Michael T. Lebec PT, Ph.D., is a Professor for the Department of Physical Therapy & Athletic Training, NAU Mountain Campus.
As an established professor teaching in the NAU Doctor of Physical Therapy (DPT) Program, I have positioned myself so I am able to teach courses that are mainly my choosing. However, this was not the case when I was a junior faculty member. My initial teaching load included multiple courses in which the senior faculty were not highly interested. In part, this was because some of these courses focused on information viewed by the typical DPT student as “dry, boring, or irrelevant.” Featured topics included traditional yawners such as research methods, critical analysis of literature, coding and billing, and good practices for documenting patient care in the medical record. I must admit, as a student, I was equally disenchanted with these topics and I am pretty sure at some point I used the phrase “I’d rather put a fork in my eye …” when describing my level of motivation for learning these concepts.
As an experienced physical therapist, I recognized the importance of learning these skills. Therefore, I took it as a personal challenge to motivate students to engage with the material. I implemented a variety of contemporary approaches, including active and collaborative learning, flipped formats, and at times, admittedly shameless implementation of humorous videos and music in an attempt to combat cognitive load and allow students to re-calibrate their attention spans. More than anything, I made efforts to clarify why it was important to learn this information. The standard approach to motivating students in professional programs to learn something in which they are not interested is that the content is “on the licensing exam”. In my experience, the effectiveness of this threat is temporary in nature, probably because it comes in the form of negative reinforcement rather than intrinsic motivation. Instead, I focused on presenting frequent real-world examples, having students apply content by solving true-to-life problems, and considering ethical and legal dilemmas in which students could potentially find themselves. What I observed, was that the more factual and sometimes disturbing the scenario, the greater the chance that students would be palpably interested in engaging. Educational literature supports this phenomenon as research describes how learners assign larger weight to ideas represented by “concrete examples with greater sensory or emotional impact” (Wanner 2015; Savion & Middledorf, 1994).
This brings me to my latest experience demonstrating the power of relevance in motivating learners. Though I have moved on from some of the challenging-to-teach courses, I kept on with others. One I have recently begun to teach focuses on “organizational and administrative principles” associated with physical therapy practice and required by regulatory bodies. Only a small percentage of entry-level DPT students are interested in running a business and even fewer view this as a learning priority at this point in their career, regardless of future aspirations.
However, after 20 years in the field, I have seen a plethora of true, complicated, and sometimes sad cases in which physical therapists have knowingly or not, gotten themselves into controversial situations. A recent class session topic of this nature concerned Risk Management, which involves discussion of different classifications of legal violations for which one could be sued, such as Fraud, Abuse, Neglect, Assault, and Battery. Even motivating myself to prep for this lesson brought thoughts of putting something somewhat sharper than a fork into my occipital orbit. However, by interspersing didactic information with discussion and analysis of real-life stories of woe, I was able to sew together a somewhat cohesive and palatable lesson.
During class, I utilized personal response systems to have students make determinations of what the proper course of action might be in each scenario, the degree to which a course of action is or is not legal, and if not, how the legal gaffe might categorized. Surprisingly, I found myself getting behind as students took more time than anticipated to debate and discuss each situation and normally silent students were raising their hands to offer opinions and ask questions.
The final scenario I presented described an all too close to home dilemma. Four years ago my spouse, who is also a physical therapist and owns a private practice in Sedona, was served with a civil lawsuit in which a patient accused her of causing “life-altering damages” during a treatment session. I framed the story a true scenario that happened to a “local physical therapy clinic”, initially leaving out identifying specifics. As I revealed the associated timeline of events, I had students pause and analyze the situation in terms of the concepts discussed earlier. Eyes widened when I stated that the plaintiff was requesting hundreds of thousands of dollars to settle the case out of court. Upon stating that the defendant in the case opted not to negotiate a lower settlement even though malpractice insurance would likely cover all costs, I heard rumblings of “good” and “she shouldn’t” and “oh my!”
I let the students come to their own conclusions about the case based on our previous discussions. Fortunately, they came to the same conclusion as the presiding judge, as I revealed that the defense’s motion to dismiss the plaintiff’s claim of negligence based on lack of “causation” was upheld. At that point, I revealed the identity of the accused practice and informed the room that this was not quite the end of the story, because at this point, the plaintiff could still appeal the ruling. But fortunately, I explained, the defense attorney recommended my spouse consider filing a motion to sue the plaintiff for legal costs, but offer to waive this right if they agreed not to file an appeal. When I clicked the remote animating the final PowerPoint bullet stating that the offer was accepted and the court officially dismissed the case in October of 2018, the room broke into applause. Though pleased, this reaction prompted me to scratch my head and wonder, “What just happened?” Not only had I never elicited this response in 17 years of teaching, but it had occurred while teaching Risk Management, of all topics. I am guessing that when they first applied to the DPT program, none of these students knew what Risk Management was let alone think it was something they would applaud.
The lesson for me in this outcome was that the students responded positively not because they were happy my spouse and I were spared of having to sell all of our belongings and wear barrels for clothes. Instead, they were engaged because they could picture themselves in that situation and were able to connect the dots between the content and how understanding it could help them avoid a similar predicament. In a 2013 version of Magna Publications’ Faculty Focus, the authors list the top three strategies for engaging learners as: Number 1 – Increase relevance, Number 2 – Increase relevance, and Number 3 – Paste funny videos and memes into your PowerPoint slides (just kidding of course, number 3 is also Increase Relevance). Doing so, in this instance and others I have encountered not only lessens the urge to place pointed objects near sensory organs when learning traditionally dry material, but also enhances comprehension in a more meaningful fashion.
References
Alford, K., and Griffin, T.J., (2013). Teaching Unprepared Students: The Importance of Increasing Relevance. Faculty Focus: Higher Ed Teaching Strategies from Magna Publications, Nov 4, 2013.
Savion, L., and Middendorf, J., (1994). Enhancing Concept Comprehension and Retention. The National Teaching and Learning Forum, 3(4), 6-8.
Wanner, T., (2015). Enhancing Student Engagement and Active Learning through Just-in-Time Teaching and the Use of Powerpoint. International Journal of Teaching and Learning in Higher Education in Higher Education, 27(1), 154-163.