Being Aware of Health Care: Using Cooperative Learning to Synthesize and Communicate U.S. Health Care Reform Issues

The learning objective was for the students to develop their ability to research, synthesize and communicate both sides of key health care policy issues being debated. This project meets the Hansen proficiencies of accessing existing knowledge, displaying command of existing knowledge, interpreting existing knowledge, interpreting and manipulating economic data, and applying existing knowledge.

The content objective for the project was for students to be able to understand and evaluate the various issues in Senator McCain's and Senator Obama's health care reform proposals.

This project is appropriate for students at the college level. Specifically, this project was used in an undergraduate health economics course. The time frame for this project was five weeks, including both in and out of class work. This project can be adjusted to fit a wide range of class sizes.

Note that although the context for this project (2008 U.S. presidential campaign) is in the past, this project can be easily adapted to fit any context. This could involve a similar event such as a future presidential campaign (provided the same issues are relevant), or could be an entirely different context. Any topic that is multi-faceted would lend itself well to this project structure.

The structure of this project is threefold. There is an initial individual portion, a middle group cooperative portion, and then a final individual portion. On the day that the project was introduced in class, I broke my class of thirty-nine students into nine groups of four or five and each group was assigned a health care reform issue being debated during the 2008 presidential election. For the initial individual portion of the project, students had one week to complete a worksheet for their assigned issue. This worksheet included sections for the student to provide background information on the assigned issue, find or create examples that illustrate the issue, summarize how Senator McCain's policy addressed the issue, and summarize how Senator Obama's policy addressed the issue. This initial individual writing assignment was to ensure that each student obtained background knowledge of his or her assigned health care reform issue before discussing it in a group.

One week later, the cooperative learning portion of the project commenced with a fifty-minute class period devoted to in-class group work. In addition to bringing a completed individual worksheet to class, each group member was required to find at least two resources to bring to class to share with the other group members. Students met in their small groups using a round table format to discuss, synthesize and compromise until a group version of the same worksheet had been produced. Specifically, each group member sequentially shared his or her response to the first section of the worksheet. Then the group evaluated and synthesized those responses and reviewed the resources brought in by the group members until a consensus was reached for a group answer for the first section. This process was then repeated for each of the three other sections of the worksheet. Each group member served as the leader of the discussion for one of the sections.

The group worksheets were collected at the end of the class period, and were returned to the students the next class with feedback and suggestions from the instructor. The groups worked together outside of class time to further develop and improve upon their responses in the group worksheet to create a ten-minute oral presentation. Immediately prior to a group's presentation, the group members were assigned at random to one of the sections from the presentation. Therefore, each student presented one section from the group's presentation but it was not known in advance which one. This component of the project implements strong positive interdependence while allowing equal participation since the group's grade would be based on the group presentation as a whole, but group members were randomly selected to present one of the sections.

The final individual portion of the project was a final written paper allowing the students to synthesize and evaluate the information presented by all the groups. The students were asked to consider themselves a third party presidential candidate and to present and discuss their position on each of the health care reform issues presented in class. This paper was due in class the day before Election Day. Given that the students were required to write about all of the issues presented but had only researched one of the issues intensely, they had to rely heavily on the information presented by the other groups. This project design caused students to understand the importance of creating effective presentations and attending class when the other groups presented. Therefore, in this project there is not only positive interdependence among group members within a group, but also among groups.

To summarize, by breaking the material involved in understanding U.S. health care reform into manageable components, students in each group became experts on a single issue and then performed the task of informing their other classmates. Ultimately, each student was responsible for understanding and being able to apply his or her knowledge of all the issues. However, the unique cooperative structure of this project made the process of learning this complex topic less daunting, more interesting, and consequently highly effective.

Included here are all of the handouts, worksheets, and grading rubrics used for this project. Feel free to edit these and use them as a guide in structuring the project for your own class.

Student handout introducing the project (Microsoft Word 43kB Mar30 09)
List of U.S. health care reform issues (Microsoft Word 31kB Sep21 09)
Individual student worksheet (Microsoft Word 31kB Mar30 09)
Group student worksheet (Microsoft Word 32kB Mar30 09)
Evaluation sheet-Individual worksheet (Microsoft Word 31kB Mar30 09)
Evaluation sheet-Group worksheet (Microsoft Word 30kB Mar30 09)
Evaluation sheet-Oral presentations (Microsoft Word 30kB Mar30 09)
Evaluation sheet-Final paper (Microsoft Word 34kB Mar30 09)
Evaluation-Summary (Microsoft Word 31kB Mar30 09)

• This project was implemented in a class of thirty-nine students; however, it can be adjusted to fit a wide range of class sizes. Depending on the number of students in your class, you may include more or less issues for the student groups to analyze. Another possibility is to change the number of sections in the worksheet (and subsequent oral presentations). Generally speaking, the number of groups must match the number of issues being assigned. Further, the group size must match the number of sections presented for each issue.
  

• I would recommend scheduling a meeting with each group sometime between the in-class group work day and the group oral presentations. This check-in point would allow you to discover any challenges a group may be facing, and assist the group in developing a plan to overcome these challenges before the oral presentation.
  

• The time frame used for the project presented here spanned five weeks consisting of roughly one week for independent research, one week for group research and preparation of the group presentation, one week for in-class presentations, and two weeks for writing the final paper. This was the schedule that worked for a class that met three days a week for fifty minutes. This time frame can be easily altered depending on the needs of your class. However, my suggestion for a project with this level of research is to include at least the equivalent of the timing used here. I would not recommend allotting less time for any of the project components.

• This project was designed for groups of four students. This was to maintain the feature of this project where each student presented one of the four sections of the group oral presentation. The actual number of students in the class was thirty-nine, so there were three groups of five students rather than four. These students were directed to break one of the sections of their presentations into two parts, making five sections to be presented.

• I would recommend using Blackboard to post all the group presentations. This is so the students can reference all of the presentations when working on the final paper. I would also suggest asking each group to provide a list of citations used in their group presentation and post this on Blackboard as well.

Students were assessed on how well they met both the learning and content objectives for this project (specified above). Specifically, students were assigned grades for all the components of the project: individual worksheets, group worksheets, oral presentations, and individual papers. The details for assigning these grades can be found in the grading rubrics. Note that the grading rubrics are available under the "Activity Description and Teaching Materials" section.