Nick Napper
With over 30 years’ experience of creating innovative training, Nick passionately promotes evidence-based education in healthcare. His research specialism is visual support for learning.
Location UK
Activity
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@PhilippaMartin It's included in the book Urban Myths about Learning & Education that we recommend above.
The original research was published in 'Silent Messages' by Albert Mehrabian (1971). He's still alive, and is on record as saying he is, 'Fed up with management trainers who continue to misquote his findings'. If you Google 'Silent Messages Mehrabian',... -
@AlawiyaAbdullah You should have three attempts at each question in the final test. This allows a chance to go back and check if uncertain of an answer. If there is a technical problem, please contact support via the tab at bottom right of this page.
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@ChrisNorman Re different educators' views on objectives, we empathise with you. It is frustrating and as with many such debates, fine for academics but not necessarily helpful for those new to teaching. The arguments show no sign of abating. To make it even more of a minefield, some educators argue against having them at all.
Many of the arguments involve... -
@BengürTaşkıran Re: learning a language compared with learning physics, at a meta-level yes, most models would apply; i.e. active instead of passive, spacing, interleaving, retrieval, deliberate practice, etc.
The differences appear at the level where subject teaching knowledge (or pedagogical content knowledge) is needed. To use your example, an expert... -
@LindaDouglas To be fair to Peter Honey (I met him once, really nice person) what he recommended was that people should aim to be a fully rounded learner by developing the areas of the four-point model that they felt less comfortable in.
That said, Frank Coffield (who we reference here) was critical of his styles model in the 2005 study, and it developed into... -
Nick Napper replied to Huma Moulaei
@HumaMoulaei Welcome to the course. Please could you write using the course language so that others may share your comments?
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@AlawiyaAbdullah I'm not sure exactly what you are asking - is your concern about your scores for quizzes at the start of each week?
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@AntoniaAmes We develop this in Week 4, where we look more closely at the role of imagination.
I feel (having read your comment) we could have made the role of imagination more explicit in this Step... If a trainer stimulates a learner's imagination using descriptive speech and thereby summons up an image in their visual working memory, they have achieved... -
@AmyDonohoe-Brown It is possible that those responsible for such DBP presentations have no idea how transient the content is? Perhaps you could arrange to test some participants' retention two weeks later. The results might be eye-opening for the creator(s). If so, you could offer to make the day more learner-centred in line with evidence-based principles...
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@LindaDouglas We should add a caveat regarding aphantasia (I think you read my earlier comment on this). However, aphantasia may not be such a problem in learning tasks we might think, see Knight et al (2022) here: https://escholarship.org/content/qt0b16s06v/qt0b16s06v.pdf?t=recj61
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Nick Napper replied to megan gurney
@megangurney Re personal bias, it is interesting how often learner liking fails to correlate with lasting learning. In experiments undertaken by Robert Bjork, even when individuals performed worse with favoured methods than with approaches that were more subject-optimal , they believe the former to have been most effective.
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Nick Napper replied to Chris Norman
@ChrisNorman You raise an interesting point. At its best, an anecdote/story provides a vicarious experience which prevents those present making a similar error in the future, or encourages them to follow the narrated example.
At it worst however, as you suggest, people may switch off and the point is lost. Guidance on how to frame and tell anecdotes,... -
@LindaDouglas Re debriefing, you raise a valid point, and one we have not had space to cover on this course. There are relatively common situations in teaching healthcare, such as someone who has recently experienced a trauma similar to that covered in the session.
But also, as you suggest with VR, learners who engage with any form of immersive experience... -
@LindaDouglas Re appreciating patient anxiety, some trainers create their own POV (Point of View) videos (also known as 'first-person' or 'subjective') by placing a 360° camera where a patient's head would be. For example it can be placed on a pillow while HCPs talk and move around as though there was a real patient. It's perhaps not as sophisticated as full...
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@PhilippaMartin 156 slides - in the context of Death by PowerPoint, that's 'Assassin' level...
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@THALIAB Welcome to the course. Please could you post comments in the course language so others may share them?
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@OrighmisanEyesan The key word is 'new' - in this context 'new' means discrete items that don't reside in Long-term Memory. Subject experts can often process more than four items for that topic, but this is because the additional ones are drawn from LTM and are not actually new to them.
The current consensus in this field is that for individuals regarded as... -
@LauraWyles Re [Although it seems to be improving, traditional hierarchies and social constructs can have a big impact on learning outcomes] We would agree with you - in the 2020s one would have thought this sort of impact should have gone ago.
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@LindaDouglas Re [if not for the forums, and the demanding assignments, I would have felt as it I went through the module 'without touching the sides' so to speak] it's interesting you mention this - I wanted to include one assignment per week on Train the Healthcare Trainer but FutureLearn advised it was against their guidelines for this type of course.
I... -
@OrighmisanEyesan We cover visual aids in more detail in Week3, and look at Feedback in Week 4. There are links to other sources and we'll be happy to provide additional links at that point if it helps.
Re assessment and the building - that image was included as an example of an analogy taken to the point where it ceased to be helpful. However, I'm not sure... -
@MichellePicken It's not always straightforward, as from the individual's viewpoint they're engaging fully. On a course that contains a break, the trainer may be able to explain the situation then and ask them to moderate their input.
Other possibilities include:
# explaining that you'll be ensuring everyone has equal input throughout the session
# ask... -
Nick Napper replied to Louise Parkes
@LouiseParkes A really poignant story and example of an older person whose years had (on that occasion at least) had not produced wisdom. You took me back decades to a shift when I was quietly ridiculed by two much older seniors for insisting an elderly lady had a fractured femur. X-rays confirmed that she did, but not so much as a glimmer of an apology was...
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@MohammadKheirHasan We've checked the course videos and they appear to be playing normally.
If this remains an issue, could you click on the 'Support' tab (at the bottom right of this page) and report the details please? -
@EstherAyuk Participants work through this course in different ways. We would agree that reading alone will produce limited learning. We recommend participants work through this course with a mentor over a 5 week period, in this way they are able to put learning into practice and then discuss these experiences with their mentor afterwards. (There may be an...
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@MichellePicken Re 'I could do a trial just to see how well it is received', how about undertaking a delayed assessment after say, a week or 10 days of the training in its current form, and then do the same with the new version for comparison?
Bear in mind that how well a course is received does not always correlate with lasting learning (and can even have... -
@LauraPetchey Agreed. 'External constraints' such as you mention often (perhaps invariably) arise from sources which lack educational expertise. It is one of the reasons we created this course and motivated us to work towards an accompanying book.
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@ChristabelMayienga The beginning of a lesson is a particularly fertile stage for the formation of memories due to a primacy effect (see serial position effect). To start with redundant information about buildings, etc can squander a potentially valuable time.
Re recapping before the start; trainer is helpful, but more efficacious is for a trainer to... -
@KatBrown Just to say I've replied to your 'contact us' email, but it may end up in your spam folder
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@DaphneChia One method that can support the situation you mention is to pair up learners of differing abilities. In this way, those who are ahead are gainfully employed helping others. In this way, the group are more likely to arrive at the lesson outcomes together.
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The development and/or changing of professional attitudes comes under a general heading of 'affective', and is much murkier. In this field, evaluation of 'Does' often finds a disparity between 'Shows that' (in end of training assessments) and 'Does' (in practice).
For example, a study of New York Police who undertook Implicit Bias training found that although... -
@DaphneChia As you suggest, the answer is yes. Many of us discover this empirically, for example when learning to drive, or play a challenging piece of music.
In a key research paper, Baddeley and Longman (1978) found that for people learning to type, practice sessions that were shorter and spread out were more effective than longer ones bunched together... -
@DawnWalklate I could perhaps have worded that reply more clearly - the number of points on a slide have no connection at all to Miller or Cowan's research. I mentioned it because the 'points on a slide' guidance was never really more than an urban myth.
For example, you could have several bullet points which all support the same element (such as symptoms of... -
Nick Napper replied to Stephen Brown
@StephenBrown We're not completely sure what you're asking?
CLT is concerned with the nature of learning content and the degree to which it may or may not overload an individual during the period of a lesson.
Whereas a conflict in Working Memory created by attempting to process two similar language sources presented simultaneously at different speeds,... -
@KatBrown From your comment in Step 4.3, it sounds as though you do some spacing, if not explicitly? The inclusion of a reflective journal might enhance this?
(What's CDE - content, delivery, engagement?) -
@AnnaSwinburn As the course progresses, we'll discuss spacing in more detail. Yearly mandatory training doesn't really fall into this category, as it's too distanced to have that effect.
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@MichellePicken That sounds like feedback to be genuinely proud of - you should keep the email - perhaps create some form of compliments journal?
Teachers and trainers are so often taken for granted; sometimes more so the better they are. Yet we all need positive feedback to grow. Rereading complements, and maybe your own thoughts at the time, can be a truly... -
@MichellePicken It's difficult, but if someone really is that tired, they're unlikely to take much in that will stick.
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@AndreaW Sounds good - if you have time, do revisit this post and share with everyone how it went.
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@AndreaW Not really. Chiefly because concentration varies according to personal inclination and motivation. Many of us can watch a long movie and concentrate all the way through, or spend a whole afternoon reading research papers on our pet topic without stopping for a break; yet may lose concentration seconds into a boring lecture.
Re exam revision, again... -
@PaulMackie Great to hear you're having conversations with fellow participants. It's totally within the spirit of this course and should enrich everyone's learning.
We would have liked to include microteaches for groups of participants in which everyone includes a technique new to them from this course. After each session, the trainer gives a... -
Nick Napper replied to Paul Mackie
@PaulMackie Many participants have mentioned that it is not easy to assess the 'Does' aspect of training. However, it sounds as though you did this, and produced a valuable outcome here.
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@PhilippaMartin Agreed. Although ‘Does’ is usually the desired outcome of training, establishing whether transfer to practice has taken place remains something of an ‘elephant in the room’.
Many participants on this course have commented to this effect. -
@OkoliU We are referring to dendritic connections which grow between neurons when lasting (long-term) memories are formed. We've represented the formation of one such connection in two horizontal diagrams above.
Note: I've edited the image captions to clarify this. I hope this helps. -
@KatBrown We would agree with you. Our hope was that participants would go through the course with a mentor (notwithstanding your comment about mentors!). The learner would discuss which sections were of practical use, try them and debrief what happened with their mentor.
This contains an additional potential of updating the mentor simultaneously.
However,... -
@KatBrown Would I be correct in reading that you've experienced this to be the general case rather than an exception?
Do you believe it's due to a choice of mentors or indicative of a wider issue? -
@MonzerMostafa Thank you - it was the phrase 'brunette pilot' I didn't understand
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@AmandaBosleylcgi We would reiterate that application of styles theory has been shown to provide no improvement in learning, and often has a negative impact on outcomes (although due to its nature, less so on post-learning feedback).
There is an irony; for whole group learning, a trainer’s belief in styles tends to encourage the provision of a range of... -
@MonzerMostafa Could you explain this comment please?
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Hi, please add comments in the same language as the course content so others may read them. Additionally could you use some form of name (at present you appear with the moniker 'hidden user).
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@LiniCherian I think you make a valid point by suggesting it's 'difficult to easily assess' this element. We tend to measure that which is easy to measure, although as Duffy (2003, 2006) notably found with nursing students and others (see for example Monroux et al. (2011 with medicine) the individual tasked with assessing learners may not fulfill the role as...
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@KanikaSinha I would agree it’s one reason. Other influential factors are often a lack of preparation time afforded to lecturers, and the finding that in the UK, lecturers and trainers for the most part receive no instruction in the educational design and use of visual aids.
As a result, slides may possess minimal generative function, beyond a reminder of key... -
Nick Napper replied to Monzer Mostafa
@MonzerMostafa Hi, welcome to the course. Please comment using the course language so that others may read your ideas.
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@VineethVimalan It is true that many people have preferences, what has been found to be untrue is that tailoring teaching to match such preferences has any benefit.
Interestingly, some researchers have shown that deliberately mismatching teaching approach to a learner's preference can produce improved results. -
@CharlotteDefries A significant issue with many forms of assessment arises when the designers, who are competent in the subject area are not so in the creation of assessments. This is frequently seen in MCQs with one correct answer accompanied by three facile options.
Although usually less of an issue with SBAs, the example you provide suggests a lack of... -
Nick Napper replied to Angela Coyne
@AngelaCoyne We explore the issue of the degree to which individual preferences influence lasting outcomes as the course progresses.
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@FatimaZazai There is a 'contact us' link just below the image of a book in Step 5.14
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@PhilippaMartin The physical demonstration of an analogy such as you describe works on a similar level to drawing a diagram in front of learners. Its impact on engagement and memory is usually much stronger than the display of a ready-made image.
As with school teachers who ‘go the extra mile’ and create their own forms of realia, trainers who employ such... -
@PhilippaMartin As a point of interest, do you fill (or I should say overfill) a real jug with water at this point?
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@AwfAlshahwani Agreed. It may be necessary to explain its educational function and benefit for a given learning situation.
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@RoshanB Often known as the 'Testing effect', the positive impact on long-term memory of tests taken during training may depend on the degree of retrieval difficulty experienced by learners. The easier it is for them to recall the correct answers, the more minimal the benefit may be.
In this course for example, those who space it over 5 weeks are more likely... -
@JulieAvey You mention four variables: manager, trainer, learner and coach. We would add a fifth, namely the person(s) who trained the trainer & coach. In healthcare we would wish each of these variables to be expert and so combine to synergistic effect. As you suggest, this does not always happen. It is the reason we created this course.
In healthcare... -
Nick Napper replied to Dale Youngs
@KatBrown I don't think that quote appears anywhere in this course?
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@RichardLing Thank you for the feedback; we will endeavour to provide this in the book.
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@MichellePicken Re [just how much goes into such a short online package], this is one of the reasons eLearning often receives a bad press; creation of an educationally sound online learning package usually requires more thought and effort than a classroom session, but doesn't always get it.
Rather like a PowerPoint 'speaker-script' presentation compared with... -
@saraheast Absolutely. Try talking to some of the learners afterwards instead (or as well as). It's interesting how much helpful feedback can be gleaned this way that doesn't appear on post-course sheets.
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@EllieTurner Some clinical teachers create Moodle SBA quizzes as supplementary activities for their learners.
For a short session there may be an anticipation of maximum information transmission, but learner centred approaches such as Socratic questioning, linear narratives with gaps for students to fill in, etc. may produce more lasting learning.
The... -
@victoriaMcGall Perhaps this would be an good topic for the short lesson plan assignment in Step 5.9?
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@AndreaCavalli You make a valid point. It has been said that even a good teacher can't teach a subject that they don't know.
We would add that as well as knowing the subject, they should possess subject teaching knowledge (also known as pedagogical content knowledge). -
@NatalieSummerhill Unfortunately so. Made even harder by the benefits of these approaches being less well known than we’d hope.
Still worth educators doing what we can though. -
@NikhilJ Completely agree. The practice you describe arises from taking teaching guidance a little too literally. Much more effective to provide an introduction in everyday language (and perhaps question whether it really needs to be repeated on a slide)
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@KatharinaW Hopefully the course doesn't have other questionable or discredited content...
If you use the fact, myth, fallacy, fact approach, perhaps let us know how you get on? -
@ElizabethClark People who act as you describe can have a pernicious effect on both trainer and learners. Sometimes it signifies a need to be recognised in the room, perhaps because they’ve studied the topic before or maybe taught it.
Recognise the question, and respond with measured professional politeness while keeping your expression neutral (as the trainer... -
@ShivaniKanabar There are some possible variables here. If several learners do this, the session may be pitched too high or moving too quickly; in which case it’s worth pausing to check comprehension and consider adjusting the level or pace.
If it’s one learner, it may help to offer them additional support during set activities. Then again, one learner may be... -
@ElizabethClark Agreed. We mention elsewhere that the first research to show discussion produces more efficacious learning than lectures was published almost 100 years ago (Bane, C. L. 1925. The lecture vs the class-discussion method of college teaching. School and society, V21, pp300-302).
We wonder whether any profession has persisted for quite so long (and so... -
@ValClayton And perhaps encourage them to join this course?
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@ValClayton Welcome back into the [educational] daylight!
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@CharityMhonde It's a very useful technique, and one I've used many times over the years.
That said, I've been caught out badly on two occasions (both times by mature learners on refreshers). They included some significant errors due to flawed mental models they must have carried for years, unknown to anyone else.
Since then I usually have a short informal... -
@KatharinaW True. There's some evidence which indicates learners only make the effort to complete free text answers if they know someone (important to them) will read it.
Although AI free text marking will be with us sooner or later, I suspect there'll be an interim period during which students are able to 'satisfy the robot' with key words and phrases -... -
@ManasviDwaraknath Agreed, knowledge needs to be contextualised.
Your example reminds me of the educationalist Diana Laurillard's analogy, where she observed that we can often give undergraduates a metaphorical 'Swiss Army knife' with an implement for removing stones from horses' hooves, but they would not be able to recognise a limping horse... -
@RichardLing Did you watch the video at the start of Step 3.10?
We made the choice to limit it to just one, because we didn't want to give an impression to those new to training that it's a common occurrence.
Interestingly, of participants who commented on this step, most had never encountered such behaviour although some said they had.
One person... -
@RichardLing Re [how much work can be involved in preparing a training package and delivering high-quality training], you've hit the nail squarely on the head.
Conversely, as may be seen from the comments of others here, it is not unknown training to be 'delivered' with (apparently) virtually no preparation and attendees recorded as 'compliant'. -
@RichardLing Retrieval practice functions optimally when some time has passed and the learner has to devote effort to retrieve the required knowledge. In a one hour session, for example, it's unlikely to have faded sufficiently.
It lends itself to a series of sessions, online courses such as this, personal study, etc.
If it's a topic on which the learner... -
@YixiBi Agreed, it needs to be planned carefully and explained to the learners.
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@GeorginaKeatley Re [very inspiring clinicians who are excellent in teaching and sometimes they are not given the credit for this], I think you make a very pertinent observation here.
I'm not sure if this has been researched beyond occasional surveys such as this,... -
@julienordstrom Re [our organizations assume a PowerPoint to get the info out is enough], agreed. Sometimes known as the 'Input/Output' fallacy, this seems to be a common misconception in adult learning.
I determined not to use jargon on this course, but allow me to share a wonderful term for what can happen with passive PowerPoint: 'Mathemathantic' -... -
@ValClayton Re [I've always wanted to get things done as quickly as possible], in a world in which we seem to be bombarded with sensory information during every waking moment, this is understandably a common desire (and appropriate if seeking a short YouTube video on how to change a blown headlamp bulb).
However, this often extends to personal choice of... -
@RohithNarayanNarayanaswamyYechanahally The educationalist David Didau employs similar terms, he refers to teaching in which an assumption is made that what is 'taught' is automatically 'learned' as the 'Input/Output myth'. You provide a pertinent example.
The frustrating thing about such training is that often, the trainers themselves are aware of such... -
@RichardLing There is a wide body of work which informs evidence-cased education. But, perhaps unsurprisingly, the terms ‘compliance’ and ‘delivery’ tend not to appear.
As you suggest, it’s not easy to leave a track well-trodden by others. Those that do, and leave the ‘Cave’ they may have unwittingly occupied, enter the daylight and realise what a bright... -
Nick Napper replied to Katharina W
@KatharinaW Absolutely. Well-told stories of do just this (assuming they are relevant!) in addition to providing vicarious experiences for the listeners.
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@MehakTahir Perhaps an informal post-course chat with one or two participants, maybe over a coffee or a phone call, might be enlightening as to how they found things as the content became more complex?
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Nick Napper replied to Logan Mitchell
@LoganMitchell Re slides without text, agreed. This can also be an issue in a session that relies heavily on video clips.
Some very effective lecturers offer copies of their PowerPoint slides which include slide-relevant summaries in the Notes section. This has the advantage that if the lecturer uses Presenter View, it’s their prompt during the session, and... -
@RichardLing The advantage of piloting a course (as opposed to observing its first run carefully) is that a trainer can frequently pause and ask questions, even over something as apparently small as a frown or a hesitation. And they can do so immediately, perhaps identifying a difficulty that the participant was not conscious of, or if they were, would have...
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@ShonaBoyle Absolutely. We talk a lot about cognitive load of learners, but cognitive load of trainers is also important if they are to be able to think and adapt as needed.
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@YovitaTjhin One helpful approach is instead of saying, ‘Would you like to have a go at this?’, say confidently, “OK, what we’re going to do now is...' and then move straight in to the activity. You could explain that everyone will be having a go and they can volunteer or you're happy to select them. Then get on with it.
Those used to a passive approach may... -
Nick Napper replied to Tanmayi Matteda
@RichardLing Practising, debating, applying new knowledge to a range of scenarios, etc. help grow additional mental connections as well as strengthening them. Engaging with others can often broaden thought processes more than staying within our own thoughts.
Although the degree of benefit is likely to vary according to the topic. For example, a lesson on drug... -
Nick Napper replied to Tanmayi Matteda
@RichardLing Absolutely. So many study days are packed with useful content and breaks taken up with networking that there is little time for reflection. A train journey home can provide such a space, but if we drive instead and arrive to family commitments, much of the day's content will be gone by the time we sit down to reflect on it late evening.
It's... -
@TanmayiMatteda Agreed. For many creators of online learning the gold standard is free text answers marked by Artificial Intelligence. As a point of interest, one version of this course that we piloted used newly developed AI to mark free text answers. Unfortunately it was found to be unable to accommodate minor typos and synonyms. Despite ongoing predictions...
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@NabegailOronce Re [ it felt like she was reading to me the whole company's guide book/manual] it's interesting that some people remain oblivious to the inadequacy of this approach, even when (not that I'm suggesting you were...) the person they're talking to glazes over. Even if they weren't a trainer, that person received at least 11 years of professionally...
