrogen
Hydrogen has three isotopes that vary in the number of neutrons. Protium, Deuterium, and Tritium

Today’s definition: Isotope – an atom that has a different number of neutrons and protons.

An atom is made of three types of subatomic particles: Protons, Neutrons, and Electrons. Protons and Neutrons are relatively heavy when compared to electrons which are over one thousand times lighter. Therefore when we are calculating the weight of an atom (Atomic weight) we add the number of protons and neutrons and disregard the weight of the electrons.

The number of protons is what defines the type of atom we have. An atom with one proton is called Hydrogen, with two protons is called Helium, etc. But you can have atoms of the same element that have different weights if they differ in the number of neutrons.

The three major isotopes of hydrogen are Protium, Deuterium, and Tritium. The most common isotope is Protium. It has one proton, one electron, and no neutrons. Its weight is one because the electron’s weight is not counted. Deuterium has one proton, one electron, and one neutron. Ignoring the electron again, we get an atomic weight of two. Tritium has one proton, one electron, and two neutrons. It has a weight of three. All of these atoms are isotopes of Hydrogen.

The problem with the definition is the use of the word different.

What does it mean to have a different number of protons and neutrons?Many people interpret it to mean that the number of protons must not be the same as the number of neutrons. Using this definition Protium and Tritium would be isotopes, but Deuterium would not. This is untrue.

Poor definition: An isotope has a different number of protons and neutrons.

Better definition: Isotopes are atoms of the same element that differ from each other in the number of neutrons.


Isotopes are atoms of the same element with different weights.

The importance of definitions – part 2

In this series, I talk about definitions. We use them to introduce someone to a new subject, and yet if done poorly it can lead to misunderstandings that can setback student’s learning. What is worse is how even instructors can fall prey to making definitional questions on tests that are inaccurate, and actually penalize students for understanding a subject too well.

Sodium and chlorine form an Ionic Bond

Today’s definition: Ionic bond- when atoms exchange electrons.

Atoms combine to form larger structures called molecules. Molecules are held together by different types of bonds. One such bond is the ionic bond. To understand how it works, you must first understand the structure of an atom.

Atoms make up pretty much everything. They are the smallest unit of matter. They have in the center particles called protons and a neutrons, and on the outside circling like ping pong balls on a string are electrons. Since electrons form the outside of an atom, they interact with other atoms.

To make a molecule, you have to stick atoms together, but the surfaces of atoms don’t want to stick together because they are made of electrons and electrons have what we call a negative charge.

Imagine touching two magnets together. The North and South heads attach and stick to each other, but the South and South heads repel each other. The same is true for North and North. In a similar way particles are repelled by particles with the same charge, and attracted by particles with different charges.

Since the surface of an atom is made of negatively charged electrons, they normally repel each other. But electrons space themselves out forming structures called shells. Each shell has a particular number of electons that can complete it, and when full that shell is balanced and stable. The atom prefers a full shell to a not full shell, and if some electron happens to chance by, it might be coaxed into switching atoms.

When an electron switches from one atom to another, it makes The atom it has moved to more negatively charged than it was before the move. It also makes the old atom more positively charged because it is missing one of its negative electrons. Since one entire atom is now positively charged, and one entire atom is negatively charged, they stick to each other. Charged atoms are called ions, and charged atoms sticking to each other to form a molecule is called an ionic bond.

The definition is poor because it misrepresents how electrons form an ionic bond. Exchange means trading. The atoms don’t trade anything. One electron moves from one atom to another, but nothing is given back. If the students expect electrons are going both ways, they can confuse it with covalent bonds where the shells of the atoms fuse and electrons are shared.

Poor definition: In an ionic bond, atoms exchange electrons.

Better definition: An ionic bond is formed when electrons are tranferred from one atom to another.

Do you have an even better way of stating it? I would love to hear how you teach it.

The importance of definitions – part 1

Today I want to talk about something that I don’t think people think enough about. Definitions. We use them to introduce someone to a new subject, and yet if done poorly it can lead to misunderstandings that can setback student’s learning of a subject. What is worse is how even instructors can fall prey to making definitional questions on tests that are inaccurate, and actually penalize students for understanding a subject too well. Let me tell you the story of a few definitions I have encountered. How they failed. And how I tried to fix them.

Insulin crystals

Definition: Insulin shuttles glucose into cells.

Insulin is a hormone found in the human body that is necessary for the regulation of sugar concentration in the blood. It lowers the amount of sugar by signalling cells to take up sugar at the same time. When many cells are taking up sugar at the same time, the sugar concentration in the blood decreases.

I teach it using an analogy. I tell the students to imagine being back in highschool. At the beginning of the day many students are in the hall at their lockers, talking with other students. Then the bell rings and the students go into the classrooms. Ten minutes later, the principal walks down the hall. How many students are left in it? None (or almost none. There’s always that one student who woke up late). In this analogy the students are glucose, the hallway is the bloodstream, the classrooms are the cells, and insulin is the bell. Insulin is a signal that causes cells (classrooms) to absorb glucose (students). When they do, the bloodstream (hallway) is cleared.

Saying that insulin shuttles sugar implies that each sugar molecule enters the classroom on a little insulin cart. That suggests a one to one relationship between sugar and insulin that can confuse a student’s understanding of hormone action.

Poor definition: Insulin shuttles sugar into the cells.

Better definition: Insulin signals cells to absorb sugar which lowers the amount of sugar in the bloodstream.

It is nice to be poetic and catchy when making definitions, but don’t be so catchy that you confuse your students doing so.

New semester. New challenges

The beginning of the semester is always a challenging time. This semester I have new students with special learning challenges that may make me need to use written notes.

I am resistent to them for a few reasons. One, my teaching is a bit Socratic. I ask questions and expect specific answers. To write them down defeats the purpose.

On the other hand. It would be worth it to have a good lesson preserved.

I have lessons that I have taught over hundred times. Every definition, every teaching decision has been timed and evaluated. When my assistants have taught it, I notice things they say that have led to misunderstandings. I know why I teach each bit, and which order is the best order to aid understanding. That is worth capturing.

So this may be a good time to begin writing that book about lectures. I have technical challenges. My laptop has died. Even so, pens still work. Stay tuned. I might publish some here.

Cheers to a good semester!

Question Clinic – The inaccurate question

In a quest to make the best exams possible, I will discuss different types of questions and how to improve them. Today’s topic is the inaccurate question.

They happen to the best of us. We write a question, and it seems straightforward. It isn’t until later (sometimes much later) that we learn that the question is actually inaccurate. It includes wrong information or is multiple choice but does not show the right answer. It confuses the students who know the material, and can even lead students to answer other questions incorrectly.

If you notice a question is inaccurate, the first thing to do is remove it. If students have already taken the test, give them credit for a correct answer without regard to which answer they gave.

You may not even realize that you have a bad question until a student confronts you about it. One reason we leave inaccurate questions in a test is because the nature of how we teach introductory subjects.

When one is learning a subject for the first time, we tend to tell the students flat obvious rules about how things work, even when we know that there are exceptions. We use words like “all” and “never” that are absolute. We also generalize, knowing that the student hasn’t been taught about any of the exceptions yet. This tends to penalize students who read ahead, or who have outside knowledge about the subject.

Example Question:

What is the pH of the small intestine?

  1. acidic
  2. neutral
  3. basic

I found this question in an old test. There was probably a reason for this question. Perhaps it was meant to show that chemicals were released into the small intestine that counteract the acidity of the stomach. Perhaps it was meant in comparison to the stomach, I don’t know. But the question is inaccurate because none of the answers is strictly true.

Why it’s wrong

The pH is a number that tells how many hydrogen ions are in a solution. Numbers below 7 are acidic, above 7 are basic. Distilled water has a pH of 7 and is called neutral. In his article “Intraluminal pH of the human gastrointestinal tract”, J. Fallingborg writes that the pH changes along the length of the small intestine. After coming from the stomach, the pH is rapidly increased from very acidic (pH 2) to about pH 6 which is slightly acidic. As it travels through the small intestine, the pH rises to about 7.4 which is slightly basic before dropping down to 5.7 as it enters the large intestine.

The question is inaccurate because the pH of the small intestine could be said to be acidic, basic, and neutral. “About neutral” would be the most accurate answer to the question as the pH stays within two points of 7, and yet, for the majority of the time it is acidic. The question for the student becomes, ‘which answer does my instructor want me to give?’, not ‘which answer is correct’, since they all are.

How to improve the question?

1.Be more specific

Ask the pH of the duodenum or the illium or the caecum. And give specific pH number’s like 6 or 5.7, that might spur memories of a particular passage in the notes. One could also ask about the mechanism. What enzyme spurs the production of sodium bicarbonate raising the pH of the lumen? (Secretin). Or How does the pH change after entering the small intestine from the stomach? (It increases).

2. Change the type of question.

If the question were an essay question, this would not be as much of a problem. It would still be a bit too unspecific. Will every pH that is possible to find in the small intestine be counted as a correct answer? What if the person had inflammatory bowel disease that could cause fluctuations in intestinal pH?  A better question would be…

Describe the pH of the intestine, and explain what factors affect it.

This allows the student to discuss what they know about intestinal pH and encourages them to add more information if possible. It encourages them to go deeper. Many teachers will call such a question harder than the first one because it requires more effort to answer, but if your student knows the answer, the first question is harder because it does not allow for an answer that is completely correct and therefore requires guessing what the teacher wants.

Inaccurate questions penalize your best students. Students who guess the answer do just as well or better than the students who know the answer. Inaccurate questions derail your good students and make the test seem more unfair and superficial.

Do you have a different opinion, or do you remember an inaccurate question that you observed on a test? Leave a comment below.


Fallingborg J. Intraluminal pH of the human gastrointestinal tract.
Dan Med Bull. 1999 Jun;46(3):183-96. https://www.ncbi.nlm.nih.gov/pubmed/10421978

Testing Philosophy

Test question form

Whether you thought of it or not, if you’ve ever given a test, you have a philosophy of testing. In your head, you have an idea of what you expect of the test. Do you expect all of your students to pass it? If not, about how many do you expect to pass? Do you expect them to be able to recall exactly what you told them, or will you show them situations they have never seen to see if they can figure out the correct answer? Are all of the questions equally hard, or do you put in  a few very hard questions to “sort the As from the Bs”? How you answer these questions reveals your philosophy of testing. It shows what you expect from a test, and will drive the questions that you will write.

One thing that I think you should consider, is whether the test you make is actually testing for what you want your students to learn. It is common for a new teacher to depend on existing test banks, and even more common for a long time teacher to use the same test questions over and over without really thinking about why.

When should you reevaluate your tests?

  • When most of your students seem to understand the material in class, but fail the test.
  • When students are frustrated and upset after the test is over.
  • When grades on the test do not seem to be correlated to activity in course.
  • When students drop in mass after the first exam.
  • When no one gets any of your essay or fill in questions right.

It is easy to blame the students, but is it their failing, or is your test to blame?

What makes a good or a bad test question? How do I improve my questions so that they are understood?  What kind of test is best for my subject?

In the next series of blog posts, I will evaluate tests and testing and give some thoughts on how to make your tests better.

Demanding Students

Teaching anatomy means that you spend time around premed and prenursing students. These students tend to be some of the most demanding when it comes to grades, because they are planning to enter a highly competitive educational application process where the difference between an A and a B may matter in whether they are accepted or not.

These students often are picky about every single point that they get in the class. This is difficult for the teacher, because much of teaching is subjective. Sometimes an answer to a question is slightly wrong, how wrong is wrong enough not to get the point. Students will often argue points from old tests, or even try to jump above the teacher and involve the administrators in the grading process.

Here are some tips for teaching demanding students.

1. Have a very clear policy on grades and write it in the syllabus.

The syllabus is what your college dean will look back on to see the policies of your class. If you didn’t state it at the beginning, it can be argued. Statements such as “No late homework will be accepted.” or “Bonus points will be awarded at the discretion of the instructor.” Can make the difference between a clear refusal to change a grade, and making a new assignment because someone skipped it and then decided later that they wanted that grade.

2. Use Rubrics for papers and more subjective assignments.

Rubrics make clear how you are grading. You probably have a rubric in your head when you are grading anyhow, just make it explicit. If possible, make the grading rubric available ahead of time.

Rubrics can contain subjective judgements. For example you could say that 10 percent of a paper is the quality of the introduction. I would further divide that into more specific points if possible.

3. Be consistent

If you say that you don’t take late work, and you accept if from one student, expect the avalanche of requests and vitriol that will follow.

If you decide to extend a deadline for one student, consider extending the deadline for all of the students.

4. Consider Bonus Points

When students are close to the line, consider offering bonus points. Bonus points are a way to separate students who are trying from students who are coasting.

Students with a sincere effort to pass will do extra work to improve their grade.  If a student does not participate in extra activities and they ask why you gave them a C with a grade of 78 instead of raising it to a B, you can point to bonus points and say that the student had an opportunity to get an higher grade if they only did the extra work.

With care, motivated students can make the class more challenging for everyone with a minimum of stress for you and them.

Dec 6, 2018

Who makes the best teacher?

Conventional wisdom in Academia is that the best teacher is the one with the most knowledge about a subject, but that is not what I have found. In my experience, the best teachers for introductory courses are the ones who struggled in the subject.


Because those teachers that are naturals in the subject, the ones who had no trouble understanding, usually don’t know why they know what they know. It has been so long since they had to learn the basics, that these facts come almost unbidden.

It is the people for whom it did NOT come naturally, those that had to consciously come up with ways to remember the material, that can help the students get past their confusion and understand the material better. The cognitive tricks that they use to learn the subject are often of the most use to beginning learners.

A new subject can be overwhelming. A teacher who struggled can point out the obvious connections without making the student feel ashamed for asking. They won’t get angry when someone asks them to slow down or repeat what they said, because they remember how many times they had to go over the material to remember it.

So what should teachers do if they suspect that they are just too good at their subject?

Consider introducing peer teaching. This will allow students who are a little ahead to do the hard work of answering the most obvious  questions so that the teacher can discuss the deeper ones.

So if you find yourself out of your depth, unsure about what you have to teach, remember, that very uncertainty is your greatest strength.