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Bringing Medicine Factors to Life


Whichever medicine specification you’re teaching you’ll be tackling the impact of factors (war, government etc – each awarding body has its own variations). Some students struggle with the concept of ‘factors’ because it doesn’t make sense to them when explained in words alone. They have a much better chance if factors become more ‘concrete’ in the kinaesthetic activities described below. These can be used at different stages of the Medicine course – as part of the introduction, during the main body of the course and for revision. Using them regularly helps students develop familiarity and confidence in discussing factors and builds up more detailed knowledge of their effects.

These activities are based upon an idea first suggested by Pete Smith and developed by Dale Banham and also upon artwork in the 2009 editions of SHP’s ‘Medicine through Time’ books – in effect they’re breathing life into the artwork by putting students (and yourself) into the roles of factors. See, for example, PowerPoint screen 1 which is from the OCR book but is used with slightly different factors in both the other books.

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This activity does not conform to any of the models listed in the 'Activities by Model' section so it's included in a miscellaneous group – on understanding causation. For other miscellaneous activities, click here.

Activity 1: Introducing factors – creating an overall enquiry about the impact of factors

This activity introduces students to the concept of factors and sets up an overall enquiry – ‘Which factors did most to help – and most to hinder – the development of medicine across time?’

As one of the knowledge targets is an understanding of the roles of factors in medical developments, it’s important to establish this question at the outset of the course. Students learn better if they know that this is an objective and, during the course, this broad enquiry question provides a sense of direction and purpose in relation to period-based factors activities. And being able to answer this question at the end of the course gives students a sense of achievement. [It’s not the only overall enquiry question they need - we recommend asking ‘why are we healthier and why do we live longer than people in the past?’ to help shape to your whole Medicine course.]

The lesson components are as follows – but you’ll decide on your own sequence depending on the nature of the class:

a) Split the class into groups - pairs or threes. Each group is one of the factors identified by your awarding body. Give each group one tabard showing the factor name clearly – one student in each group will ‘become’ that factor as part of the physical activity.

b) Label one side of the room ‘Medical progress – people live longer healthier lives’ and wear a tabard yourself labelled ‘Medicine and health’.

Explain that you, Medicine, are trying to move across the room towards progress but that some things – called factors – have either helped or hindered your progress. [Depending on the group you could go into ‘really helped you a lot’ or other subtleties e.g. helped a little, slowed you down or stopped you altogether depending on what the class can cope with].

The class groups are the factors – ‘today we’re going to begin thinking about the impact of the factors’. Make this concrete by bringing out a couple of students in tabards and guide them so that one demonstrates the idea of factors helping Medicine – ushering you towards ‘progress’ and the other hinders you, standing in front of you as if about to block or tackle you in your attempts to make progress. [does this stop you completely or just slow you down – both are possible]

Now introduce the overall enquiry question relating to factors:

‘Which factors did most to help – and most to hinder – the development of medicine across time?’

[link back to enquiry process in KS3 if it would help – what do they remember about how to undertake an enquiry – this shows that what’s been learned at KS3 helps you do better at GCSE.]

c) The first task for each group is

‘Do you think that your factor helped or hindered the development of medicine across time?’

Give groups a short length of time to come up with some first thoughts – without books - about the impact of their factor. Much will depend on how comfortable they are with the idea of enquiry, particularly suggesting answers without background knowledge. For those classes who aren’t used to this idea then you’ll need to provide a couple of ‘clue’ cards to complete or think about e.g. for war – ‘war gives doctors a lot of ….’

Emphasise you need a decision on helped or hindered – even if it’s a common-sense guess. If you do have a group who really haven’t a clue make a virtue of it in stages d and e below – put that tabard in a separate ‘unknown’ category – where do we think this will end up?

d) Their thinking time over, it’s time to get the ‘student-factors’ on their feet. You become ‘Medicine’ again – ask which groups think that their factor has hindered your efforts to make progress. One student from each group which thinks it has hindered you comes out (wearing the group tabard) and stands between you and the Progress label, as if blocking your path to progress. You can now discuss why these groups chose ‘hindered’ rather than ‘helped’.

If you want the rest of the class to record this, get them to create a chart of the room, showing the Progress label and which factors stand between ‘Medicine’ and ‘Progress’. They could also annotate it with the reasons for the choices.

e) Now bring out the factors that think they have helped you – they stand on your other side as if pushing you towards progress. Discuss why the groups chose to be on the ‘help’ side of the room. Again students can record the scene on paper.

An alternative way of recording this is to take photographs of the scenes and keep them as a record of this initial hypothesis. Another way of recording the impact of factors is to use a football pitch diagram such as that on PowerPoint screen 2 [note - you may not wish to include the gradations of helped and hindered at this stage]. This diagram appears in the 2009 SHP medicine books.

f) You now have an overall hypothesis about which factors have helped and which have hindered medical developments. Students have also begun to use the names of factors and the terminology of helped and hindered. You can come back to this initial hypothesis as you work through the course and use the same ideas for end-of-course revision.

Activity 2: Identifying the roles of factors in individual periods

As either a research or consolidation activity on factors, set pairs the task of being a factor in a period of history, for example ‘This afternoon, Mr Smith, we are going to be War in the Middle Ages. Their task is to

a) decide on War’s place on a Helped Medicine - Hindered Medicine in the Middle Ages ‘washing line’. Having decided this, one of the pair takes his or her place on the ‘washing line’ – perhaps holding props to symbolize their factor (this may help some students remember the factors and add a touch of memorability to the lesson – a table of props to choose from is a good way to set this up)

b) spend one minute explaining War’s impact on medicine in the Middle Ages (perhaps the task of the other member of the pair). ‘War is standing at the Helped end because …’

By the end of the activity each of the factors will have taken its place on the continuum – a digital photograph could be compared with similar scenes for other periods e.g. are the same or different factors helping medicine across a variety of periods? If tackled several times students could also be encouraged to make comparisons across time during their explanation.

[a useful puzzle for students is how they position their factor if it has both helped and hindered medicine]

Activity 3: Revising factors – bringing your enquiry to a close

This activity is based on the artwork in the 2009 SHP Medicine books showing factors grouped round a patient in bed (see PowerPoint slide 3 – this is the OCR version but each book has a different artwork fitting the relevant specification).

The task is for students, working in period groups, to recreate that image for their period but with one important difference – it needs to be turned into a kind of ‘ripple diagram’, using a sequence like this:

Next to the bed = the most important factor.

One step away = a crucial factor.

2 steps away - an important factor.

3 steps away = a quite important factor.

If the factor played no role it stands outside the room looking in through a door.

 As this is revision at the end of the course, each group takes responsibility for one period of history and then has to justify their picture/shape to the rest of the class. This could be done with two classes together in a hall so that all periods are covered.

Dale Banham notes:

‘It was a lot more pacy as a revision session on factors.

They need 15 mins - I broke this down into ...

5 mins research/recap from notes/book

5 mins discussing shape

5 mins working on argument for justifying shape 

When they presented their conclusions each member of the group was responsible for a factor and had to explain this factor’s position in the picture.  It really helped them pick up on patterns. With a more advanced group you could use string to show how factors were linked.’

The final versions of the ‘physical artwork’ can again be recorded using a digital camera and the images put into a revision PowerPoint to show how the importance of the factors changes over time.


1. Which students seem to have benefited from making the concept of factors more ‘concrete’ and what does this suggest about their future learning?

2. Have these activities helped students talk more effectively about the roles of factors?

3. How could these activities help students develop more effectively structured and detailed written work?

4. Are there any other examples of artwork in textbooks that could be the basis for physical activities?

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Constructive feedback is always welcome, particularly anything that will help other teachers.

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Activity 1

Activity 2

Activity 3