Active Learning on www.thinkinghistory.co.uk

Public Health through the Ages

Introduction

The creation of this exercise was the result of a conversation between Dan Moorhouse and Adam Henson, then a trainee teacher in his first week in school based training. The exercise has been used several times now and has been adapted for this site as a result of feedback received from colleagues within the training school, from Ian Dawson and from pupils in Years 10 and 11.

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Support

A formatted version of this activity should print from your browser (omitting this support section).

Or, a WORD version of this activity can be downloaded, click here.

Useful resources are shown at the bottom of the page, click here

This activity is based on the ’Timeline & Living Graph’ style of model; for more examples of this model, click here.

Objectives

This exercise is intended to:

  • Develop chronological awareness of pupils
  • Develop understanding of change and continuity.
  • Provide pupils with an opportunity to develop their understanding of progress and regress.

Setting Up

1. A large open space in which pupils can move around is required for this activity. Moving tables and chairs to the sides of the classroom should provide enough space.

2. Use a piece of string as a Timeline. This should be placed on the floor along the length of the room. Add date cards to this to illustrate the scale of time covered. Suitable cards for this would be 2000BC, 1500BC, 1000BC, 500BC, 1AD, 500AD, 1000AD and 1500AD.

3. Place ‘Progress’ and ‘Regress’ markers on the walls on either side of the Timeline and place Continuity next to the timeline so that the room has a layout like this:

PROGRESS

 

CONTINUITY

2000BC – 1500BC – 1000BC – 500BC – 1AD – 500AD – 1000AD – 1500AD

 

REGRESS

The Activity

The first activity is a simple exercise to consolidate pupils’ chronological awareness. Select pupils to place ‘era’ cards on the timeline. Use cards to illustrate:

  • Prehistory
  • Ancient Egypt
  • Ancient Greece
  • The Roman Empire
  • The Dark Ages
  • The Middle Ages

Discuss with the class what problems there are placing these cards on a timeline. Pupils should note that the eras overlap and there may be a discussion about exactly when eras begin and end. Using colour-coordinated pegs on the timeline is a useful way of illustrating the agreed start and end points of each era.

Give each pupil a card with an event on it - see end of activity description for cards [ click here ].

Ask pupils to think carefully about whether the event, development or change on their card is an example of medical progress, regression or continuity. Pupils should move to the appropriate part of the classroom.

Ask pupils to consider the types of things that led to either progress or regression. Why did some things remain the same? Ask a number of pupils to explain the impact of the card they have.

Once the pupils have demonstrated that they understand the concepts of continuity, progression and regression explain to them that they need to be aware of the way in which these developments occurred. To do this each group (Progress, Regress and Continuity) should place themselves into chronological order.

Ask all of the pupils to place their cards on the timeline. No cards should be placed on top of another, if two cards need placing at the same time, they should be placed next to each other, moving out from the timeline.

On the floor, the pupils should now have created something like this: (this is for illustrative purposes only, the dates don’t match the places noted here)

PROGRESS

 

Progress card

Progress card

Progress card

 

Progress card

 

Progress card

2000BC – 1500BC – 1000BC – 500BC – 1AD – 500AD – 1000AD – 1500AD

Continuity card

Continuity card

Regression card

Continuity card

Regression card

Regression card

 

Continuity card

REGRESS

 

Ask the class to move back to the progress / regress markers by the wall and look at the timeline.

What trends do they notice? Is there a period of time that stands out as being the most progressive or regressive? Why do they think that so many examples of progression or regression come in such a short space of time? Why do some things stay the same even when other things are changing rapidly?

Ask pupils to look carefully at the colours of the cards. Can they see any patterns running through the 4 different colours that have been used? Are some colours more predominantly progressive or regressive?

In general terms the colour coding is:

  • Blue – investment in public health by central authorities.
  • Green – role of religion.
  • Red – relating to war.
  • Black– outbreaks of disease.

Significance

Pupils can be asked to rate the significance of each of these events. Ask the class to think carefully about the likely impact of the event they have been given. They can give it a score out of 5 for impact, with 1 being ‘least impact’ and 5 being ‘most impact’. In order to illustrate the scale of these changes, pupils then move away from the timeline using one step for each point they have scored their event. Place the cards on the floor where they finish then return to the side to observe the results.

Debriefing

Discuss the positioning of each card asking the pupils to explain what impact the event would have had on Health. How does continued practice and belief impact on Health?

Activity Cards

100AD. Connection of homes to sewage system is mandated in Rome (made compulsory).

St Thomas ’ monastery opens an infirmary (12th Century AD)

The Normans lay waste to much of England, leaving dead animals in the fields and towns and villages destroyed. (1066 – 1087)

664AD. The Plague is recorded in London for the first time.

Regimen, a healthy way of living, forms a part of Cultural values. (Recorded 400BC)

1700BC. Minoan Crete develops a system of toilets cleaned by running water.

167AD. Plague ravishes Rome.

High expenditure on wars with France leads to a lack of available funds for Public Works. 1336AD.

300BC. Athens has a system of underground sewers built. Waste is flushed to an out of town pool.

The Plague of Athens. 430BC.

Viking raids. As Anglo-Saxon England fights for survival, Roman Public Health crumbles. 795AD.

Priests shave and wash daily. 2500BC.

Flagellation becomes popular. 1349AD.

Water is piped to hospitals and camps along Hadrian’s Wall. 120AD.

The Black Death. 1348AD

412BC. Hippocrates records Influenza epidemic.

Aqueducts are built to take clean water to the town of South Shields (222AD).

Hospital opens at St. Bartholomew’s in London. (1123)

4000BC. Homes in Babylon are connected to cesspits by a system of pipes.

The Roman army leaves Britain due to problems elsewhere in the empire. Baths, Hospitals are no longer maintained. 410AD.

 

Possible Additions

The following can be added to the activity to add examples of things that would have been commonplace in more rural settings and for common people. In many cases these are things that continued to exist as practices or beliefs.

Annona introduced into Imperial Roman Empire. This is a kind of welfare ticket for plebeians that they could exchange for food at Government stores.

Artefacts discovered in Roman Villas in Southern England suggest that people used a combination of Divine faith and natural herbal remedies to maintain their health. The Romans noted a link between dirt and disease. As a result people in the Roman Empire used clean water and disposed of human waste away from their homes.

Medicae are available to aid women in child birth. (Medicae is a term that roughly translates to Midwife).

Colonies were established for people infected with diseases such as Leprosy. Evidence of such colonies exists in Ancient Greek, Roman and medieval writings. Those living in villages rarely had the help of doctors, who practiced mostly in the cities and courts.

People went to Priests, monks and other religious people for health advice, cures and to ask for gods help.

Notes & Variations

This exercise was developed for use with a year 10 mixed ability class who have had little prior experience of active learning teaching techniques. Adam Henson completed the first draft of the exercise in the first week of the school-based section of his Initial Teacher Training. It has been developed in consultation with Dan Moorhouse as part of the training programme and used to good effect with two different groups. Any suggestions on how to develop this lesson will be passed onto Adam in order to aid his development as a teacher.

The exercise is adaptable to include later developments in Public Health. An updated version of this exercise will likely include references to the way that people tackled the Plague of 1665/6, attitudes towards disease during the Industrial Revolution, the introduction of the Welfare State and post world war two events. Examples of continuity throughout the whole span of Public Health include items already noted in the existing activity and will probably be added to: Faith Healing and the notion of Laissez-faire being considered.

Reflections

  1. How effective was your use of space and movement? Would you do anything differently in terms of organization next time? (and don’t be afraid to pat yourself on the back!)
  2. How often have you used this kind of living graph activity before with this class? Does the frequency of use affect its effectiveness and, if so, what effects will this have on your overall course planning?
  3. How did tackling this topic through this physical activity affect students’ learning? e.g. was understanding of the patterns of events deeper?

Resources

This activity was based on the ideas raised in these online discussions:

Active Learning in History

Active Learning Revisited

Living Graphs

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Feedback

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

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This Page

Introduction

Support

Objectives

Setting Up

The Activity

Debriefing

Activity Cards

Possible Additions

Notes & Variations

Reflections

Resources

Feedback