Using Case Stories and Other Methods to Delight Yourself and Your Students
Admit it, you don’t like teaching biology in your psychology class. It’s not that it’s unimportant, but reading and talking about it can be so … well, not fun. Many of us who teach psychology have a limited biology background and unless a course is specifically about biological psychology, most students do not expect to learn about nerve cells or ion channels. When did someone ever say, “I want to study psychology to master the cytoarchitectonics of the brain’s cortical modules”?
When we teach biology in psychology courses, I think that we often forget principles of good teaching and effective public speaking. The result is class sessions that are overly detailed and poorly digested. We try to: 1) cover too much, 2) in less time, 3) with multisyllabic jargon, 4) while talking more and faster, 5) covering material only once and in only one way, 5) focusing on “trees” rather than the “forest,” 6) involving students less and using overwhelming visual aids, and 7) using few examples or demonstrations. The only time that teachers and students are in concert is in a collective sigh of relief as the ordeal ends.
The purpose of this column is to help restore basic principles of good teaching and public speaking to teaching biology in a psychology class. However, the ideas below could apply to any teaching.
Remember the Rules of Public Speaking
Whether you teach in a discussion-oriented or a lecture format, when you lead your classroom sessions you must employ fundamentals of good public speaking. One framework comes from speechwriter James C. Humes. From studying great orators, Humes (1996, 2002) describes basic principles of public speaking. Among them are: 1) start strongly, 2) talk plainly, 3) have a theme, 4) paint a picture, and 5) end emotionally. Let us review each rule separately, and consider using them more frequently as we teach biology in our psychology classes.
Rule 1: Start Strongly
Speeches should start with an impressive, captivating, memorable moment. There is plenty of time later to blend in thanks to the fine folks of the [organization name] who invited you, fond recollections of how you and [organization’s founder] are good friends, praise for last night’s dinner of [local cuisine] that the [region] is famous for, and compliments to the folks of [nearby town only locals know] who were so warm to you years ago. Rather than lead with these momentum-sapping platitudes, great speakers grab our interest right up front.
In covering biological material, one way to start strongly is to describe a person with a neurological problem. Such a case story is a teaching vehicle to make abstract concepts more real and identifiable — giving a face, as it were, to the material. You can summarize a real case from the literature (e.g. read issues of Neurocase or Neuropsychologia, or skim through a neuropsychology or behavioral neurology textbook), or build a hypothetical case from classic signs and symptoms in a textbook. For example, consider how you might teach the biology of vision. You could show a picture of the parts of the eyeball, name and describe them, then show the retina and describe how light comes in and gets transduced, then tell how visual fields split as information goes into the brain.
Yawn. Snore. REM sleep.
Try this instead:
A 60-year-old woman saw her doctor for an exam. She had developed “blurred vision” a month ago. “Maybe I need new glasses,” she offered, “but, the only time I have trouble seeing is when I read — the words just don’t seem real.” When the doctor tested her vision, she never reported any visual stimuli presented in her right visual field, no matter which eye she used. She could still see in her left visual field, so she could catch a ball thrown to her and could walk around the office without bumping into things. She could not read any words, but she could see the letters and point to them. She could write perfectly, but as soon as she did, she asked, “What does it say?” Apparently, she could not read the very words she had just written! A brain magnetic resonance imaging study confirmed a stroke affecting her left occipital lobe, including fibers of the back part of the corpus callosum.
This story describes a classic behavioral neurology syndrome, alexia without agraphia. Note how you can use this story to teach the biology of vision. Ask students to throw out ideas about what was wrong, such as: “What could she do? What could she not do? Let’s look at the biology of vision and try to understand her.” Then, always referring back to this lady, you can still go to the same pictures you were going to show before (“Let’s look at her eyeball … now let’s look at her retina …”). In this way, something abstract and remote is made real, concrete, and part of a story, and students want to know about it.
Other ways to start strongly might be to make material personal. For example, when I get migraine headaches, sometimes I lose vision in one visual field a few minutes before the headache (a well known phenomenon). I might ask the class to guess why, then look through diagrams of “my” visual system and ask for comments along the way. I have an MRI picture of my brain I can show them, too. Who can resist commenting on their teacher’s brain?
Or, start strongly by framing class with some questions: “Today we are discussing the biology of memory. What is memory? What does a mind need to do to make memory happen? What does a brain need to do? How might this/these fail? What would it be like to have a memory disorder?” You can then tie these questions to a case of, say, transient global amnesia.
Rule 2: Talk Plainly
The “talk plainly” rule dominates history’s great speeches. Scholars argue over the exact words of Abraham Lincoln’s Gettysburg Address. We do know, however, that of the approximately 240 words of the speech, about 75 percent were one-syllable words. Lincoln knew that speaking well requires speaking plainly and clearly. Consider if Martin Luther King’s “I have a dream” had instead been “It is my fervent desire, not yet realized, but, I envision, will henceforth come to fruition.” Not so catchy. Similarly, John Kennedy’s “Ask not what your country can do for you, ask what you can do for your country” is a better call to action than “Eschew nationalistic hedonism in favor of its altruistic opposite.”
There are three especially important applications of the talk plainly rule when teaching biological material.
Use simple, regular words. Medical students learn words like cardiac and hepatic and renal when English already includes heart and liver and kidney. Do not follow in kind. Whenever possible, use the perfectly wonderful English words that you and your students already know. Talking plainly does not make you sound dumb; it makes you understood.
It is important to avoid using jargon when it is not needed, when its only purpose is to make you sound smart. But there are terms that a discipline uses and a nomenclature that students must therefore learn. So, at times you may have no choice but to use words that seem like jargon to students. For example, in discussing ions inside and outside of a nerve cell, you may need to say sodium and potassium and membrane. If you do need to use jargon (and be sure you really do need to), then explain it, define it, or discuss its origin (e.g. corpus callosum means “hard body”). (A medical dictionary such as Stedman’s  is an excellent resource.) Then, for a time, keep referring back to that common ground each time you use the term. For example, when I introduce the term polarity, I say, “Polarity just means a difference. Whenever you hear ‘polar,’ think ‘different’.” Then each time I use the polar- root again, I reprise the definition: —Normally, a nerve cell is electrically polarized, that is the electricity inside is different than outside … Nerve cells do new things when they are depolarized — that is, when the inside and outside become less polar, or less different.”
Use simple style. Second, the “talk plainly” rule also refers to the level of your discourse, the style of your language. Must you really say, “The intracytoplasmic ionic milieu, in contrast to the extracellular one, establishes a transmembrane polarity which is intracellularly negative”? The real message is: “The electrical charge inside a cell is negative compared to the outside.” Just say that.
Cut detail. The “talk plainly” rule dictates the topics you address in class. Here, you should mercilessly cut detail. Harshly decide what is not necessary and stick to the main points. You do not need to cover everything. Give your students the skeleton, and let them add the meaty details during at-home study. Occasionally in class you can, and should, highlight a point with more details. Doing so adds interest and shows how to pursue higher levels of analysis, but do not let the details become the main point of your class time.
Other applications of the “talk plainly” rule include:
- For every visual aid, have one clinching explanation (“The main point of this picture is …”).
- Rather than showing one complicated diagram, break it into many pictures that each makes a main point.
- Punctuate whenever possible by organizing material into lists, or by taking a complicated process and organizing it as a step-by-step sequence.
- Be truthful. There is a lot of material you may not know either because no one knows, or because it is outside your knowledge. Do not try to oversell what you do not know. If there are holes in the story, admit it. Use such moments as opportunities: Start a discussion, explore what the answer might be or how one could find out, or come back to class next time and report on what you’ve learned.
Rule 3: Have a Theme
A good dictionary contains most of the great works of literature. All the words are there, just not sequenced as they are in a real book. How things are bound together makes all the difference. Similarly, in good oral presentations, the parts fit together. There must be a theme, not just a list of nonconverging statements.
In a typical class session, there are a relatively few discrete concepts that students learn. So, carefully pick the few points that you want to teach, pick them well, and then make these themes hold your class session together.
State a theme explicitly. It helps to be clear on what the theme is. Consider again the biology of vision. There, a challenging topic is how visual information splits into visual fields that go to opposite sides of the brain. A bad way to teach this topic is just to show the classic diagram showing where pathways cross over or not, where synapses are, and what happens after damage at various places. This approach shows important details but is vague on how it all hangs together.
Instead, try starting by stating a theme: “Each half of the brain likes to construct a representation for the opposite side of space.” Repeat it for emphasis and highlight the word “space.” From that theme, you can now make sensible predictions. Of course, motor control would cross over essentially 100 percent, and skin sense information would cross over 100 percent. And, entirely predictably now, one would not want each eyeball to send all information to the opposite side of the brain, since each eyeball sees both the left and right sides of the world. Instead, we need to know from where each piece of retina gets its light. Picture an eyeball in horizontal cross-section, with rays of light coming through the pupil. From this, it is clear that the left eye’s nasal retina (i.e. inner half) “sees” the left side of the world, and the right eye’s nasal retina “sees” the right side of the world. Again: “Each half of the brain likes to construct a representation for the opposite side of space.” So, fibers from each eye’s nasal retina must cross to the opposite side of the brain. By contrast, the left eye’s temporal retina “sees” the right side of the world, and the right eye’s temporal retina “sees” the left side of the world. Yet again: “Each half of the brain likes to construct a representation for the opposite side of space.” So, fibers from each eye’s temporal retina go to the same side of the brain. Talk it through with the pictures.
A great way to make a class revolve around a theme is to refer back to a case story, perhaps one that you started class with that day (“start strongly”). Can you see how much more interesting the last paragraph becomes if you were discussing the alexia-without-agraphia lady, or my pre-migraine visual loss?
Show students the “forest.” Otherwise, the details they get are just so many “trees.” Of course, this strategy is important for all teaching, since long-term memory relies on semantic encoding. With biological material, the dictum is even more important. Here, the material is, by nature, remote from one’s experiences. Students are well practiced with using language, engaging in social discourse, responding to punishment, and feeling emotions. They can relate to these “real” topics. But most will never see an ion or a cell or, for that matter, a brain. These things are just not “real” in the same sense that the rest of a psychology course can be. You need to make these things semantically meaningful, to stress basic points, to show the forest.
One way to show the forest is to tie biological material with other areas of psychology. Explicitly link biology to some aspect of behavior or mentation. Never just show a brain structure. Instead, discuss the aspects of behavior that depend on this part of the brain. Do not just show ions and ion channels. Rather, talk about how drugs may affect these things to cause psychological changes. Similarly, bring up biology in other areas of your course. In talking about food selection and hunger in a unit on motivation, for example, mention research on hypothalamic mechanisms of hunger and satiety, or how hormonal interactions between the gut and brain alter eating behavior. These methods allow students to relate topics to each other, and see the “forest” of psychology.
Teach the same idea more than once, but in different ways each time. As students extract the basic thrust of each repetition, they begin to understand the tie that binds, the theme that unites. You might alternate between a forest-level description of a process and a trees-level description, between text and graphics, between examples and principles.
Rule 4: Paint a Picture
Recall how Winston Churchill proclaimed the start of the cold war: “From Stettin in the Baltic, to Trieste in the Adriatic, an iron curtain has descended across the continent.” These words labeled the conflict with a concrete image, an icon that the world used for decades. In speaking, the words we use get people to think thoughts. When words also get people to imagine scenes, their thoughts become more concrete, their meaning more crystallized and, ultimately, better remembered.
In teaching biological material, an obvious application of the “paint a picture” rule is to use visual aids. You have many opportunities to do so. You can present experiments with cartoons or photographs showing methods, stimuli, techniques, and data. Photographs and schematics can show brain structures at different levels of detail or from different viewpoints. You can show pictures of materials used to test neurology patients, perhaps along with samples of patients’ output. The judicious use of videos and class demonstrations can help “paint a picture” by the live images they create.
You can get many such media easily. Ask colleagues to share materials, access source material from your textbook publisher, scan images from a book or article, create your own graphics with simple computer software, or download materials from an almost limitless supply on the internet (e.g. try a Google search, clicking on “images” to narrow the search).
In using visual aids, I make three suggestions.
Understand the point of using visuals. Often, you could say what you want without a picture. Using an actual picture helps to seal the deal. It should make what you say easy to imagine and understand and, ultimately, remember.
Present the same material differently. Especially when showing anatomical pictures, try to show images from different viewpoints (top, bottom, side) or using different artistic styles (cartoons, schematics, actual photographs). This method gives people a chance to get the main point and to build a three-dimensional perspective on otherwise unfamiliar objects.
Use visual aids as complements. Visual aids should complement what is said, not compete with it or take the place of it. Minimize details so the main point is clear, use a minimum of words, trim or edit images so that they inform rather than noisily distract. Each picture should make one or at most two basic points.
Let us consider how nicely a figure can work by returning to the alexia-without-agraphia patient from above. I used the simple Paint program pre-installed on most PCs to draw the two figures above (see Figure 1). On the top is a normal brain. It shows, schematically, the general flow of visual information as it enters the retina and goes into the brain. Left visual field, or LVF, information is in dark gray; right visual field, or RVF, information is in light gray. Using this diagram makes it easier to follow the words-only descriptions (above) for how visual fields cross. Now look at the diagram on the bottom, with a lesion in the back part of the left hemisphere. By folding in a discussion of hemispheric specialization, you can now explain the patient. Damage to her left visual pathway caused RVF loss. She also had damage to her corpus callosum (the thick black lines). Thus, although she could still see in her LVF, this information could not go to the more linguistically competent left hemisphere. So, she could not read. She could still write because the language production systems for this function were themselves undamaged.
Rule 5: End Emotionally
The phenomena of serial position effects remind us that the start and end of class are more likely to be remembered than what happens in between. Strong speakers, unlike old soldiers, do not just fade away. Instead, strong speakers end by making people emotional, motivated, and ready to rise adoringly as if a reflexive autonomic response! (Well, maybe not that enthusiastic.)
In teaching biology in a psychology class, many of the suggestions above help end class on a motivational or emotional note. I sometimes pass out copies of my brain MRI and ask students to come back next time with the structures labeled, or with an outline of where to give me a stroke so I cannot lecture but could still give grades. Or, tell me what is “wrong” with my brain (there are some benign examples!).
You might end class with a case story. Ask students to be ready next time to say how a brain injury could produce the signs and symptoms. Or, ask them to describe carefully the person’s impaired versus preserved functions, and how they could test their ideas. Or, ask them to compare the case at the end of class to one that started the class.
Like a soap opera you can’t stop watching, ending class in these ways gives students feelings and questions. In this way, they leave motivated to read, study, do assignments, and come back for more.
References and Recommended Reading
- Banich, M. T. (2003). Cognitive neuroscience and neuropsychology (2nd ed.). New York: Houghton-Mifflin.
- Goldberg, S. (1979). Clinical neuroanatomy made ridiculously simple. Miami, FL: Medmaster.
- Heilman, K. M. (2002). Matter of mind. New York: Oxford.
- Humes, J. C. (1996). Winston Churchill’s method of public speaking. Philadelphia: University of Pennsylvania.
- Humes, J. C. (2002). Speak like Churchill, stand like Lincoln: 21 practical secrets of history’s greatest speakers. New York: Crown Publishing.
- Jozefowicz, R. F., & Holloway, R. G. (1999). Case studies in neuroscience. Philadelphia: FA Davis.
- Rolak, L. A. (2001). Neurology secrets (3rd ed.). Philadelphia: Hanley & Belfus.
- Sacks, O. (1970). The man who mistook his wife for a hat and other clinical tales. New York: Harper & Row.
- Stedman, T. (2000). Stedman’s Medical Dictionary (27th ed.). Lippincott, Williams, and Wilkins.
Leave a comment below and continue the conversation.