Lectures do not exist in isolation from other learning and teaching modalities and well-designed programmes, modules or learning encounters facilitate learners in developing their knowledge, understanding and skills through ‘scaffolding’ of learning events. The concept of scaffolding is derived from the work of the Russian psychologist Vygotsky as well as others (such as Bruner) who researched into early language development.
Vygotsky suggested that individuals learn through the ‘teacher’ constructing events with sufficient challenge so that learners are in the ‘Zone of Proximal Development’. This is best achieved through structuring learning so that learners engage meaningfully with appropriate topics and tasks, taking on more responsibility for their own learning as they become more competent.
For health professions teachers, the idea of scaffolding is a routine way of teaching practical skills through demonstration, deliberate practice and feedback. Supported by the teacher, the learner is placed into different situations (zones of proximal development) throughout their learning and thus moves from novice to expert. For example learners develop from being able to insert a nasogastric tube or a catheter into an adult manikin to being able to perform the skills with very ill patients, with children or in acute situations.
There are two ways scaffolding can be used in lectures which are primarily concerned with developing knowledge and understanding. First, the individual lecture itself must be located within the programme to support the learner at their stage of professional development. It needs to be clearly linked to other parts of the course and to pre- and post-reading or activities. In the examples above, some of the early lecture-based learning might include normal anatomy and physiology as well as common conditions or situations in which the learner might be required to perform the skill.
This is where e- and m-learning can be very useful to help signpost the learners to linked topics, further reading, self-assessments or other extended learning opportunities. One of the ways this is increasingly being achieved is through the ‘flipped classroom’ which we discuss next.
Secondly, when we consider the structure of the lecture itself, it must be designed to be challenging enough to encourage and facilitate deeper learning and engagement with the subject matter. This is what the rest of the module considers.