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NATIONAL
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Welcome!
Guest
Presenter:
Eliana
Lobo,
M.A.,
CoreCHITM
Trainer
of
Trainers
of
Healthcare
Interpreters

Learning Objectives for Today
• Learn how to break up or tier, existing lesson
plans and workshop content for:
• Levels of proficiency
• Teaching styles
• Both
• Review how to
• Identify learning objective(s) using Bloom’s Taxonomy
• Create lesson plans/learning plans that are tiered into
a minimum of three, and a maximum of six tiers, using
Bloom’s six stages as a guide
• Create Rubrics for
• Formative assessments
• Summative assessments

What is Tiering?
• Often, attendees have different levels of proficiency
when they show up for your workshop or conference
presentation. You, as the trainer, often spends a good
portion of your limited time slot, reviewing basic
concepts with beginners. This can end up short
changing the more proficient and experienced
learners present.
• Tiering allows the trainer to break-out learning content,
so that it can work with different students’ levels of
proficiency, all within the same training or workshop
• Tiering can also be utilized to develop learning plans
that are differentiated by learning styles
• Auditory
• Visual
• Kinesthetic

Before You Tier
• Identify/Clarify the Learning Objectives for your
class or workshop
• Develop Rubrics for each module to peg
students’
• Understanding
• Competence
• Proficiency

Competent vs. Proficient
What’s the difference?

The best interpreters are highly
proficient, rather than merely
competent. In other words, they
are able to fulfill the demands of
the task at hand as they come up.

Competency
• Competency: as defined by Merriam-Webster,
is the ability to do something successfully or
efficiently.
For interpreters, it means having the skills set of languages,
terminology, knowledge of culture and strong listening
and memory skills combined to function capably as an
interpreter.
I want you to aspire to being MORE than merely a
competent interpreter.
• How does competent differ from being proficient?
10

Proficiency
• Proficiency: as defined in the goals and targets for
teachers of world languages means one can--Use
language spontaneously, in unexpected situations,
to communicate any and all needs during that
particular moment in time
• As interpreters, our profession is filled with daily unexpected,
spontaneous moments.
• We often have to draw upon knowledge of history,
geography, world events, regional conflicts as well as
traditional beliefs and practices, in order to do a good job
for our patients and have their providers understand their
needs and complaints.
11

Tiering Existing Lesson/
Learning Plans
For Different Proficiency Levels

Creating Tiered Training for
Different Levels of Proficiency
1. Define Learning Objective
2. Apply Bloom’s Taxonomy
3. Develop Rubrics for different proficiency levels
4. Create Teaching Style Grid for the Training
A. Basic
B. Standard
C. Specialized
5. Devise learning plans for different delivery or
teaching styles
A. Audio –Students learn by listening
B. Visual - Students learn by observing
C. Kinesthetic - Students learn by doing

Defining Learning Objective
• Having clear learning objectives for each
level of proficiency, and, for each of the three
main teaching styles is your starting point
• I find it helpful to use Bloom’s Taxonomy to
clearly state the final learning objective and
then work my back down the steps to the
beginning of the process
• So let’s review Bloom’s Taxonomy

Bloom’s Taxonomy
• In 1956, Benjamin Bloom (with collaborators Max
Englehart, Edward Furst, Walter Hill, and David
Krathwohl), published a framework for categorizing
educational goals: Taxonomy of Educational Objectives
• Familiarly known as “Bloom’s Taxonomy”
• The framework elaborated by Bloom et. al., consisted of
six major categories: Knowledge, Comprehension,
Application, Analysis, Synthesis, and Evaluation. The
categories after Knowledge were presented as “skills
and abilities,” with the understanding that knowledge
was the necessary precondition for putting these skills
and abilities into practice.
• While each category contained subcategories, all
lying along a continuum from simple to complex and
concrete to abstract, the taxonomy is popularly
remembered according to the six main categories.

Start with Bloom’s Taxonomy

Develop an exercise or task
for each level of Bloom’s
(beginning with the bottom level of the pyramid)
1. Remember
2. Understand
3. Apply
4. Analyze
5. Evaluate
6. Create

Develop an exercise or task for each level
For example, enhancing memory or recall
• Remember/Recall
• Recall a list of seven different prescription medications
• Understand
• Differences between long-term and short-term memory
• Techniques to use to support recall (chunking, creating a story,
etc.)
• Apply
• Experiment with different memory techniques using random
word lists
• Analyze
• Track errors according to the technique utilized
• Record metrics over multiple attempts with different techniques
• Evaluate
• Assess to choose a technique that is beneficial for a student’s
learning, OR
• Self-Assess to choose a technique that is beneficial for one’s
learning
• Create
• Customized training routine

Free Online Tools for Developing Rubrics
for your training/learning plans
• Rubistar.
• Has a page to help you develop a new, custom
rubric for your training and teaching
• http://rubistar.4teachers.org/index.php?
screen=NewRubric
• Rubric Maker
• Also allows you to create custom rubrics
• http://rubric-maker.com/

Rubric created
with RubiStar,
for my Portuguese
language class

Sample Ways to Tier Terminology
for scenario practicum in class, individuals roles could be assigned
according to each student’s proficiency
• Basic Medical Terminology
• Basic – Basic Human Physiology, understanding and
finding equivalents for Healthcare Provider Job Titles in
target language, Insurance, Family Medicine/Primary
Care
• Medical & Social Services Terminology
• Standard - Human Physiology and Medical
Specializations, Housing, Customer Service, Infection
Control, Wayfinding, Clinics and Therapy, Domestic
Violence
• Specialized Terminology
• Advanced - Mental Health, Acute Care,
Oncology, Genetics Counseling, Organ Donation,
Neuropsychological evaluations, Involuntary
commitment

A second way to tier
lesson plans
By Delivery Method or Teaching Style

Creating Tiered Training for
Different Teaching Styles
• Often, we think of these three basic
categories when we think about different
delivery or teaching styles
• Audio
• Visual
• Kinesthetic
But there are many more…

Differentiating Content by
Teaching Styles
Different approaches
to teaching and learning

Tweaking your existing lesson plans
to better suit different learning styles
• Verbal
• Visual
• Musical/Auditory
• Physical/Kinesthetic
• Combination
• Solitary
• Social
• Logical/Mathematical
• In-Person classroom (0-30 students)
• In-Person conference/large audience
• Remote/Online delivery

Tiering a Memory Exercise
Examples/Sample Tiers

For Auditory Delivery
Read ALOUD from a list of 12 or more everyday items
Do this twice, have students write down as many as they can recall.
• Mardi Gras bead
• Wooden Spoon
• Magnifying Glass
• Shoe horn
• Date stamp
• Ceramic tile
• Golf ball
• Moisturizer
• Chopsticks
• Keychain
• Penlight
• Teacup
• Red apple
• Sea shell

For Auditory Delivery
Play a recording of someone reading a list of 12 or more everyday
items, then have students write down as many as they can recall.
• You can select different audio files and then vary or increase
the speed
• The more words per minute, the greater the degree of difficulty
• For best results, you should have the recording downloaded
onto a flash drive or embedded in the presentation to minimize
lag time

For Visual Delivery
Display photo of a sample grouping of 12 or more everyday items
for 90 seconds, students write down as many as they can recall

For Kinesthetic Delivery
Bring a wooden bowl to class containing everyday items for memory
exercise, allow students to hold or manipulate items for 90 seconds, then
cover with a towel. Have them write down as many as they can remember.

Outside/Online Resources
• Often, online resources will feature a
handful of suggested links, featuring
specific exercises or skills drills.
• These are often already tiered progressively in
terms of difficulty, for you
• Upon review, you can select or tweak the
suggestions for your learning objective and
students’ needs

For example: 9 memory exercises
• http://smartidiom.pt/en/9-exercises-to-improve-short-term-
memory-while-interpreting/
― Exercise 1: shadowing
― Exercise 2: shadowing with a twist
― Exercise 3: Freer shadowing with a twist
― Exercise 4: attentive listening for key elements
― Exercise 5: progressively expanding recall apacity
― Exercise 6: visualization
― Exercise 7: segmentation
― Exercise 8: recognizing incoherence or ambiguity
― Exercise 9: remembering messages you disagree
with or find offensive

For example: 5 memory exercises
• https://www.magneticmemorymethod.com/brain-exercises/
― Exercise 1:
The 4-Details Observation Exercise
― Exercise 2:
Number Brain Exercises
That Skyrocket Your Concentration
― Exercise 3:
Repeat What People Say In Your Mind
― Exercise 4:
The Metronome-Clapping Exercise
― Exercise 5:
Create A Memory Palace

Tech tools to assist you in creating:
progressive and interactive exercises/drills
iPhone
• Best voice recording apps for
iPhone and iPad - iDownloadBlog
• www.idownloadblog.com/
2016/05/22/best-voice-recording-
apps-iphone-ipad/
• Audio Speed Changer Free on the
App Store - iTunes - Apple
• https://itunes.apple.com/us/app/
audio-speed-changer-free/
id680523422?mt=8
Android
• How to Change the Speed of Audio
Playback With these 4 Android Apps
• https://www.guidingtech.com/56100/
alter-speed-audio-playback-android-
apps/
• Speed Changer - Android Apps on
Google Play
• https://play.google.com/store/apps/
details?
id=jp.ne.sakura.ccice.audipo&hl=en
These voice recording apps for smart phones, which are ubiquitous today

Assessing Student Learning
Formative and Summative Assessments

2 Classroom Tech tools
to assist in facilitating: interactive participation
and formative assessments
iPhone
• Plickers on the App Store
- iTunes – Apple
• https://itunes.apple.com/
us/app/plickers/
id701184049?mt=8
Android
• Plickers - Android Apps on
Google Play
• https://play.google.com/
store/apps/details?
id=com.plickers.client.andr
oid&hl=en
Plickers: https://www.plickers.com/
Plickers is a powerful, yet simple tool, that lets teachers
collect real-time formative assessment data without the
need for student devices or app installation

2 Classroom Tech tools
to assist in facilitating: interactive participation
and formative assessments
• Free version online
• Mentimeter is an interactive presentation and
training tech tool, very much like Plickers
• Ask a question
• Audience/Students vote or answer
• Can display answers as graphs or charts
• Results displayed in real-time with no app
installation needed
Mentimeter: https://www.mentimeter.com

Formative Assessments
• Tech tools like Plickers and Mentimeter
allow the trainer greater flexibility in
making formative assessments during the
actual training class
• These tools allow for anonymity since
“players” (students or attendees) can
select an avatar rather than using their
real name
• Still, it affords the teacher or trainer a real
glimpse into how many in your group have a
firm grasp of a concept and how many don’t
• Allows for tailoring content delivery on the fly, in
order to review or re-introduce an idea, topic or
skill in a brand new way

Assessing the effectiveness of
your lesson plan
Formative & Summative Assessments

Formative vs. Summative Assessments

A third way to tier your lesson plans
By BOTH Proficiency & Delivery Style

Tiering by Task Type
Moving beyond lecture and assigned reading
If you can teach a single concept in different ways,
students will retain the learning better. The very same
exercise or skills drill, when taught in multiple ways, will
appeal to different learning types. Your goal is to have
something for everyone.
It may sound funny, but this is one of the reasons I always have
some kind of healthy snack like popcorn or grapes, as well as a
tray full of items to fiddle with in the center of the table for each
student grouping. The tray holds assorted pipe cleaners and
different colored markers, as well paper. The tactile items assist
kinesthetic learners pay attention in class. The snacks engage
students’ sense of smell, taste and touch. All of which helps
retention of the material being taught.
So, how does one tier a lesson plan by task?

Tic-Tac-Toe Grid
for building tiered learning plans
Basic Standard Advanced
Audio
Visual
Kinesthetic

Example: Tiered Memory Exercise
Basic Standard Advanced
Audio
Visual
Kinesthetic
Recall
4-5 items
from audio
clip
Recall
6-7 items
from audio
clip
Recall
7-9 items
from audio
clip
Recall
4-5 items
from slide
or illustration
Recall
6-7 items
from slide
or illustration
Recall
7-9 items
from slide
or illustration
Recall
4-5 items
from 3D
objects*
Recall
6-7 items
from 3D
objects*
Recall
7-9 items
from 3D
objects*
* Eclectic assortment of household items in a bowl or basket

Example: Tiered Terminology
Basic Standard Advanced
Audio
Visual
Kinesthetic
Recall list of
medical
specialties
Recall/interpret list
of medical specialties,
discuss specific
challenges for
individual scenarios
Identify and
Interpret
bodily
systems from
pictures
Identify
equipment by
touch, when
blindfolded
Identify and
interpret names
for equipment by
touch, when
blindfolded
Don and doff
PPE, (personal
protective
equipment)
properly
Recall and
Interpret list
of medical
specialties
Identify from
pictures and
Interpret
names for tools
or machinery
providers use in
different depts
Identify and
Interpret forms
used by providers
in different
departments from
samples

Always begin with Bloom’s Taxonomy

Develop an exercise or task
for each level, beginning with the bottom level
1. Remember
2. Understand
3. Apply
4. Analyze
5. Evaluate
6. Create

Link exercises to each level
1. Remember
1. Assigned Reading
2. Lecture
2. Understand
1. Asks questions
2. Pair and share
3. Apply
1. Explain to partner
2. Quiz
4. Analyze
1. Discuss in small groups
2. Debate in teams
5. Evaluate
1. Debrief discussion or debate
2. Feedback
6. Create
1. Personal materials like glossaries for one’s
language pair, scripts for challenging situations
2. Scenario/Skits

Keep in mind how students take in information,
have tasks prepared for each type of process
• Taking it IN
• Reading
• Watching (video or film)
• Listening to a recording or lecture
• Putting it OUT
• Writing
• Drawing
• Discussing
• Interactive
• Share and Pair
• Shadowing fellow students
• Playing a Part in a Scenario or small
group activity
• Presentational
• Show and Tell
• Practicum
• Sight Translation

Tic-Tac-Toe Grid
for building tiered learning plans
Basic Standard Advanced
Inward
Outward
Presentational

Tic-Tac-Toe Grid
for building tiered learning plans
Basic Standard Advanced
Inward
Outward
Presentational
Introduce yourself
in both
languages,
reminding parties
to use 1st person &
HIPAA
Write your
standard intro-
duction, that
you will use
going forward
Read about the
components
that should be
present in your
introduction
Interpret
patients’ rights &
responsibilities
for the facilities
where you will
be working
Write about your
understanding of
patients’ rights &
responsibilities for
the facilities
where you will be
working
Read about
patients’ rights
and
responsibilities
Read about
advanced
directives
Write about your
understanding of
advanced directives
and any culturally
specific challenges for
your language pair
Interpret
advanced
directives for
your language
pair

Recommended Resources
for Developing Training Content
• Healthcare related content
ü https://medium.freecodecamp.org/200-universities-just-launched-560-
free-online-courses-heres-the-full-list-d9dd13600b04
ü https://www.coursera.org/
ü http://www.tedmed.com/videos
ü https://www.store.healthyroadsmedia.org
ü https://ethnomed.org/clinical
• Recorded speeches in specific language pairs
ü http://www.speechpool.net/en/
ü http://webtv.un.org

Resources Used in this Webinar
• Bloom’s Taxonomy, by Patricia Armstrong, Assistant Director,
Center for Teaching, Vanderbilt University, https://
cft.vanderbilt.edu/guides-sub-pages/blooms-taxonomy/
• Tic-Tac-Toe Grid for Learning Plans, Teach-nology – The
Online Teacher Resource, http://www.teach-nology.com/
lessons/lsn_pln_view_lessons.php?
action=view&cat_id=1&lsn_id=22041
• Rubistar, http://rubistar.4teachers.org/index.php?
screen=NewRubric
• Rubric Maker, http://rubric-maker.com/
• 9 exercises to improve short-term memory while interpreting,
2 August 2017, By Catarina Ramos, https://smartidiom.pt/en/
9-exercises-to-improve-short-term-memory-while-
interpreting/
• 5 Brain Exercises That Ensure Memory Improvement, Last
Updated October 12, 2017 By Anthony Metivier, https://
www.magneticmemorymethod.com/brain-exercises/

Remember, You Can Do It!
Just remember these steps:
• Identify/Clarify the main Learning Objectives for your class,
your workshop or presentation
• Create your lesson/learning/workshop plan
• Develop Rubrics for each module
• Use the Tic-Tac-Toe grid to create activities that support learning for
each of the three main levels of proficiency and for each of the
three main teaching styles.
• You are now ready to face a roomful of workshop attendees
• Choose tasks that will enhance their learning experience
• Tweak content to reflect greater or lesser degree of prior
knowledge or proficiency in the room as determined by your
formative assessment during the course of your training

Questions?
Please feel free to contact me!

NATIONAL
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Announcements

NATIONAL
COUNCIL
ON
INTERPRETING
IN
HEALTH
CARE
You
can
access
the
recording
of
the
live
webinar
presenta6on
at
www.ncihc.org/trainerswebinars
Home
for
Trainers
Interpreter
Trainers
Webinars
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ini6a6ve
of
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NATIONAL
COUNCIL
ON
INTERPRETING
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HEALTH
CARE
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