“It is a universal feeling—realizing your students do not understand the lesson you spent hours preparing. As former middle school science teachers and current medical students, we have experienced this frustration from both

sides.” This is how fourth-year Yale School of Medicine (YSM) MD student Marina Gaeta Gazzola and second-year MD student Madisen Swallow begin their perspective piece, Middle school meets MedEd: Five K-12 teaching strategies medical educators should know, recently published in the journal Medical Teacher. Thilan Wijesekera, MD, MHS, assistant professor and Teaching and Learning Center associate for clinical reasoning educator development, also contributed to the article.

Gazzola and Swallow met through Teach for America before becoming students at YSM. Both were teaching in New Haven Public Schools, Gazzola as a middle school bilingual science teacher and Swallow as a middle school science teacher. Swallow describes Gazzola, who was four years ahead of her in Teach for America, as both a friend and a mentor.

About a year ago, Gazzola and Swallow were discussing how their careers as teachers have influenced the way they see their own education and the way they learn at the graduate level. “We were talking about how many of the techniques we used every day as teachers would be helpful in our learning experiences. We recognized that many of our positive experiences here have been with medical educators who used similar teaching models, though they may have been called something different than what is in a K-12 classroom,” Swallow shares. They decided they would turn their thoughts into a formal essay, which they hope will benefit others now that it has been published.

Their perspective piece shares five examples of teaching strategies for K-12 education, designed to ensure student understanding of content and classroom expectations, which could be applied to the medical school setting with only small changes to an educator’s teaching approach. Swallow says many of the examples they provide in their article for the medical education setting were inspired by positive examples they had seen YSM faculty use.

One of those is what they call the 5E model, which they define as “an inquiry-based lesson-planning model that progresses through well-defined stages of learning and testing knowledge: engage, explore, explain, extend, and evaluate (Bybee et al. 2006),” explaining it can occur during one learning session or span across a number of sessions. They then provide an example of teaching K-12 students about mitosis—the cellular process that replicates chromosomes and produces two identical nuclei in preparation for cell division—through this method. A teacher first would engage students by asking them how tall they were five years ago and then have them talk to each other about how they think living organisms grow. During the explore phase, students would watch a video showing mitosis, without any sound or words describing what was happening, and write down their own observations. Next, a teacher would explain what mitosis is in ten minutes or less and then, in the extend phase, small groups of students would create mitosis models with pipe cleaners and describe in writing what is happening. Finally, the teacher would give a short quiz, with a few questions about mitosis, to evaluate comprehension.

Gazzola, Swallow, and Wijesekera then describe how the 5E model could be used to teach the pulmonary exam in the medical education setting. A faculty member could engage students by playing classical music and asking them to take notes on the instruments they hear and then discuss their observations with classmates. Then the students could listen to normal and abnormal lung sounds, without any identification of which was which, and be asked to write down their thoughts and share them with classmates (the explore phase). Next, a professor could give a ten-minute presentation on lung exam technique and sounds (the explain phase), after which students could listen to additional sounds and be asked to categorize them as normal or abnormal, including specifying the abnormality, as they extend their learning. Finally, the professor could evaluate the students with an exit quiz, to assess understanding, which will help them plan future lessons.

Reflecting on the article, Swallow, who is interested in a career in medical education, says, “I am passionate about continuing to grow the skills I started to learn as a K-12 teacher and use those to continue to advance medicine and medical education.” She adds, “I believe that once you are a teacher, it remains for life, providing a lens to view the world around you and interpret any educational opportunity.”