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Making the Rounds: A Prescription for Success?

January 26, 2011

I spent this past weekend catching up with some college friends who are now physicians.  As we reminisced about bad dorm food, all-nighter study sessions, and a few adventurous road trips, the conversation inevitably turned to our respective careers.  There was no shortage of stories about the noticeable impacts of budget cuts, the memorable patients and students we have met, and the ebbs and flows, highs and lows, of two very challenging professions.

As physicians often do, my friends also traded war stories about their experiences as interns and residents.  They hated the long hours and tough working conditions, but spoke fondly of the on-the-job training and mentorship routinely offered by more experienced physicians, something that far exceeds anything provided to new teachers.  An important component of this training and mentorship, which often continues well into one’s medical practice, is the “rounds.”  Working in teams, doctors visit patient rooms where the assigned physician explains the symptoms, discusses the diagnosis, and takes questions about the treatment plan.  Hearing about the benefits of the “rounds” only highlighted the isolation often felt by new and even seasoned teachers confined to their own classrooms, and administrators who gradually lose touch with the classroom completely.

We continue to debate the merits of standardized teacher assessments and accountability measures.  However, a significant portion of our time and energy may be better spent by looking at systems and protocols that open up our classrooms to peer observation and discussions about teaching and learning.  There are important lessons educators can learn from the “rounds” model.  While the world of medicine can keep its 30-hour shifts, the group practice of observing, reflecting, and then perfecting the care and treatment of patients may translate well in the world of education.

The idea is not new.  In the book Instructional Rounds in Education:  A Network Approach to Improving Teaching and Learning, co-authored with Elizabeth A. City, Sarah E. Fiarman, and Lee Teitel, Harvard Professor Richard F. Elmore expands upon this model in persuasive and important ways.  Teachers and administrators work too often in isolation.  At the start of the school year, we receive standardized test scores and student evaluations, and may find the time to discuss a student’s strengths and weaknesses with that student’s former teacher.  During the year, there are faculty meetings and hopefully some staff development sessions.  However, the opportunity to be in another teacher’s classroom, watching that teacher teach and reflecting on the learning that is taking place, is infrequent or nonexistent at many schools.

The medical world seems to have gotten it right in terms of training, improving, and sustaining expertise.  Rather than limiting learning to the lecture halls, doctors make the rounds with colleagues to observe, listen, collaborate, and learn. 

Improved learning happens with improved teaching.  Elmore proposes the following model in Instructional Rounds:

  • A team of faculty, principals, instructional leaders, and/or superintendents is established.  Each team member’s school identifies areas of need and a theory of action to address these areas.  On a smaller scale, the team may consist of teachers and administrators from a single site.
  • The team meets each month at one team members’ school site.  The meeting site rotates each month.
  • In the morning, the team circulates among classrooms to observe the teaching and learning taking place.
  • In the afternoon, the team members discuss their observations.  The members describe what they saw, analyze patterns, predict learning, and recommend the next level of work.

During the process, there is an emphasis on learning and teaching, not on the specific teacher.  The objective is to focus on what is happening in the classroom rather than judge what should be happening.  The goal is to describe what is seen; to find evidence of an effective classroom and effective teaching.  Establishing “instructional rounds” creates an environment where no one person is viewed as having all the answers.  Everyone is a learner and problem-solver, collaborating to design best practices to meet the needs of students.

Elmore argues, and I agree, that you cannot change performance without changing the “instructional core”:  the relationship between teacher, student, and content. To address one without considering the others will not bring about desired change.  Creating systems that honor and provide opportunities for observation and reflection – within a school, across a district, or between districts – helps address the deeper questions of how students learn and how teachers can build curriculum that supports this learning. 

There are some important education lessons to be gleaned from the medical profession.  As we continue the dialogue about education reform, it is important to look beyond test scores.  Real, systemic change in our schools will happen only by closely examining the models we have in place. A model centered on building collaborative learning environments, such as the “rounds,” is a great start.

2 Comments leave one →
  1. January 26, 2011 7:50 am

    Rounds generally end once a doctor finishes training, and doctors thereafter are even less likely to comment on each other’s work than teachers are.

    Student teaching corresponds to med school residency—the problem may just be that there is not enough student teaching with expert enough supervision to provide the needed training.

  2. Peter D. Ford III permalink
    January 26, 2011 5:30 pm

    As most unique and promising solutions the challenge will be in the execution. The edu-bureaucracy is very slow to adopt labor-intensive and paradigm shifting change, which describes this approach; I can hear already administrators and Union reps complaining about the extra time, thus extra pay, required to make this work. I could see consulting firms rushing to fill the gap of this approach that regular classroom teachers and school administrators may leave, creating another cottage industry in education.
    A fine idea indeed, yet I wonder if we have the stomach to make it work.

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