Checking Understanding Exercise
Heron Mathis
Heart health is an essential part of your overall health and well-being. Your primary care provider will monitor your blood pressure and lab work during an annual physical exam or more frequently. If you have symptoms that indicate your heart may not be functioning properly, such as blood pressure higher than the recommended level, chest pain or swelling in your feet or legs, you may be referred to a cardiologist.
A cardiologist uses diagnostic testing to evaluate the heart's ability to pump and move blood and oxygen throughout your body. Hearing you need a test on your heart may be confusing or scary, so understanding the purpose of the tests can help put you at ease.
A cardiac stress test shows how your heart works during physical activity. Also known as an exercise stress test, it can detect problems with blood flow when the heart is pumping faster and harder than usual. The test can be done while walking on a treadmill or riding a stationary bike. Or you may be given a drug to mimic the effects of exercise while in a seated, resting position.
A nuclear stress test may be recommended if an exercise stress test doesn't reveal the cause of your symptoms. During a nuclear stress test, short-lived radioactive medications are injected into the body and taken up by the heart to create an image of the heart's function at rest and with stress. This medication rapidly leaves the body after the test and is safe and painless.
During a coronary CT angiogram, advanced CT technology and injected dye are used to take high-resolution 3D images of your heart. The 3D pictures of the beating heart and major blood vessels are used to identify coronary artery blockages. From the 3D images, your healthcare team can see if there are plaque or calcium deposits in the arteries.
Sound waves produce images of your heart during an echocardiogram. This is a common test to see your heart beating and pumping blood. The images from an echocardiogram can help identify heart disease, detect congenital heart defects before birth and check for problems with the valves or chambers of your heart.
An electrocardiogram (EKG or ECG) is a noninvasive and painless way to quickly detect heart problems and monitor the heart health of people of all ages. You may have an ECG if you have symptoms such as chest pain, dizziness, confusion, heart palpitations or shortness of breath.
Small, adhesive electrodes are attached to your chest, arms and legs during an ECG. The electrodes record the electrical activity of your heart, and the ECG machine prints out a chart of your heart's electrical signals.
It is important to confirm that you have explained things in a manner your patients understand. The teach-back method is a way of checking understanding by asking patients to state in their own words what they need to know or do about their health. The related show-me method allows you to confirm that patients are able to follow specific instructions, such as how to use an inhaler.
"One of our residents decided to do her QI [quality improvement] project on using teach-back. Since people were worried that teach-back would take more time, she collected data that showed her average visit length decreased as she practiced teach-back, and was shorter than other residents who were not using teach-back. She also gathered data showing that patients who got teach-back were more satisfied than patients who did not. Then she spread teach-back to her colleagues."
Clinicians are often worried that they do not have time to use clear communication strategies. Invite skeptics to watch this video of Dr. Clifford Coleman using many of these strategies in a 15-minute visit. Do not ask questions that can be answered with a "yes" or "no." "Do you understand?" and "Does that make sense?" are NOT teach-back questions. Patients are likely to answer "yes" whether they understand or not.
Ask staff to fill out anonymously the Conviction and Confidence Scale before you start using teach-back and then 1 and 3 months later. Track changes in the responses to see if people increasingly believe that teach-back is important and have confidence in using the method.
The Teach-Back Observation Tool should be used by a designated observer as clinicians build their skills and confidence with teach-back. There is also a teach-back question on the Communication Observation Form. Use the findings to guide evaluation, coaching, and additional learning to establish consistent habits.
Instructors can use the results of CFUs to inform instruction, for example to plan reviews of learned material, or to identify students in need of individualized support. Students benefit from CFU by getting a regular snapshot of their current knowledge and skills. This frequent feedback makes learning visible to students, allowing them to identify gaps in their understanding in time to make necessary shifts in their study.
Integrating CFU into your lessons also ensures learning is active. CFU require students to show their understanding or to use a new skill. This takes students out of the passive role of listening or reading and puts them in the position of showing their learning in active modes such as speaking and writing.
To use CFU most effectively, first identify learning goals for each lesson. Pay particular attention to difficult concepts that you know from experience students will struggle with. Once those concepts are clearly outlined, design informal check in questions, mock exam questions, or low stakes in class activities that will provide observable evidence of conceptual understanding for each one. If you are considering changing your assessment style from multiple-choice exams to some other mode, such as open-book exams or project-based assessments, you already have a set of CFU created in those exam questions!
Ask students to self-assess their understanding using hand signals: thumb up if you understand, thumb down if not. Use this quick and easy feedback to determine whether you should continue instruction or review material.
To gather student responses quickly during instruction, ask students to respond to a question on a sticky note and post it somewhere in the room. For larger classes, you can use Padlet, a virtual sticky board.
Like Post it Up, Show Me asks students to answer a question during class time and show their responses on a whiteboard. You can use mini white boards, classroom whiteboards, or a virtual whiteboard, like Jamboard.
This CFU attempts to uncover student misconceptions. The instructor presents a statement and asks students to choose the correct response. Popular question types are true/false and agree/disagree. Responses can be gathered in class by cold calling, having students share out in small groups or pairs, or using polling tools like Zoom polls (remote) or iClicker (live and remote).
To check students' understanding of material covered during class, design a mini quiz for students to complete at the end of class. This should be low stakes, as the purpose is to help you identify concepts for later review. Consider creating an ungraded quiz in Canvas with unlimited attempts.
Similar to the Exit Quiz, the one minute paper is an opportunity to assess student understanding of a key concept or give students time to ask questions. You can use pen and paper for this exercise or virtual tools like Google Forms and Canvas.
Ask students to create a visual representation of a learned concept. They can draw a picture or concept map to show their understanding. In addition to pen and paper options, there are many free electronic applications students can use to create concept maps such as Bubbl.us, Lucidchart for Google, Coggle, CMap, or MindMaple. Once completed, you can also ask students to complete a gallery walk of all visuals.
Asking students to write a summary of a learned concept helps learners identify gaps in their own understanding. Doing this in class allows the instructor to address learning gaps before moving on. You can collect summaries in a variety of ways. Post it notes, shared google doc, discussion board post, or external chat tools.
This is similar to Turn and Talk, but this activity provides students with more intentional processing time. Before students pair up to discuss a discussion prompt or share an answer, they write their response down. This method provides scaffolding for students who find it difficult to express themselves when speaking.
Normally, class presentations would be a graded assignment, but when used as a CFU, it becomes an opportunity for students to apply what was learned and attempt to explain it. The presentations can be quick, with or without supporting materials and given by an individual student or small groups.
Homework is also a tool to allow students processing time and a way to discover gaps in understanding. For this reason, it is important to provide timely feedback. You can use online grading tools like Gradescope, Speedgrader, and Canvas quizzes to help with grading.
The FIVE FOR LIFE PROGRAM is an articulated, evidence-based, K-12 fitness and health curriculum that aligns with SHAPE America National Standards for K-12 Physical Education. Using age-appropriate academic instructional units in an activity-based setting, the FIVE FOR LIFE PROGRAM moves students through a continuum of learning without compromising activity time for students. The Basic (Elementary), Intermediate (Middle School) and Advanced (High School) include Student Introductions, Vocabulary Lists, Activities with Formative Assessments and Summative Unit Assessments.
WELNET is designed to provide physical educators with a tool to gather student fitness data and communicate results. WELNET modules offer a variety of tracking and assessment tools, including measuring the five components of fitness, checking students' understanding of fitness and health concepts, tracking students' health-related habits and behaviors, supporting student goal setting and producing reports in each module to analyze trends, improve instruction and achieve program goals and outcomes.
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