teaching
DESCRIPTION
TRANSCRIPT
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
PHTLS Instructor CoursePHTLS Instructor Course
The Teaching–Learning Transaction
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PurposePurpose
To prepare entry-level PHTLS instructors To prepare entry-level PHTLS instructors to teach and evaluate cognitive and to teach and evaluate cognitive and
psychomotor skills in PHTLS coursespsychomotor skills in PHTLS courses
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ObjectivesObjectives
As a result of active participation in this As a result of active participation in this lesson you should be able to:lesson you should be able to: Discuss classroom and skill station activities that Discuss classroom and skill station activities that
enhance the teachingenhance the teaching––learning transaction in learning transaction in PHTLSPHTLS
Apply principles of adult learning to PHTLSApply principles of adult learning to PHTLS
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ObjectivesObjectives
As a result of active participation in this As a result of active participation in this lesson you should be able to:lesson you should be able to: Correlate PHTLS course objectives with different Correlate PHTLS course objectives with different
methods of teachingmethods of teaching Discuss considerations in evaluating and providing Discuss considerations in evaluating and providing
feedback to course participantsfeedback to course participants
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OverviewOverview
Learning, teaching, and the relationship Learning, teaching, and the relationship between thembetween them
LectureLecture––discussion and interactive discussion and interactive presentation of PHTLS lecturespresentation of PHTLS lectures
Teaching skills and effective presentation of Teaching skills and effective presentation of PHTLS skills stationsPHTLS skills stations
Evaluation: written and practicalEvaluation: written and practical
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LearningLearning
The reconstruction and reorganization of The reconstruction and reorganization of experience, which increases our ability to experience, which increases our ability to
direct further experiencedirect further experience
Construction of meaning from experienceConstruction of meaning from experience
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TeachingTeaching
Instruction or contribution to the development Instruction or contribution to the development of othersof others
Skillfully arranging the learning experienceSkillfully arranging the learning experience Identifying and using “teachable moments”Identifying and using “teachable moments”
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Teaching and LearningTeaching and Learning
PHTLS courses involve a teachingPHTLS courses involve a teaching––learning learning transaction between the instructor and the transaction between the instructor and the course participantscourse participants
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Three Domains of LearningThree Domains of Learning
CognitiveCognitive Knowing Knowing whatwhat
PsychomotorPsychomotor Knowing Knowing howhow
AffectiveAffective Attitude toward contentAttitude toward content
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Cognitive Domain LevelsCognitive Domain Levels
At what level should participants operate?At what level should participants operate? KnowledgeKnowledge ComprehensionComprehension ApplicationApplication AnalysisAnalysis SynthesisSynthesis EvaluationEvaluation
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Psychomotor Domain LevelsPsychomotor Domain Levels
Practice and experience are needed to Practice and experience are needed to progress from level to levelprogress from level to level ImitationImitation ManipulationManipulation PrecisionPrecision ArticulationArticulation NaturalizationNaturalization
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Affective Domain LevelsAffective Domain Levels
Best way to teach is through role modelingBest way to teach is through role modeling ReceivingReceiving RespondingResponding ValuingValuing OrganizationOrganization CharacterizationCharacterization
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Readiness to LearnReadiness to Learn
Must value the role of EMS in the care of the Must value the role of EMS in the care of the trauma patienttrauma patient
Must recognize the gap between actual Must recognize the gap between actual performance and what is expectedperformance and what is expected Role of baseline evaluations and pretestingRole of baseline evaluations and pretesting
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Appealing to Learning StylesAppealing to Learning Styles
Preferred method of receiving and processing Preferred method of receiving and processing informationinformation
Many theories and models of learning stylesMany theories and models of learning styles
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Appealing to Learning StylesAppealing to Learning Styles
Perceptual modalitiesPerceptual modalities AuditoryAuditory VisualVisual KinestheticKinesthetic
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Hemispheric DominanceHemispheric Dominance
Left BrainLeft Brain VerbalVerbal AbstractAbstract
• Conceptual; uses Conceptual; uses symbolssymbols
LinearLinear• Sequential/cause and Sequential/cause and
effecteffect
RationalRational• Uses logicUses logic
Right BrainRight Brain NonverbalNonverbal ConcreteConcrete
• ExperienceExperience
• ““Big picture”Big picture”
NonlinearNonlinear• Thinks metaphoricallyThinks metaphorically
NonrationalNonrational• IntuitiveIntuitive
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Adult LearnersAdult Learners
Motivated by the need to knowMotivated by the need to know Need to be self-directingNeed to be self-directing Adults have experiencesAdults have experiences
Foundation or barrier?Foundation or barrier?
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TeachingTeaching
Instruction or contribution to the Instruction or contribution to the development of othersdevelopment of others
Skillfully arranging the learning experienceSkillfully arranging the learning experience Methods:Methods:
Lecture-discussionLecture-discussion QuestioningQuestioning DemonstrationDemonstration Guided practiceGuided practice
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The goal of teaching is to design The goal of teaching is to design and deliver instruction that will fill and deliver instruction that will fill
the gap.the gap.
Less Knowledge
Teaching–Learning Transaction
More Knowledge
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Lecture/DiscussionLecture/Discussion
Efficient way to deliver information to a large Efficient way to deliver information to a large group group
Lecture alone is less effective than Lecture alone is less effective than lecture/discussionlecture/discussion Learners must be engagedLearners must be engaged
Discussion is facilitated by questioningDiscussion is facilitated by questioning
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The LecturerThe Lecturer
Educate or edutain?Educate or edutain? Knowledge alone does not make a good Knowledge alone does not make a good
lecturerlecturer Charisma alone does not educateCharisma alone does not educate Lecturer needs to be dynamic Lecturer needs to be dynamic and and
informationalinformational
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Lecture KeysLecture Keys
Know your audienceKnow your audience Know where change needs to occurKnow where change needs to occur Direct your lecture toward meeting audience Direct your lecture toward meeting audience
needsneeds Stay focused on the objectivesStay focused on the objectives Reinforce important pointsReinforce important points
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Lecture Preparation
Read the chapterRead the chapter Review the content outline and slidesReview the content outline and slides Practice, practice, practicePractice, practice, practice
Timing and deliveryTiming and delivery Avoid reinforcing mistakes by practicing to Avoid reinforcing mistakes by practicing to
correct themcorrect them
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Preparing YOUR Lecture
Add your notes to the teaching outlineAdd your notes to the teaching outline Include possible questions to askInclude possible questions to ask
Integrate the lecture material with the Integrate the lecture material with the slidesslides Don’t read from the slides Don’t read from the slides
Being unprepared showsBeing unprepared shows
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Successful Lecture
Keep key points to a minimumKeep key points to a minimum Summarize often for emphasisSummarize often for emphasis It’s okay not to know it It’s okay not to know it allall
Be prepared at a level higher than you will be Be prepared at a level higher than you will be presentingpresenting
Know what resources exist that could answer Know what resources exist that could answer participants’ questionsparticipants’ questions
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Interactive PresentationInteractive Presentation
LessonsLessons Case-based Case-based Facilitate participant interactionFacilitate participant interaction
Lesson plansLesson plans PowerPoint speaker notesPowerPoint speaker notes Printed lessons in the Instructor’s ManualPrinted lessons in the Instructor’s Manual
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Interactive PresentationInteractive Presentation
Using the lesson plansUsing the lesson plans Critical in delivering content sequentially and Critical in delivering content sequentially and
interactivelyinteractively Take advantage of built-in featuresTake advantage of built-in features Solicit answers to built-in questionsSolicit answers to built-in questions Be prepared with follow-up questionsBe prepared with follow-up questions Allow opportunity to answerAllow opportunity to answer
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Use of FeaturesUse of Features
PowerPoint notes (with some Windows XP™ PowerPoint notes (with some Windows XP™ operating systems)operating systems) ““Slide show”Slide show” ““Set up show”Set up show” ““Show presenter view”Show presenter view”
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Lecture TechniquesLecture Techniques
RelaxRelax——find a few friendly faces to focus onfind a few friendly faces to focus on Involve the studentsInvolve the students Be comfortable with not knowing everythingBe comfortable with not knowing everything Vary the pace and pitch of your deliveryVary the pace and pitch of your delivery Maintain eye contactMaintain eye contact Avoid distractionsAvoid distractions
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Why Use Questions?Why Use Questions?
Stimulate interest in the topicStimulate interest in the topic Determine knowledge and experienceDetermine knowledge and experience Stress key pointsStress key points Generate discussionGenerate discussion Stimulate reflectionStimulate reflection Stimulate critical thinkingStimulate critical thinking
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Successful Questioning
Give the participant time to answerGive the participant time to answer Don’t allow one participant to dominateDon’t allow one participant to dominate Reinforce correct answersReinforce correct answers
Ask the participant to repeat what was said for Ask the participant to repeat what was said for emphasis, oremphasis, or
Rephrase the participant’s answerRephrase the participant’s answer
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Guidelines for QuestioningGuidelines for Questioning
Provide a frame of referenceProvide a frame of reference Prompt the answer if necessaryPrompt the answer if necessary Anticipate possible responses and be able to Anticipate possible responses and be able to
redirect in a positive mannerredirect in a positive manner Be specificBe specific Use both closed-ended and open-ended Use both closed-ended and open-ended
questionsquestions
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Open-Ended QuestionsOpen-Ended Questions
Can you give me an example?Can you give me an example? What do you mean by . . . ?What do you mean by . . . ? Where would that lead? What would be the Where would that lead? What would be the
consequences?consequences? What would we have to assume for things to What would we have to assume for things to
work out that way?work out that way? What are some other possibilities?What are some other possibilities?
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Open-Ended QuestionsOpen-Ended Questions
How do you know that’s right?How do you know that’s right? Would you do the same thing the next time? Would you do the same thing the next time?
Why/Why not?Why/Why not? Why do you say that?Why do you say that?
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Managing the Lecture EnvironmentManaging the Lecture Environment
LightingLighting MicrophonesMicrophones AV equipment and materialsAV equipment and materials NotesNotes TemperatureTemperature
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Matching Instructors with LessonsMatching Instructors with Lessons
Choose lectures and skills for which you are Choose lectures and skills for which you are well-prepared and that match your abilitieswell-prepared and that match your abilities
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Teaching and Learning SkillsTeaching and Learning Skills
Transfer of skills is enhanced by a realistic Transfer of skills is enhanced by a realistic context for demonstration and practicecontext for demonstration and practice
Before demonstration participants should Before demonstration participants should know:know:
What is to be doneWhat is to be done Why it is to be doneWhy it is to be done When it is to be doneWhen it is to be done
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Teaching and Learning SkillsTeaching and Learning Skills
Whole-part-whole presentation facilitates Whole-part-whole presentation facilitates learninglearning Demonstrate the skill in real time Demonstrate the skill in real time Demonstrate and discuss the skill step-by-step Demonstrate and discuss the skill step-by-step Demonstrate the skill in real timeDemonstrate the skill in real time
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Teaching and Learning SkillsTeaching and Learning Skills
Stages of psychomotor learningStages of psychomotor learning Acquisition of prerequisite knowledgeAcquisition of prerequisite knowledge Learning each step of the skillLearning each step of the skill Transferring control of task from the eyes to Transferring control of task from the eyes to
kinesthetic movementskinesthetic movements Automatization of the skillAutomatization of the skill Generalization of the skillGeneralization of the skill
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Giving FeedbackGiving Feedback
Except in final and baseline stations, correct Except in final and baseline stations, correct errors immediatelyerrors immediately
Focus on the performance, not the personFocus on the performance, not the person Provide a rationale and state how the Provide a rationale and state how the
performance was different than the desired performance was different than the desired performanceperformance
Make suggestions for approaching the skillMake suggestions for approaching the skill
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Skills StationsSkills Stations
Stay on task (do not lecture)Stay on task (do not lecture) Adhere to rotation schedule Adhere to rotation schedule Recognize importance of principles over Recognize importance of principles over
preferencespreferences Emphasis: Emphasis:
Every participant has hands-on skills practiceEvery participant has hands-on skills practice
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Skill StationsSkill Stations
Know station goalKnow station goal Have equipment present; in working orderHave equipment present; in working order Have enough equipment for all groupsHave enough equipment for all groups Ensure presence of a “patient”: coached in Ensure presence of a “patient”: coached in
advanceadvance Address safety concernsAddress safety concerns
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Skill Stations
DeliveryDelivery Orient participants to the skill stationOrient participants to the skill station Participants demonstrate the skillParticipants demonstrate the skill Correct errors immediatelyCorrect errors immediately
• We learn what we doWe learn what we do
Give feedback and positive reinforcementGive feedback and positive reinforcement Practice, practice, practicePractice, practice, practice
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Final Evaluations: PurposeFinal Evaluations: Purpose
What does the PHTLS card mean?What does the PHTLS card mean?
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Written ExaminationWritten Examination
Examination is prepared from a table of Examination is prepared from a table of specifications based on PHTLS core measurable specifications based on PHTLS core measurable itemsitems
ConsiderationsConsiderations Representative sample of knowledgeRepresentative sample of knowledge Difficulty of itemsDifficulty of items Relationship of items to critical trauma management Relationship of items to critical trauma management
knowledgeknowledge Multiple item-writers and reviewersMultiple item-writers and reviewers
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Written ExaminationWritten Examination
What is considered “passing” on the written What is considered “passing” on the written exam?exam?
Remediation/retestingRemediation/retesting Annotated exam copyAnnotated exam copy
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Final Evaluation StationsFinal Evaluation Stations
Give clear directionsGive clear directions Observe carefully but unobtrusivelyObserve carefully but unobtrusively Recognize importance of principles over Recognize importance of principles over
preferencespreferences Emphases:Emphases:
Allowing participants to demonstrate what they Allowing participants to demonstrate what they have learned in the coursehave learned in the course
Assessing participants’ strengths and areas Assessing participants’ strengths and areas needing further developmentneeding further development
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Final Station ScenariosFinal Station Scenarios
PreparationPreparation Know the station flowKnow the station flow Have equipment present; in working orderHave equipment present; in working order Have enough equipment for all groupsHave enough equipment for all groups ““Patient”: present, moulaged, coachedPatient”: present, moulaged, coached Know the critical errorsKnow the critical errors Address safety concernsAddress safety concerns
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Final Practical EvaluationFinal Practical Evaluation
Inter-rater reliabilityInter-rater reliability Will two examiners watching the same Will two examiners watching the same
performance give the same score?performance give the same score? Intra-rater reliabilityIntra-rater reliability
Will a single examiner score identical Will a single examiner score identical performances the same way every time?performances the same way every time?
BiasBias
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Final Practical EvaluationFinal Practical Evaluation
Intra-rater reliabilityIntra-rater reliability We all have biases that affect our decisionsWe all have biases that affect our decisions Consciously or unconsciouslyConsciously or unconsciously Evaluate the performance, not the personEvaluate the performance, not the person Always ask:Always ask:
• Would I evaluate every other participant the same as I am Would I evaluate every other participant the same as I am evaluating this participant for this performance?evaluating this participant for this performance?
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Final Practical EvaluationFinal Practical Evaluation
Inter-rater reliabilityInter-rater reliability Valuing principles over preferencesValuing principles over preferences Scoring instrumentScoring instrument
• Can the written criteria be interpreted too broadly or too Can the written criteria be interpreted too broadly or too narrowly?narrowly?
Increasing inter-rater reliabilityIncreasing inter-rater reliability• Examiners have common understanding of principles Examiners have common understanding of principles
and the instrumentand the instrument
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Final Practical EvaluationFinal Practical Evaluation
Inter-rater reliabilityInter-rater reliability Video exerciseVideo exercise
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Final Station ScenariosFinal Station Scenarios
DeliveryDelivery Know the scenarioKnow the scenario Stay where you can seeStay where you can see If participants don’t do it, it isn’t doneIf participants don’t do it, it isn’t done Real time is keyReal time is key Be consistent with all groupsBe consistent with all groups Have extra equipment availableHave extra equipment available
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Final Station ScenariosFinal Station Scenarios
KeysKeys Let the patient give as much information as Let the patient give as much information as
possiblepossible——the patient the patient makesmakes the station the station
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Final Station ScenariosFinal Station Scenarios
Know what is passingKnow what is passing Encourage participants to evaluate themselvesEncourage participants to evaluate themselves Give feedback according to timeGive feedback according to time Give feedback based on critical error criteria; both Give feedback based on critical error criteria; both
positive and negativepositive and negative Don’t be afraid to re-evaluate someoneDon’t be afraid to re-evaluate someone
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Learning SummaryLearning Summary
We learn when we recognize and value the We learn when we recognize and value the need to knowneed to know
We have different preferred methods for We have different preferred methods for receiving and processing informationreceiving and processing information
We learn in three different domainsWe learn in three different domains
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Learning SummaryLearning Summary
Learning occurs as a result of reflection on Learning occurs as a result of reflection on experiencesexperiences
We must have an experience that can be We must have an experience that can be connected to prior experiences connected to prior experiences
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Teaching SummaryTeaching Summary
Teaching is skillfully arranging the learning Teaching is skillfully arranging the learning experienceexperience
Focus on gapsFocus on gaps Lecture should be enhanced by questions Lecture should be enhanced by questions
and discussionand discussion Be prepared and organizedBe prepared and organized
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Teaching SummaryTeaching Summary
Engage participants in the teaching-learning Engage participants in the teaching-learning transactiontransaction
Skills are learned best in contextSkills are learned best in context Correct errors immediatelyCorrect errors immediately Give feedback to improve performanceGive feedback to improve performance
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Teaching SummaryTeaching Summary
Match instructors’ strengths to the lessonsMatch instructors’ strengths to the lessons Use lesson plan features for interactivity Use lesson plan features for interactivity Later versions of PowerPoint™ and Later versions of PowerPoint™ and
Windows™ allow presenter to view notes on Windows™ allow presenter to view notes on computer screen while projecting slidescomputer screen while projecting slides
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Evaluation SummaryEvaluation Summary
Final evaluations serve to allow participants Final evaluations serve to allow participants to demonstrate increased knowledge of to demonstrate increased knowledge of trauma managementtrauma management
Annotated written evaluationsAnnotated written evaluations Increasing validity of practical evaluationsIncreasing validity of practical evaluations
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Teaching TechniquesTeaching Techniques
Questions?Questions?
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Prepared, enthusiastic Prepared, enthusiastic instructors create a positive, enjoyable instructors create a positive, enjoyable environment for the teachingenvironment for the teaching––learning learning
transaction.transaction.