gms | German Medical Science

Research in Medical Education – Chances and Challenges International Conference

20.05. - 22.05.2009, Heidelberg

Retrospective “Think aloud” (RTA) as a technique to describe teacher’s cognitive processes during teaching

Meeting Abstract

  • author Christian Siggemann - University Medicine Berlin, Benjamin Franklin Medical Center, Department of anaesthesiology and perioperative intensive care medicine, Berlin, Germany
  • Maria Rupprecht - Universtiy Regensburg, Institute of pedagogic psychology, Regensburg, Germany
  • Kirstin Hansen - University Regensburg, Institute of pedagogic psychology, Regensburg, Germany
  • corresponding author presenting/speaker Jan Breckwoldt - Charité – University Medicine Berlin, Benjamin Franklin Medical Center, Department of anaesthesiology and perioperative intensive care medicine, Berlin, Germany

Research in Medical Education - Chances and Challenges 2009. Heidelberg, 20.-22.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09rmeA5

doi: 10.3205/09rme05, urn:nbn:de:0183-09rme052

Veröffentlicht: 5. Mai 2009

© 2009 Siggemann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objectives: Quality of teaching can be measured by various methods such as students` evaluation, students` test results, analysis by experts via visitation or videography or by objective standardised teaching examinations [1], [2]. However, what can’t be described by these methods are cognitive processes of the teacher while teaching. These might reflect the level of awareness related to the teaching encounter, sometimes referred to as metacognition [3]. Metacognition is thought to be attributed to teaching expertise and could be of importance for describing the development of expertise. To determine the amount and level of metacognition during clinical teaching we found retrospective “think aloud” (RTA) based on video recordings to be a suitable method, which is widely used in social sciences to reveal cognitive processes [4], [5].

Methods: In a clinical teaching setting we recorded 50-min teaching sessions on video. Standardised sections were selected from those videos and presented to the specific teacher. After a “warm up”-sequence to become familiar with the method, the teacher was asked to speak out aloud his thoughts while watching his teaching session. Subsequently an additional standard teaching session with another teacher was presented. The RTA session was voice recorded and transcribed into a written protocol. The protocols were analyzed regarding the following categories:

  • Quantity of spoken words as a global measure for the ability of abstraction
  • Ability and amount of critical reflection of different teaching situations and methods
  • Speaking about the lessons` contents vs. speaking about teaching itself.

We further correlated these categories with the level of expertise of the test subjects.

Results: In the setting described above the teachers successfully participated in the RTA. Their thoughts on the teaching sessions were organized into different categories. First analysis of our data shows the following trends: Those teachers who we labled as experts in the field of clinical teaching expressed fewer thoughts. However, they referred more to the teaching process itself then those teachers with a lower level of expertise. Furthermore, novices were especially critical towards the content of their own lesson and their behavior. Experts on the other hand focused especially on teaching methods, both their own and those of the teacher in the standardised lesson.

Conclusions: The results of the “think-aloud” protocols have to be matched with other dimensions of teaching such as quality and self-assessement by teachers. Whether the method is useful for distinguishing different levels of metacognition and to attribute these to the level of expertise of the clinical teacher is subject of further analysis.

If metacognition clearly correlates with the level of expertise in clinical teaching, the RTA should be a method to indirectly measure expertise. Further research concerning the correlation between metacognition and teaching quality is in progress.


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