Disclaimer: This article is intended for Post Graduate students appearing for their practical examinations in Community Medicine. However, the article is of a general nature, and may be of use to others as well.

The process of lesson planning (also known as instructional design planning) is an important part of the practical examination in several universities. I will approach this topic from the perspective of someone who has no idea about lesson planning (as the university examination may be the first time many students prepare a lesson plan), and assume no prior knowledge of medical education technology.

Background Information:

Definition

A lesson plan is a written account of intended educational objectives and specific means by which these are to be achieved during an instructional session.

Bloom’s Taxonomy

Before attempting to create a lesson plan, it is useful to know Bloom’s Taxonomy. In essence, Benjamin Bloom described different domains of learning. (This has undergone revisions over time, so I will describe the latest.) The domains of learning are:

1. Cognitive domain (deals with knowledge/thinking)
2. Psychomotor domain (deals with skills/doing)
3. Affective domain (deals with emotions/feeling)

Each of the domains are divided into levels, from the simplest (lowest level/order) to the most complex (highest level/order). Each level is associated with key words (verbs). Key words/verbs are used (in learning objectives) to indicate the level of learning that is addressed within a domain. Figure 1 shows levels within the cognitive domain.

Figure 1. Bloom’s Taxonomy for the cognitive domain. Some verbs associated with each level are listed at the end of the corresponding lines.

Why are the verbs listed against each level important? One will have to use appropriate verbs when framing learning objectives to identify the domain and level of learning that is targeted.

It is important to note that all domains are important, and instruction should strive to involve multiple domains. However, from the examination perspective, usually one only needs to address one of the domains- either knowledge, skills, or attitude/communication.

Learning Objectives

Every learning session/activity must seek to achieve one or more learning objective. A learning objective is a statement of what learners should achieve (what they will be able to know/do/feel) at the end of the session/activity.

A good learning objective describes the following:

• Audience (who the learners are)
• Behaviour (what they should be able to know/do/feel)
• Condition (the circumstances/conditions under which the behaviour must be performed)
• Degree (the precision/accuracy with which the behaviour must be performed)

The above is referred to as the ABCD approach to framing learning objectives, and is an easy way to frame good objectives.

The Strategy

Now, we start from the point where you have been instructed to conduct an instructional session by the examiners. How should you proceed?

Step 1: Identify the domain(s) of learning

Based on the prompt, one must determine the principal domain (cognitive/psychomotor/affective) that must be targeted in the instructional session.

In general, prompts related to theory topics mainly involve the cognitive domain. Topics where learners must physically do something (measure blood pressure/height/weight, etc.) are mainly psychomotor. Topics where learners are exposed to/must participate in role-plays/counselling/communication, etc. are mainly affective. That said, the other domains will have to be invoked regardless of the principal domain targeted- one cannot measure blood pressure or counsel a patient without knowing the theoretical aspects of blood pressure measurement/the condition for which counselling is being offered.

Candidates must strive to utilize all domains in the instructional session for maximum effect (of instruction).

Step 2: Identify the Audience

This is the easiest part since the prompt given to you will specify the topic and audience. Knowing who the audience is (3^rd MBBS students/ healthcare workers/ general public, etc.) helps determine

1. Whether they have prior knowledge/familiarity with the topic/skill
2. Which level of the appropriate domain one needs to target

The above two considerations help focus the instructional session by informing examinees what is relevant for the audience, and what learning objectives might be acceptable. In addition, one must determine the size of the audience, since this will determine space requirements, other resources needed, and how the session is conducted (lecture/small group discussion, etc.).

Step 3: Determine the setting

Sometimes the setting is obvious- theory lectures must be conducted in a lecture hall- and therefore left unstated in the prompt. However, on other occasions, the setting is specified (anganwadi centre/health centre/mobile clinic/village, etc.). The setting indicates the resources that may potentially be available for the instructional session, and helps narrow the choice of teaching/AV aids to be used for the session. Ultimately, this has a bearing on the learning objectives as well.

Step 4: Determine session duration

Depending on the prompt, one may or may not have been provided the total duration of the instructional session. If not provided, one must determine what duration will be appropriate given the details from the preceding three steps. While lectures will have to be planned for an hour, the duration of other instructional sessions (like demonstrations/health education sessions in the community, etc.) should not be very lengthy.

Step 5: Develop learning objectives

From the preceding steps, one should have obtained a fairly good idea about what can be covered in the instructional session. Learning objective(s) can be developed using the ABCD approach mentioned earlier. Care must be taken not to have too many objectives.

As one must have some way of determining if the objectives were achieved, it is prudent to begin by considering assessment first- how will you determine if objectives have been achieved? That is, prepare a list of potential objectives, then ask yourself how you will assess if each objective has been achieved. Eliminate objectives that are difficult to assess, or achieve within the time available for the instructional session.

Step 6: Determine how to conduct the session

This is the part where you think about the actual session, and need to answer the following questions:

• How will you determine prior knowledge?
• How will you introduce the topic in an interesting way (set induction)?
• Which points will you cover?
• How will you deliver the content of your session (lecture ± hand-outs/demonstration, etc.)?
• How will you link your session content with prior knowledge?
• What are your (3 to 4 max.) take-home messages (should be linked to your objective(s))?
• What resources will you need (teaching aids/AV equipment, etc.)? Are the teaching aids already prepared/available, or must they be created afresh?
• How will you assess learning (you should already know this from Step 5)?
• How will you conclude the session (instructor summary/audience summary/homework/further reading, etc.)?
• For lecture: When will you take attendance?

Step 7: Determine time for each activity

One must assign time for each activity included in the instructional session such that all tasks are completed within the stipulated/available timeframe.

The importance of this step cannot be overstated- failure to perform this step may cause the session to end unexpectedly (too soon or too late). Everything planned for the session must be assigned a specific duration, no matter how small the action/activity may seem to be. This includes asking questions, taking attendance, answering questions/doubts, summarizing, etc. If interrupted by an examiner and asked to go to a specified time point in the session (‘go to minute 15 of your session’), one must be able to do so within reasonable tolerance for error.

Step 8: Prepare the lesson plan

By now you have the information needed to create your own lesson plan. All you have to do is input the same in a lesson plan template. I recommend that you determine the format used in your institution/university, and use the same, since several formats are used in practice. For your convenience, I have provided a simple lesson plan template below, with comments in parentheses.

Lesson plan template

Name of instructor:                                                                        Date:

Audience:                                                                                           Time (duration):

No. of learners:                                                                                                Subject:

Topic:

General objective: (Broad objective of the instructional session-mention only one overall objective!)

Specific Learning Objectives (These are abbreviated as: SLOs)

At the end of the session, the learners should be able to:

1. (Substitute with objectives developed in Step 5)
2. (Ensure objectives are numbered and listed in chronological order)

Set induction: (How will you generate interest in the topic?)

SLO	Content	Method	Media	Duration
1	(Briefly describe what point(s) you will cover)	(Describe in one word- Eg. Narration/display/demonstration, etc.)	(Describe briefly- Eg. OHP/Whiteboard, etc.)	(State in minutes- Eg. 5 minutes)
2
3
4

Evaluation: (How will you assess achievement of SLOs? If the same method (short answer questions/MCQs/oral questions, etc.) will be used to assess all SLOs, a single sentence here may suffice. Else, assessment for each SLO must be specified separately-Eg. SLO 1 will be assessed via short answer questions, SLO 2 will be assessed via practice on manikin/using simulated patients, etc.)

Follow-up Assignment: (List an activity that will help consolidate/apply what was taught in the session)

Tips

Try and restrict your lesson plan to a single sheet of paper.

Obtain print copies of your lesson plan to distribute among examiners.

Memorize your lesson plan.

Ensure that all media/teaching aids mentioned in the lesson plan are available and in working condition before the pedagogy session commences. Nevertheless, be prepared for unforeseen events- mechanical/technical problems, power failure, etc.

Useful Links:

Link to related video on YouTube:

https://www.youtube.com/watch?v=1f6mfSXzEDs

Link to short course on pedagogy for PG students:

https://www.youtube.com/playlist?list=PLGDXvtCQ5iDCWy0nQT-WcUqipRWdueFkN

A good introduction to Bloom’s Taxonomy is available here:

https://www.niallmcnulty.com/2019/12/introduction-to-blooms-taxonomy/

A good article describing how to frame learning objectives using the ABCD approach is available here (also describes Bloom’s taxonomy):

https://educationaltechnology.net/using-blooms-taxonomy-to-write-effective-learning-objectives-the-abcd-approach/