Using Bloom’s Taxonomy to Improve Student Competence in Medical Terminology
Susan Sportsman, PhD, RN, ANEF, FAAN Managing Director Collaborative Momentum Consulting
The Problem Two faculty who teach medical terminology are lamenting their students’ inability to retain the information they “learned” in their medical terminology course when they move to using this material in their further studies. One educator describes a student who did very well in the course but who later complained she could never remember the spelling or definitions of specific terms as she moved into her medical billing and coding courses: “ It is so hard to remember those complex medical words when you haven’t used them for a while. ” Unfortunately, this refrain is not uncommon among students. What can faculty who teach medical terminology do to ensure that students are able to apply this information long after they leave the medical terminology class?
FADavis.com
1
The Solution 1.
Exploring strategies for ensuring that medical terminology is firmly implanted in students’ long-term memory requires faculty to consider two aspects of the teaching–learning process. The first involves choosing appropriate teaching methodology; the second, developing effective testing approaches. In both cases, applying the Cognitive Domain of Bloom’s Taxonomy is critical. The Cognitive Domain of Bloom’s Taxonomy, with which most teachers are familiar, describes the processes students use to work with knowledge (Armstrong, 2010). Table A below provides an illustration of the breadth of cognition individuals use as they work with knowledge in a variety of circumstances and times.
Table A: Definitions of Bloom’s Cognitive Skills
DEFINITION ABILITY TO:
COGNITIVE SKILL
Know
Remember content previously introduced.
Master the meaning of the content. Students understand what is being communicated and are able to present the material in their own way.
Understand
Apply
Apply learned material in new and concrete situations.
Analyze
Break the learned content into parts and use them in new situations.
Evaluate
Make judgments about the learned content based on accepted criteria.
Put elements of learned material together to form a new coherent or functional whole; reorganize elements into a new pattern or structure.
Create
Table A above illustrates that these processes build upon one another. For example, a learner must understand the knowledge before they can apply it in a new context. As students work with the knowledge, they will be able to expand its use in the real world. This process does not necessarily take very long if they are given the opportunity to work with the knowledge in a variety of contexts over the length of the students’ program of study. In the health professions, when graduates are expected to act in a competent manner upon graduation, they certainly must be able apply, analyze, evaluate, and perhaps even create some appropriate new uses for medical terms. What teaching–learning and evaluation strategies should faculty provide so students are able apply, analyze, or evaluate medical terminology when they reach their professional course work? First of all, the learning objectives for the medical terminology course must reflect the level of cognition the faculty requires them to perform. Table B gives examples of these types of objectives.
2
Table B: Examples of Learning Objectives by Level of Cognition
LEVEL OF COGNITION
EXAMPLE OF LEARNING OBJECTIVES
VERBS USED TO REPRESENT LEVEL OF COGNITION
Use medical terms appropriately in a variety of contexts.
Act, administer, assess, change, chart, choose, demonstrate, determine, develop, discover, draw, establish, imitate, implement, include, inform, instruct, participate, predict, prepare. provide, report, select, show, solve, use Distinguish, confirm, categorize, organize, translate, contrast, differentiate, question, investigate, examine, compare, discriminate, detect, classify, outline, analyze Evaluate, prove, refute, argue, justify, support, convince, debate, weigh, prioritize, judge
Apply
Categorize medical terms according to the body systems to which they apply.
Analyze
Evaluate the appropriateness of the use of the medical term in selected documents.
Evaluate
2.
Learning Activities
Testing Student Competence The learning objectives also play a role in developing exams to test students’ knowledge, since they are designed to highlight what is important in the course. It follows that the test items should be crafted to give students the opportunity to use the knowledge presented in situations close to the expectations of the workplace. While rote memorization (repeating certain facts until it is instilled in their memory bank) may be helpful in the initial exploration of knowledge, this approach alone will not prepare students to use knowledge in a meaningful way in the workplace. Just as teaching–learning activities should be designed to represent, as closely as possible, “real-world” scenarios, so should test questions. For this reason, most licensing or certification examination questions are written at either the application, analysis, or evaluation level. This requires that courses leading to such exams should mirror this expectation. Learning objectives provide the road map for designing the teaching–learning activities in class or in homework. For example, the following activities correspond to the objectives outlined in Table B: § Apply: Student will translate examples of patients’ descriptions of their history into appropriate medical terminology. § Analyze: Students will categorize a list of medical terms according to the body systems they represent. § Evaluate: Individually or in groups, students will review examples of medical documents and determine the appropriateness of various terms in various contexts. They should be able to correct any mistakes found by substituting the correct term. Importantly, retention of knowledge does not occur if the student interacts with the knowledge only once in class. Students are more likely to retain information if they repeatedly use the knowledge necessary for a competent practitioner.
3.
3
Below are some examples of medical terminology test questions which represent application, analysis, or evaluation cognitive levels.
APPLY: 1. Which of the following refers to a disease of the kidney.
ANALYSIS: 1. Which of the following
EVALUATION: 1. Which of the following medical
abbreviations represent conditions of the cardiovascular system? Select all that apply (SATA) a. CAD b. MI c. COPD d. CHF Answer. a, b, d
terms would you be likely to find in a laboratory report? Select all that apply (SATA)
a. Cardiopathy b. Nephropathy c. Neuropathy d. Myopathy Answer: b
a. Hyperkalemia b. Hyperesthesia c. Hyponatremia d. Hyperkinetic Answer: a, c
4.
Knowing and Understanding
Tips for Developing Exam Questions that Represent Higher Level Cognitive Skills 5. When are the Cognitive Skills of knowing and understanding useful in students’ progression in developing competence? Knowing and understanding are the foundation upon which the rest of Bloom’s Cognitive Taxonomy is built, particularly in learning medical terminology. Practice in knowing and understanding is most useful in teaching–learning activities, such as pre-tests or pre-class or in-class activities. Such approaches provide opportunities to work with the material as previously discussed. However, when using examinations that evaluate competency in an area, it is most helpful for test items to be drawn from the world of work. Here are some useful tips for designing test items that require application, analysis, or evaluation on the part of the students. 1. Always use plausible incorrect answers in the questions. If the incorrect answers are unlikely to be correct, the chance of guessing increases, making it less likely that the question actually assesses the competence of the student in this situation. 2. Assessing the analytical ability can be easily assessed, even in multiple-choice testing, by presenting charts that students must use to answer the questions. 3. When students must hold more than one fact in their mind to answer the question, questions are likely to be higher order. This multi-logical thinking requires students to evaluate more than one fact in order to answer the question. Using wording such as “the most appropriate” or “most important” sets the stage for this analysis. 4. Case studies—telling stories that require students to solve a problem will also enhance their application and analysis skills.
4
Conclusion 6. Preparing students for the “real world” begins in the early stage of the students’ course of study and continues until graduation. The use of Bloom’s Level of Cognition provides a framework for learning objectives, teaching–learning activities, and particularly assessment of their competence that will pay dividends for new graduates.
About the author Susan Sportsman, PhD, RN, ANEF, FAAN , is a nationally recognized speaker and consultant with over 10 years of consulting experience, providing program development and other consultation services to nursing and health professions programs throughout the United States and Canada. Previously, she served as Dean of the College of Health Sciences and Human Services at Midwestern State University in Wichita Falls, Texas.
LEARN MORE! FADavis.com/MedTerm | Hello@FADavis.com
References Armstrong, P. (2010). Bloom’s Taxonomy. Vanderbilt University Center for Teaching. https://cft.vanderbilt.edu/guides-sub-pages/blooms-taxonomy/ Accessed, 2023 Pappas, C. (2014) How to Write Multiple-Choice Questions Based on the Revised Bloom’s Taxonomy E-Learning Industry. https://elearningindustry. com/how-to-write-multiple-choice-questions-based-on-revised-bloom-s-taxonomy Accessed 2023
© F.A. Davis
5
Page 1 Page 2 Page 3 Page 4 Page 5Powered by FlippingBook