Two Pills Tips: Teaching Outdoors!
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Who: Small groups, such as experiential students on rotations 


What: We’ll do case discussions, SOAP notes, topic discussions, and evaluations outside.  We have also done “park rounds” where we walk around the park and discuss teaching topics of rounds.  (Nothing patient specific of course). 


Where: We have done “park rounds” b/c there was a park across the street from the hospital.  For student discussions, we often find ourselves on benches outside the hospital.  I enjoy having our discussions near the ambulance bay b/c it shows students a different side of patient care.  It shows the role of the EMT and what the patients look like before they’re neatly in their hospital gowns and with lines in. 


When: Mine are often in the afternoon when it’s warmest. 



-Check your weather app to make sure the weather is cooperating.  Students will complain if it’s too cold, too windy, etc.  You don’t usually want to make multiple trips. 

-There are naturally more distractions outside-don’t expect to straight lecture and have students pay attention to you.  Outdoors is best for discussions where all are actively participating. 

-Make sure you do not discuss anything patient specific.  That should, of course, be a given all over the hospital but especially outdoors.  I think having discussions outdoors actually reinforces the importance of patient privacy and HIPAA in my students. 

-Be sure to include engaging topics and those that are relatively brief.  Attention spans are short, but especially with outdoor distractions.  Consider limiting your time to 20-30 mins or less. 

-If you want to take outdoor learning to the next level, check out Forest Schools which originated in 1993.  These schools are based on Scandinavian principles that emphasize human contact with nature. 


Why: We are under fluorescent lights most of the day.  Why not get a little Vitamin D and sunshine? 

-Author Richard Louv came up with the phrase “nature-defecit disorder”-students have too much indoor stimulation, screen time, etc 

-Data studying children in an outdoor curriculum found that they scored higher on assessments in math and science compared to a traditional setting. 

- Improve recall: Improving recall can come from experiencing something new and unfamiliar. Classrooms where day in and day out the lighting, temperature, layout, and scenery are always the same does not have much to offer in this area. But moving the class outside opens up fresh stimuli for the senses. I certainly remember the SOAP notes and topics we discussed outside, much more than in the small conference room where the rest of our discussions take place. 

-Study of college students: By transforming an on-campus course into a blended course, we were able to conduct seminars outdoors in nearby nature while walking. These walking seminars were evaluated among 131 students and nine teachers leading the walking seminars. The responses to the student survey and teacher interviews indicate that discussions, sense of well-being and the general quality of the seminar improved, regardless of how physically active participants were the rest of the time. The study shows one way to increase physical activity with small means; in our case

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