Vol 3 no 1 may 2015

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IJHSS.NET

Vol. 3, No. 1

May 2015

International Journal of Humanities & Social Sciences

e-ISSN: p-ISSN:

1694-2639 1694-2620

AAJHSS.ORG Vol 3, No 1 – May 2015 Table of Contents A solution for great peace in agape of Luke’s gospel Younghoon Kim (Ph.D)

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Measuring and assessing gender violence Fred Spiring, Ph.D., P. Stats.

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A framework for mainstreaming patient-centered communication in community-based healthcare organizations Dr. Dina Refki, Dr. Stergios Roussos and Dr. Grace Mose

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Effective Teaching in History: The Perspectives of History StudentTeachers Gideon Boadu

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International Journal of Humanities and Social Sciences p-ISSN: 1694-2620 e-ISSN: 1694-2639 Volume 3, No 1, pp. 1-8, ©IJHSS

A solution for great peace in agape of Luke’s gospel Younghoon Kim1 (Ph.D) Korea University Seoul, Korea Abstract Agape is the core emphasis in Jesus‟ teaching in New Testament. Jesus usually taught his disciples, Jews, and others agape. The important teaching of agape is to love and forgive neighbors who were Jews, Christians, Romans, and even disciples each other. However, Luke different from Matthew, Mark and John used agape in his unique reason. Luke made his writings from sources different from other gospels. What was different from other gospels? Why did Luke use them in different context? First of all, important words were taken in Luke‟s gospel. It informs the reason why agape was different in Luke‟s gospel through researching. In doing so, it shows intention of Luke which is educational meaning of agape for solving conflicts with peace in Jesus‟ days.

Keywords: agape, teaching, neighbors, forgiveness, peace.

Introduction With development of high technology in contemporary society, it looks like living in more convenience and comfort than old ages. However, it is easy to access to look at wars, disagreements, and conflicts in mass media such as T.V., radio, newspaper, internet, and etc. In some cases, it is hardly to solve the problems. Likewise, it was some disagreement and conflict in Jesus days. They were kinds of religious, racial, and sex conflicts. The paper introduced that agape of Jesus could be one of great solutions especially in Luke‟s gospel.

There are 122 agapes in New Testament. Among these, 66 agapes are in four gospels.

There are 9 in Matthew, 5 in Mark, 13 in Luke, and 39 in John (Morrison, 1979). It shows that the use of agape is more than half in four gospels. Even though John used the word agape much more than in Luke‟s gospel, it is a little different from John‟s gospel. Luke different from other gospels was interested in society. Luke concerned especially the weak of his community more than John‟s gospel. The paper studies Luke‟s social interesting with agape. It also researches how different agape was in Luke from Matthew and Mark. It focuses on the author‟s interesting of Luke‟s gospel and why Luke used agape in educational situation as well. In fact agape which Jesus emphasized to his disciples and people was the best lesson in Jesus teachings. Jesus did not teach agape to his disciples simply, but purposed it as an intended word for solving social problems in Luke‟s gospel. It shows that the lesson which Jesus taught for agape is the meaning of education for his disciples and those who followed Jesus at that time for peace between them, and it would 1

Younghoon Kim is a Research Professor in Research Institution of Education, Korea University in Seoul, Korea. His research interest is educational philosophy in east and west, and comparative study between Christianity and other religions in education.

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even give some valuable teaching to us for great peace in nations and others nowadays.

Purpose of the study The purpose of the current research was to investigate why Luke used agape in different story and circumstance from other gospels. The intention of using agapes was analyzed in the current research.

Methodology It researches as following to be clear for the purpose of the paper. First of all, it studies an analytic concordance in New Testament. It also researches theological context in four gospels about Jesus days.

It explores paragraphs used by agapes in Luke‟s gospel. It will show what different they are from other gospels - Matthew and Mark - such as time, place, and the purpose which each author intended.

Analysis Three paragraphs which include words such as agape, enemy, neighbor, and forgive were selected. Then, they are categorized into different points from other gospels based on history, culture, and custom between Roman Empire and Israelites.

It researches how purpose Luke used agape. It needs to study history, culture, and custom between the Roman Empire and Israelites. It informs the reason why Jesus intended to teach agape to his disciples and those who followed him. We also analyzed how many times Jesus intended to teach agapes and why. It studies three important paragraphs used by agape in Luke‟s gospel.

Discussion and result It states that agape which was used in Luke‟s gospel was intended by educational meaning over one of great lessens for solving conflicts in Jesus‟ days. It informs why Jesus needed educational teaching to his disciples and people who followed him. In doing so, it shows that agape which Jesus used to teach had the intended educational meaning especially in Luke‟s gospel.

First paragraph This paragraph is considered as the lesson of plain because the place is on the plain. However, Matthew used the similar paragraph on the mount. Luke different from Matthew had different focus. Luke was interested in the word “enemies.”

“But I say to you that hear, Love your enemies, do good to those who hate you, bless those who curse you, pray for those who abuse you. To him who strikes you on the cheek, offer the other also; and from him who takes away your coat do not withhold even your shirt. Give to everyone who begs from you; and of him who takes away your goods do not ask them again. And as you wish that men would do to you, do so to them. If you love those who love you, what credit is that to you? For even sinners love those who love them. And if you do good to those who do good to you, what credit is that to you? For even sinners do the same. And if you lend to those from whom you hope to receive, what credit is that to you? Even sinners lend to sinners, to receive as much again. But love your enemies, and do good, and lend, expecting nothing in return; and your reward will

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be great, and you will be sons of the Most High; for he is kind to the ungrateful and the selfish.”2 The parallel of this paragraph is Matthew 5:47-48. It is very famous for the Sermon on the Mount to those who have read New Testament. Matthew chapter 5 begins with preaching of the Sermon on the Mount. Matthew 5:47-48 placed in it. The contents of the Sermon on the Mount were Jesus‟ useful teaching about the law, anger, adultery, divorce, oaths, retaliation, and even love for enemies. According to Matthew chapter 5 especially Matthew 5:47-48, Jesus‟ sermon looked so typical such as other teachings. However, as for love for enemies in Luke, it looks that Luke purposed something special for educating his disciples. Luke chapter 6 starts that disciples ate ears on Sabbath. And then Jesus taught and worked on Sabbath, and Jesus selected 12 disciples, and then Jesus preached sermons called “plain lesson” with the golden rule. Among sermons, Luke used the lesson of agape. As for the place of agapes, it looked that Luke had some intention for using agape in this place. In this reason, according to Luke chapter 6, the plain lessons of “love for enemies” could be some special purpose different from Matthew definitely.

In Luke 6, a Greek word “exthlous” means “enemies” as plural, “eulogetei” as “bless” and “ploseukesthe” as “pray” much more emphasize “love” as agape. Then, who were enemies?

According to plural, they could be a group or an organization other than ordinary persons (Plummer, 1977). The expression of “enemies” could mean the group who persecuted Israelites because of religious conflict between Roman Empire and them in those days. Therefore Theissen (2000) stated that “enemies” could be Roman Empire or Roman soldiers. Steven M. Bryan (2002) mentioned that Israelites was ruled by Romans after they had power of attacking Macedonia. Roman Empire served many gods and wanted Jews to take the emperor like their God. However, Jews did not like to do that. Although Romans did not totally interfere with religious practices, sometimes they did, and then Jews would rebel against it (Justo, 1984). Jews had always hoped to recover their political power with their religion in Israel. It was firmly rooted on the words of Bible. They had waited their religious leader eagerly who will recover Israel (Isaiah 29:18-19; 35:5-6; 61:1). So Jews were very anxious to restore their politic authority including religious power. Although zealots insisted violence to resist it, Jesus taught them nonviolence especially to his disciples (Cassidy, 1978). As a matter of fact his disciples very wanted that Jesus would recover Israel politically and religiously from Roman Empire. However, Jesus came out the nonviolent person to Roman Empire or others. In fact nonviolence is against violence and would expect the change of action in the other parts for nonviolence.

In Luke 6:12-19, Jesus took Simon named Peter who was one of zealots. After selecting his disciples, he taught nonviolence lessons to them. Why did Jesus teach it to them? Actually nonviolence makes people avoid violent action. In addition, nonviolence attitude to Roman Empire was one of good ways for coexistence between Christians and Romans (Rowe, 2005). In doing so, Christians could stay peace with Romans. This makes naturally Romans contact the gospels of Bible as well. Therefore agape which Jesus taught to his disciples is not simply the lesson for loving people but intended one for peace with Romans and Christian mission.

Accordingly agape could include educational meaning for peace with Romas in Luke‟s gospel. If Christians would not stay peace with Romans, Roman Empire would attack or persecute Jews definitely and they would not have attention of the gospel which Christians introduce them as well. Therefore, Jesus selected his disciples including Peter as a zealot. Then Jesus purposed to show his purposed teaching as loving enemies in Luke‟s gospel. It is much more than simple lessons. It is religious and educational teaching for his disciples very clearly for survival.

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Luke 6:27-31. http://aajhss.org/index.php/ijhss

Especially Jesus used golden rule which was usually used in bad relation with business and friends in those days with agape (Kirk, 2003). Jesus must have wanted that Christianity was not against Roman Empire and to stay peace with them. Wink (1970) mentioned that the nonviolent teaching of Jesus to his disciples makes Romans themselves know that the persecution to Israelite was not proper and they have open mind to Christians and even Jews.

Agape of Jesus is one of religious and ordinary lessons in Christians and even not involved people of Christianity. Matthew, Mark, and John used agape in meaning of loving neighbors on usual teaching of Jesus. However, Luke used the usual agape lesson as special educational purpose for peace and mission with Romans. It is not only religious goal but also survival.

Second paragraph Luke different from other gospels had different thought of neighbor. In this paragraph, Jesus informed the meaning of neighbor as the story of Good Samaritan.

“And behold, a lawyer stood up to put him to the test, saying, “Teacher, what shall I do to inherit eternal life?” He said to him, “What is written in the law? How do you read?" And he answered, “You shall love the Lord your God with all your heart, and with all your soul, and with all your strength, and with all your mind; and your neighbor as yourself.” And he said to him, “You have answered right; do this, and you will live.” But he, desiring to justify himself, said to Jesus, “And who is my neighbor?” Jesus replied, “A man was going down from Jerusalem to Jericho, and he fell among robbers, who stripped him and beat him, and departed, leaving him half dead. Now by chance a priest was going down that road; and when he saw him he passed by on the other side. So likewise a Levite, when he came to the place and saw him, passed by on the other side. But a Samaritan, as he journeyed, came to where he was; and when he saw him, he had compassion, and went to him and bound up his wounds, pouring on oil and wine; then he set him on his own beast and brought him to an inn, and took care of him. And the next day he took out two denarii and gave them to the innkeeper, saying, „Take care of him; and whatever more you spend, I will repay you when I come back.‟ Which of these three, do you think, proved neighbor to the man who fell among the robbers?” He said, “The one who showed mercy on him.” And Jesus said to him, “Go and do likewise.”3 This paragraph was traditionally famous for the great commandment by Jesus. The parallels of these are Matthew 22:34-40 and Mark 12:28-31. The contents of Matthew and Mark were very similar. It is that Sadducees came to Jesus and discussed about resurrection. It was followed by the great commandment. A lawyer asked Jesus “Teacher, which is the great commandment in the law?” and then Jesus answered “love the Lord thy God with all thy heart, and with all thy soul, and with all thy mind.” However, unlike Matthew and Mark, there was no discussion of resurrection in Luke. A lawyer asked to Jesus “Teacher, what shall I do to inherit eternal life?” and then Jesus said to him, “What is written in the law? How do you read? And he answered, you shall love the Lord your God with all your heart, and with all your soul, and with all your strength, and with all your mind; and your neighbor as yourself.” In Luke the lawyer asked how to inherit eternal life, and then Jesus answered the great commandment. It was very different from Matthew and Mark. In addition, the lawyer asked “who is my neighbor”, and then 3

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Luke 10:25-37. http://aajhss.org/index.php/ijhss

Jesus mentioned the story of Good Samaritan as the example of agape. Actually this story appeared only in Luke. Therefore it was generally accepted as the special source of Luke. Even though it shows what is living with agape, the story has over meaning for loving neighbor.

Definitely, it is the lesson for loving neighbor by Jesus (Sprinkle, 2007). However, it is not easy to understand that the story looks a simple lesson for loving neighbor because it is very difficult to accept the story normally. A man faced with difficulty due to robbers, but both a priest and a Levite were going down that road. In those days, they were high class persons in Jewish religion.

In addition it is guessed that they were respected by people. However, they just passed by the person who had difficulty. Unlike them, a Samaritan helped him. This story is strange very much.

If the person who helped him was the priest or the Levite, it would be so natural. As we know, those who have lots of wealth and things could help those who need help. It is very curious why did Luke show the story different from Matthew and Mark? Reinstorf (2002) stated that Luke would expect that the story of Good Samaritan would give the lesson for practicing agape with Jews as loving neighbor. However, Luke had another purpose for the story. In Bible the relationship between Jews and Samaritans came from Old Testament. After the death of the king Solomon, Israelite was separated as north and south in 8 B.C. Then Assyrian Empire attacked the north and ruled it, and then there were international marriages between them. This marriage started to make a kind of tension between south and north. According to Bible, Jews were prohibited that they have other religions in the law. In addition some people in north had different God in Assyrian Empire other than God in Bible. It resulted in conflict between north and south because north did not keep the first commandment in Law (Esler, 2000). Besides, Samaritan worshiped for Zeus Xenios as Greek god in welcoming ceremony in Gerizim temple.

It made that the relation between them was getting worse (Thornton, 1996). For example Matthew10:5-6 “These twelve Jesus sent out, charging them, go nowhere among the Gentiles, and enter no town of the Samaritans, but go rather to the lost sheep of the house of Israel.”

When Jesus sent his disciples for mission, he said “don‟t go to town of the Samaritans.” It shows that there was still some conflict between them in those days. If the Good Samaritan story was intended just as loving neighbor, the priest or the Levite would help him who needed help.

However Luke used the Good Samaritan story to explain “who is neighbor?” with agape of loving neighbor. Here, it shows that Luke had another purpose with the Good Samaritan story.

Stein (1981) introduced two kinds of Good Samaritan stories adapted from original one. It is a brief summary. First, he informed the Cotton Patch Version of Luke and Acts of Clarence Jordan. It is Good Samaritan story adapted from the Bible to help Black-American to easily read.

When a man was going from Atlanta to Albany, a few robbers blocked and hit him. A white preacher passed by on the other side. And then, a white leader of church choir passed by on the other side as well. This story shows to replace the priest and the Levite into the white preacher and the white leader of church choir. Therefore, it is not that Luke informed simple agape as loving neighbor but that Luke intended a solution in tension and confliction between Jews and Samaritan. In the Good Samaritan story Jesus taught a lawyer what is true neighbor? And what is agape? Luke purposed to teach true meaning of neighbor and agape as loving neighbor. True neighbor is not simply thinking what is a law? but keeping and practicing the law (Sprinkle, 2007).

As a matter of fact Samaritan was always hurt by Jews. It is natural that Samaritans have to receive care and love by others. However, it is the Samaritan who helped him. Therefore, it shows that true agape is to first open others. In the same manner, the confliction between White and Black people in America was very severe. Black people were always hurt, hit, and persecuted

by White people. However a Black one helped the person who really needed help.

In addition, Stein introduced another Good Samaritan story. When a man was going to attend politic meeting for Hitler from Berlin to Frankfurt, he was attacked by robber. And then, a high executive of Nazi passed by on the other side. A pastor of Lutheran Church also passed by on the other side. However, a Jew found and helped him. It means that Good Samaritan story 5

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is not simple lesson for loving neighbor. The story shows the lesson of solution in strong confliction between Nazi and Jews. As we know Jews was severely persecuted by Nazi at that time. However a Jew opened his mind to apology, and helped others as agape. Therefore the clauses of Luke were not simple lesson but good teaching of true agape. Furthermore it means that Luke wanted agape with educational meaning over loving neighbor through Jesus (Longenecker, 2009).

The three gospels Matthew, Mark, and John except Luke used agape in ordinary meaning of loving neighbors on usual teaching of Jesus. However, Luke used agape lesson into more specialized educational purpose for peace between Jews and Samaritans. It shows not only peace between Black and White people but also true forgiveness to assailants who are never forgiven.

Third paragraph In this paragraph, Luke is interested in forgiveness to a woman specially. Furthermore, the intention of Luke was focused on sex discrimination in Jesus days.

“One of the Pharisees asked him to eat with him, and he went into the Pharisee's house, and took his place at table. And behold, a woman of the city, who was a sinner, when she learned that he was at table in the Pharisee's house, brought an alabaster flask of ointment, and standing behind him at his feet, weeping, she began to wet his feet with her tears, and wiped them with the hair of her head, and kissed his feet, and anointed them with the ointment.

Now when the Pharisee who had invited him saw it, he said to himself, “If this man was a prophet, he would have known who and what sort of woman this is who is touching him, for she is a sinner.” And Jesus answering said to him, “Simon, I have something to say to you.” And he answered, “What is it, Teacher?” “A certain creditor had two debtors; one owed five hundred denarii, and the other fifty. When they could not pay, he forgave them both.

Now which of them will love him more?” Simon answered, “The one, I suppose, to whom he forgave more.” And he said to him, “You have judged rightly.” Then turning toward the woman he said to Simon, “Do you see this woman? I entered your house, you gave me no water for my feet, but she has wet my feet with her tears and wiped them with her hair. You gave me no kiss, but from the time I came in she has not ceased to kiss my feet. You did not anoint my head with oil, but she has anointed my feet with ointment.

Therefore I tell you, her sins, which are many, are forgiven, for she loved much; but he who is forgiven little, loves little. And he said to her, “Your sins are forgiven.” Then those who were at table with him began to say among themselves, “Who is this, who even forgives sins?” And he said to the woman, “Your faith has saved you; go in peace.”4 The paragraph appears in Matthew 26:6-13 and Mark 14:3-9. It placed in similar sequence.

The chief priests and the elders of people discussed about arresting Jesus. When a woman poured an alabaster cruse of ointment, disciples discussed regarding acting Jesus. Then Judas Iscariot who was one of 12 disciples delivered Jesus to the chief priests. However, Luke placed this in chapter 7 which is in plain lesson. The similar story of Matthew and Mark is in Bethany, in the house of Simon the leper. In case of Luke, this is in one of Pharisees. Therefore it means that Luke used this in different situation from Matthew and Mark. As for contents, there were some different parts. In case of Matthew and Mark, when a woman poured, disciples said that this 4

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Luke 7:36-50. http://aajhss.org/index.php/ijhss

ointment might have been sold and given to the poor. But Luke did not use the expression. In Matthew and Mark, Jesus said that wherever this gospel shall be preached, the woman shall be spoken for memorial of her. On the other hand, there is no word like this in Luke. According to these facts, Matthew and Mark, they focused on pouring ointment, but Luke was interested in forgiveness of her with agape.

A woman who was a sinner wanted to pour the ointment to Jesus. As a matter of fact there was a law - if you contact with a sinner even chatting with him, you would be a sinner. A Pharisee was simply looking at how Jesus would do with the woman. However, Jesus knew what he thought through seeing him and showed him agape which is in forgiveness for great harmony.

Jesus did not discuss about what is right or not about laws. Rather Jesus taught audiences to forgive her as agape. Furthermore Jesus even loved her truly as agape (Crabbe, 2011). Fitzmyer (1981) mentioned that Luke added 7:44-47 and purposed to emphasize the act of forgiving the sinner. Therefore it is clear that Luke intended that Jesus taught agape for great harmony to his disciples and others as an educational meaning which you have to love and forgive others.

It is very obvious that Luke showed this story with another purpose. In those days, females did not receive right equally in the society of Jews and the early part of Christianity. In Exodus 20:17 “You shall not covet your neighbor's house; you shall not covet your neighbor's wife, or his manservant, or his maidservant, or his ox, or his ass, or anything that is your neighbor's.” In this clause, female was thought by one of things as property. Jeremias (1969) mentioned that females could not attend official meetings. When a female went also out, she must take a veil. The status of female was much less than male in those days very clearly.

Therefore the different purpose of Luke was going to give the solution regarding discrimination between male and female to audiences in Jesus‟s days.

In addition, Cosgrove (2005) stated that the woman was not a usual sinner in Luke. He insisted that she had long hair. It would symbolize the meaning of sexual intercourse. So he guessed that the sin of the woman would be adultery. As a matter of fact Jesus was born in authenticity of Jews and respected by people in those days. When he was invited by a Pharisee, he contacted with the woman who was the sinner. Simon saw it and wanted to point out her fault. However, Jesus knew his thought and taught the true meaning of agape to him. It showed that the law of love and forgiveness is greater than Jew‟s law. Flender (1967) mentioned that this story is teaching for disciples to respect the repressed woman at that time. Unlike Matthew and Mark, Luke showed that agape was over simply forgiving sinners and had the great power for harmony. Luke purposed to show the power of agape and to overcome discrimination between female and male in Jesus‟ days as well. Luke was interested in the weak in Jesus‟ days very much.

He saw the story in another angle and informed the solution of social problems in those days. It was educational meaning for Jesus‟ disciples and people.

Although three gospels Matthew, Mark, and John also introduced the woman, they did not emphasize her as the sinner. However, Luke used agape lesson not only in ordinary meaning of loving neighbors but also in educational teaching for great harmony intended by Luke. It is very obvious intention in educational teaching.

Conclusion Agape is the best teaching of Jesus such as loving neighbors and forgiving enemies in New Testament. However, Luke used agape in different story and circumstances as Jesus‟ teaching. Luke made his writings from other sources and intended agape with his special purpose.

It showed how the author of Luke used agape different from others for peace. The reason is that agape would be the good way of teaching and learning for solving strong disagreements with 7

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peace. Therefore agape in Luke was not a simple lesson but the word with educational meaning for great peace and harmony even in contemporary society with social problems between black and white, male and female, and etc.

References Biblia-Druck D-Stuttgart (1998). The Greek New Testament. Fourth Revised Edition. Stuttgart: Deutsche Bibelgesellschat.

Biblia-Druck Stuttgart (1979). Septuaginta. Stuttgart: Deutsche Bibelgesellschat.

Biblia Hebraica Stuttgartensia (1990). BibliaHebraica. Stuttgart: Deutsche Bibelgesellschat.

Bryan, S. M. (2002). Jesus and Israel’s Traditions of Judgment and Restoration. Cambridge: Cambridge University Press.

Canadian Bible Society (1990). Holy Bible NRSV. Nashville: Thomas Nelson, Inc. Canadian Bible Society (1978). The Holy Bible NIV. Zondervan Bible Publishers, Inc. Cassidy, R. J. (1978). Jesus Politics and Society. New York: Orbis Book.

Cosgrove, C.H. (2005). A Woman's Unbound Hair in the Greco-Roman World, with Special Reference to the Story of the "Sinful Woman" in Luke 7:36-50. Society of Biblical Literature Journal of Biblical Literature, 124(4), 675-692.

Crabbe, K. (2011). A Sinner and Pharisee: Challenge at Simon‟s Table in Luke 7:36-50. The Pacifica Theological Studies Association Journal of the Melbourne College of Divinity, 24(3), 247-266.

Esler, P. F. (2000). Jesus and the Reduction of Intergroup Conflict: the Parable of the Good Samaritan in the Light of Social Identity Theory. Brill Academic Publishers Biblical Interpretation, 8(4), 325-357.

Fitzmyer, J. A. (1981). The Gospel According to LukeⅠ-Ⅸ. New York: Doubleday & Company, INC. Jeremias, J. (1963). The Parables of Jesus. Hooke, S. H (Tr.). New York: Charles Scribner's Sons.

Kirk, A. (2003). "Love Your Enemies," the Golden Rule, and Ancient Reciprocity (Luke 6:27-35).

Society of Biblical Literature Journal of Biblical Literature, 122(4), 667-686.

Longenecker, B. W. (2009). The Story of the Samaritan and the Innkeeper (Luke 10:30-35): A Study in Character Rehabilitation. Brill Biblical Interpretation, 17(4), 422-447.

Morrison, C. (1979). An Analytical Concordance to the Revised Standard Version of the New Testament.

Philadelphia: The Westminster Press.

National Council of the Churches of Christ (1980). The Bible RSV. New York: American Bible Society.

Nestle-Aland (1979). Greek New Testament 26th edition. Stuttgart: Deutsche Bibelgesellschat.

Plummer, A. (1977). The Gospel According to St. Luke. Edinburgh: T. & T. Clark.

Reinstorf, D. (2002). Luke‟s Parables and the Purpose of Luke‟s Gospel. Centre for Theological & Instruction Hervormde Theologies Studies, 58(3), 1281-1295.

Robertus Weber (Ed.). (1969). Biblia Sacra Vulgata. Stuttgart: Deutsche Bibelgesellschat.

Rowe, C. K. (2005). Luke-Acts and the Imperial Cult: A Way through the Conundrum? The American Theological Library Association Journal for the Study of the New Testament, 27(3), 279-300.

Sprinkle, P. M. (2007). The Use of Genesis 42:18 (not Leviticus 18:5) in Luke 10:28: Joseph and the Good Samaritan. The Institute of Biblical Research Bulletin for Biblical Research, 17(2), 193206.

Stein, R. H. (1981). An Introduction to the Parables of Jesus. Philadelphia: The Westminster Press.

The Zondervan Corporation (1962). Holy Bible KJV. Michigan: Zondervan Publishing House.

Theissen, G. (2000). Die Religion der Ersten Christen: eine Theorie des Urchristentums. Gütersloh: GütersloherVerlagshaus.

Thornton, T.G.C. (1996). Anti-Samaritan exegesis reflected in Josephus' retelling of Deuteronomy, Joshua, and Judges. Clarendon The Journal of Theological Studies, 47(1), 125-130.

Throckmorton, B. H (Jr.). (1992). Gospel Parallels. Nashville: Thomas Nelson Publishers.

Wink, W. (1970). Jesus and Nonviolence. Minneapolis: Fortress Press.

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International Journal of Humanities and Social Sciences p-ISSN: 1694-2620 e-ISSN: 1694-2639 Volume 3, No 1, pp. 9-27, ©IJHSS

Measuring and assessing gender violence Fred Spiring, Ph.D., P. Stats.

Statistical Research Officer Bureau of Women’s Affairs Office of the Prime Minister 5-9 South Odeon Avenue Kingston, JAMAICA Abstract As Jamaica moves through implementation of their National Policy on Gender Equality (NPGE) and develops harassment legislation, there is a need to be able to identify and assess the impact of such programs and initiatives. In addition Funding Agencies are increasingly requiring evidence that developed initiatives are reaching their target audience and are having a measurable impact. With the assistance of the Jamaica Constabulary Force, procedures for monitoring and assessing Violence, Gender Based Violence, Domestic Violence and Intimate Partner Violence are proposed and illustrated.

Keywords: Gender Based Violence, Domestic Violence, Intimate partner Violence Introduction The current mission of Jamaica’s Bureau of Women’s Affairs (BWA) is “To enable women to achieve their full potential as participants in Jamaica’s social, cultural and economic development and with equitable access to benefits from the country’s resources”. The BWA seeks to carry out this objective through Policy Development, Analysis, Research, Documentation, Project Planning, Monitoring, Public Education and Community Outreach.

In order to assess and monitor the impact of legislation, policies, programs and initiatives quantitatively, it is necessary to first develop procedures for measuring the processes of interest.

Recently a huge outcry from the Jamaican public and media saw a call for action to reduce the frequency of violent acts. Several recent cases (Jamaica Observer (2012), The Gleaner (2012)) mobilized the public to call for action in preventing future rape and murder incidents. Many Government Agencies as well as NGOs promoted various actions or interventions in response.

Calls for action were wide spread across Jamaica, all having the public’s safety of primary importance.

One such call was for a mechanism to measure, monitor and assess violence. In this manuscript we develop a mechanism for measuring violence, illustrate processes for gathering the data and conclude with two examples of assessing, monitoring and triggering an intervention.

In both examples, data from Jamaica’s Constabulary Force (JCF) are used to illustrate the value in having a formal measuring technique for violence, as well as monitoring quantitatively the impact of programs set in place to reduce the frequency and impact of violence in Jamaica. In both examples victim data is used to signal the need for attention and to assess the impact of the actions. Perpetrator and geographic profiles are then used to identify potential strategies designed to reduce the frequency of violence.

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Violence Performance Indicators Currently the most comprehensive set of violence performance indicators (PI) are those proposed by the “Friends of the Chair” (United Nations Economic and Social Council (2008)) and involve four types of violence including Physical, Sexual, Economic and Psychological. We propose a hybrid version of the “Friends of the Chair” performance indicator that reads as follows: [a] The total number & age-specific rate of men and women subject to violence in the last 12 months by type, severity, relationship to perpetrator and frequency, where the types of violence include Physical, Sexual, Psychological and Economic; Severity includes moderate and severe; Relationship to perpetrator includes intimate, other relative, known person, stranger, state authority; and Frequency includes one, few or many times; And [b] The total number & age-specific rate of men and women subject to violence over their lifetime by type, severity, relationship to perpetrator and frequency, where the types of violence include Physical, Sexual, Psychological and Economic; Severity includes moderate and severe; Relationship to perpetrator includes intimate, other relative, known person, stranger, state authority; and Frequency includes one, few or many times.

Following this definition of Violence, Figure 1 illustrates through the use of a Venn diagram, the relationship of the four violences with respect to women and men. In this case we have broken down violence into that against women and men and then further suggest that all four types of violence (Physical, Sexual, Economic and Psychological) occur for both female and male victims.

Figure 1 does not reflect incident rates, only that males and females are potential victims of the four violences.

Many have attempted to define Gender Based Violence (GBV) with varying degrees of success. The Declaration on the Elimination of Violence against Women outlined in United Nations Department of Public Information (1996) provides a definition of gender based violence as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life”. Unfortunately this definition fails to consider any form of economic violence. In a similar vein, The United Nations Secretary-General’s coordinated database on violence against women, Questionnaire to Member States of April 2012 (United Nations (2012)) goes as far to suggest that all violence against women is gender based. Although taking this perspective facilitates data gathering, it does not recognize the fact that there is violence against both women and men that is not necessarily gender based. Developing data acquisition techniques that allow for the assessment of gender-based, domestic and intimate partner violence will, in the long term, better serve the various users of the information. To prevent repeating problems similar to those encountered with Millennium Development Goal 7, Indicator 7.8 the “Proportion of Population Using An Improved Drinking Water Source” (BBC News: Science & Environment (2012)), where the indicator was promoted as a proxy for “Access To Safe Drinking Water”, rather than strictly “access to improved drinking water source” without a measure of water quality. It would seem prudent to develop a measurable assessment of gender based, domestic and intimate partner violence that would avoid this type of controversy. The development of a performance indicator that a) is informative, b) addresses the issue directly and c) is repeatable should be the first stage in the process.

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Violence P h y s i c a l

Against Women

Against Men

S e x u a l

E c o n o m i c

P s y c h o l .

Figure 1. Physical, Sexual, Economic & Psychological Violence Against Women and Men We propose that Gender-Based Violence be considered to be any act of violence that is attributable to the sex of the victim(s). This definition would include all sexual violences including Rape, Carnal Abuse, Sex with Child Under 16, Incest, Buggery and Sexual Assault, while also including violence against sex workers, gay bashing, with-holding of marital funds or property, genital mutilation, neglect, emotional abuse, ... . Figure 2 is used to illustrate that Gender Based Violence is not restricted to female or male victims and can manifest itself in any of the four defined violences.

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Violence P h y s i c a l

Against Women

Against Men Gender Based

S e x u a l

E c o n o m i c

P s y c h o l .

Figure 2. Gender Based Violence Against Women and Men The United Nations Fund for Population Activities (2005) State of World Population 2005 report suggests that “Gender-based violence is perhaps the most widespread and socially tolerated of human rights violations.” The report goes on to say that “Gender-based violence may involve intimate partners, family members, acquaintances or strangers.” Similarly the UN Special Rapporteur (1996) on Violence Against Women defined domestic violence “as violence that occurs within the private spheres, generally between individuals who are related through intimacy, blood or law.”

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Violence P h y s i c a l

Against Women

Against Men Gender Based Domestic

S e x u a l

E c o n o m i c

P s y c h o l .

Figure 3. Relationship of Domestic Violence to Gender Based Violence Figure 3 captures the United Nations Fund for Population Activities (UNFPA) point that Gender-Based Violence includes all cases of Domestic Violence, but that there are situations where Gender-Based Violence is not considered to be Domestic Violence. Examples would include violence against an unrelated sex worker and gay bashing. Domestic violence includes, but is not limited to spousal/partner abuse, as violence against children and the elderly are also forms of Domestic violence. Figure 4 illustrates this concept by including all forms of Intimate partner violence within Domestic violence, while allowing other violence including child and elderly abuse to be considered Domestic Violence.

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Violence P h y s i c a l

Against Women

Against Men Gender Based Domestic Intimate Partner

S e x u a l

E c o n o m i c

P s y c h o l .

Figure 4. The Relationships among Intimate Partner, Domestic and Gender Based Violence Capturing Gender Based Violence Data Defining the relationship among Gender-Based, Domestic and Intimate Partner Violence allows us to then devise methods that will provide accurate, reliable data for monitoring and assessing levels of the various violences. Unfortunately the definitions associated with the various violences have often been manipulated to reflect the focus of a particular study or the availability of existing data. All too frequently the assessment as to whether an incident is Domestic or Intimate Partner violence has been left to the recording individual or agency. Cultural norms and societal stigmas often play a role in this assessment. In many instances the onus is placed on the victim’s first contact to assess whether or not the incident should be identified as Domestic or Intimate Partner violence. The victim’s first contact maybe a member of the local police force, an agency social worker or a crisis centre volunteer each with differing levels of training and knowledge. These types of issues in turn hinder comparisons among violence indicators at all levels including local, national and International.

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Rather than asking the first contact to make a judgement, it is proposed that if the sex and age of the victim and the perpetrator are recorded, then the relationship between the victim and perpetrator can be used to identify the vast majority of Intimate Partner and Domestic Violences. For those Gender-Based violences that are not considered Domestic or Intimate Partner, input from the incident reporter may be required. In such cases the reporting person would be asked to assess whether or not the “Root cause of the violence was Gender-based� with possible responses being Yes, No or Unknown. If the first contact reports the incident as Unknown and the incident is not a case of Domestic Violence or Intimate partner violence, then as the incident proceeds through the investigation period more information may become available. For example as the perpetrator proceeds through the court system, clearer indications as to the motive for the violence may become evident.

Consider the following Generic reporting form (Figure 5): Type of Violence: Physical Sexual Psychological Economic Perpetrator: Female Grandfather/Grandmother Father/Mother Stepfather/Stepmother Partner(Spouse/Comm Law) Ex-Partner Boyfriend/Girlfriend Sibling Son/Daughter Grandson/Granddaughter Relative Visiting Relationship Friend or Acquaintance State Authority Other Org/Enterprise Self Other Victim: Female Root cause of the violence was Gender based: Yes Figure 5. Generic Reporting Form where the reporting person would include a) the type of violence by checking the appropriate box (i.e., Physical, Sexual, Economic or Psychological), b) the sex and age of the perpetrator/aggressor as well as the relationship to the victim and c) the sex, age and root cause of the violence for the victim. This would allow the assessment of Domestic, Intimate Partner and Gender Based Violence for females and males.

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Figure 6. An Example of a Report indicating Domestic Violence Consider the above report (Figure 6), where the victim of Economic violence was identified as a 64 year old female, the perpetrator a 19 year old male and the perpetrator relationship to the victim being Grandson/Granddaughter. The relationship of the perpetrator to victim in the report would indicate this was a case of Domestic Violence.

In the second example (Figure 7), the victim of Sexual violence is a 38 year old female, the perpetrator a 44 year old male and the perpetrator relationship to the victim identified as Partner (Spouse/Common Law). Since the perpetrator relationship to the victim was identified as Partner(Spouse/Common Law) the report would be identified as a case of Intimate Partner Violence.

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Figure 7. An Example of a Report indicating Intimate Partner Violence

Figure 8. An Example of a Report indicating Gender-Based Violence

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In the third example (Figure 8) the victim of Physical Violence is a 24 year old male, the perpetrator a 19 year old male and the perpetrator relationship to the victim being Other with the added input that the recorder indicated the “root cause of the violence was Gender Based”, the report would be identified as a case of Gender Based Violence, that was neither Domestic or Intimate Partner violence.

Figure 9. An Example of a Report indicating Gender-Based Violence In the fourth example (Figure 9) the incident was identified as a case of Sexual violence with the victim a 15 year old female, the perpetrator a 16 year old male and the perpetrator relationship to the victim being “Friend or Aquaintance”. The report would be classified as a case of Gender-Based Violence, but neither Domestic or Intimate Partner violence.

In most jurisdictions, recording the age and sex of both victim and perpetrator as well as the type of violence is already being done. The required changes are in the area of the completeness of the perpetrator relationship to the victim. In the case of Jamaica, the Integrated Crime and Violence Information System’s (ICVIS) Sexual Assault Form and related instructions (see Appendix: Working Copy) currently requires that the age and sex of both the victim and perpetrator be recorded in addition to including the relationship between the victim and perpetrator/aggressor. The form asks that the aggressor/perpetrators be identified as: father, mother, stepfather, stepmother, common law spouse, ex-partner, sibling, son/daughter, relative, friend or acquaintance, other.

A minor modification to this list of aggressor/perpetrator to include: grandparents, partner, grandchildren, girlfriend/boyfriend, relative, state authority, Organization/Enterprise (e.g., community based leader, faith based leader) and stranger

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would facilitate compliance with the proposed Violence Indicators. The proposed definition would remove much of the subjectivity involved in the interpretation and classification of Gender-based, Domestic and Intimate Partner violence.

Figure 10 illustrates where the four examples would fall when using the proposed violence performance indicators. Recall that Example 1 (depicted as Ex. 1 in Figure 10) was identified as a case of Domestic Violence (Economic) against a female. Example 2 was a case of Intimate Partner Sexual Violence against a female (depicted as Ex.2 in Figure 10). Example 3 was a case of Gender-Based Physical Violence against a male (depicted as Ex.3 in Figure 10) and Example 4 was a case of Gender-Based Sexual Violence against a female (depicted as Ex.4 in Figure 10) Violence P h y s i c a l

Against Women

Against Men Gender Based Domestic

Ex. 4 Ex. 2

S e x u a l

Ex. 3

Intimate Partner

Ex.1

E c o n o m i c

P s y c h o l .

Figure 10. Relationships among Intimate Partner, Domestic and Gender Based Violence

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Analyzing the Performance Indicators Using Existing Data Tables 1, 2, 3 & 4 contain the data frequencies and Figures 11, 12, 13 & 14 the frequency charts for Physical, Economic, Sexual and Psychological violence by sex and age for 2011 in Jamaica (Jamaica Constabulary Force Statistics and Information Management Unit (2012a), Jamaica Constabulary Force Statistics and Information Management Unit (2012b), Jamaica Constabulary Force Statistics and Information Management Unit (2012c), Office of the Children’s Registry (2012)). Looking first at Physical Violence defined as the frequency of Murders and Shooting, we can address the proposed Physical Violence performance indicator: [a] The total number & age-specific rate of men and women subject to Physical Violence in the last 12 months 900 800

Victims of Physical Violence

700 600 500 400

2011 M

300

2011 F

200 100 0

Figure 11. Frequency chart of Physical Violence Against Females and Males for 2011 by age Figure 11 illustrates the first rising, then declining age group frequencies of Physical Violence for both females and males for 2011. Also from Figure 11 it is clear that the Physical Violence frequencies for males are approximately an order of magnitude (10 times) larger than those frequencies for females. Table 1 contains the Total and Age-specific frequencies (rates) of Physical violence for the calendar year 2011.

Table 1. Physical Violence Frequencies and Totals by sex and age for 2011 Age 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 20

M 5 9 17 197 344 329 283 267 213 157 113 50

F 5 4 3 29 40 45 37 36 27 26 21 11 http://aajhss.org/index.php/ijhss

60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 Unknown Total

28 25 9 3 4 0 0 0 854 2907

7 5 7 2 0 0 0 0 30 335

Economic Violence Next looking at Economic Violence defined as the frequency of Break-ins, Robbery and Larceny, we can again address the proposed Economic Violence performance indicator: [a] The total number & age-specific rate of men and women subject to Economic violence in the last 12 months 600

Victims of Economic Violence

500 400 300 2011 M 200

2011 F

100 0

Figure 12. Economic Violence Frequencies and Totals by sex and age Table 2. Economic Violence Frequencies and Totals by sex and age Age 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 21

M 0 2 52 245 451 527 507 531 457 420 365 249

F 0 2 25 221 469 481 492 410 357 329 231 209 http://aajhss.org/index.php/ijhss

60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 Unknown Total

170 115 83 40 21 6 5 0 73 4319

106 59 48 25 18 10 2 0 41 3535

Figure 12 illustrates the similar rising then declining age group frequencies of Economic Violence for both females and males for the calendar year of 2011. Table 2 contains the Total and Age-specific frequencies (rates) of Economic violence for the same year (2011).

Sexual Violence Next looking at Sexual Violence defined as the frequency of Rape and Carnal Abuse/Sex with Child under 16, we can address the proposed Sexual Violence performance indicator for females: [a] The total number & age-specific rate of women subject to Sexual violence in the last 12 months in the case of females and no assessment of any kind for males.

300

Victims of Sexual Violence 2011

250 200 150 100 50

unknown

95-99

90-94

85-89

80-84

75-79

70-74

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19

ten-14

five-9

0-4

0

Figure 13. Sexual Violence Frequencies and Totals by age Figure 13 again illustrates the familiar rising then declining age group frequencies for Sexual Violence (Rape only, as Carnal Abuse/Sex with child under 16 is not yet age disaggregated) against females in the calendar year of 2011. Table 3 contains the Total and Age-specific frequencies (for rape) of Sexual Violence against females for the same year (2011).

Table 3. Sexual Violence Frequencies and Totals by sex and age age 0-4 5-9 10-14 15-19 20-24 22

2011 2 19 211 280 127 http://aajhss.org/index.php/ijhss

25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 unknown Sub Total (Rape) Sub Total (Carnal) Total

63 48 14 8 14 6 2 3 4 1 0 0 0 1 0 3 806 830 1636

Psychological Violence Lastly examining Psychological Violence defined as the frequency of Emotional Abuse and Neglect, we can address a portion of the proposed Psychological Violence performance indicator including: [a] The total number of men and women under 18 years of age subject to Psychological Violence in the last 12 months

Psychological Violence 2011 2400 2300 2200 2100 2000 1900 1800 1700 Male

Female

Figure 14. Psychological Violence Totals by sex Figure 14 illustrates the total frequencies for Psychological Violence against females and males in the year of 2011. Table 4 contains the Total for Psychological Violence against females and males for the same year (2011). Note that the Psychological data is not age disaggregated at this time.

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Table 4. Psychological Violence Totals by sex Age 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 Total Emotional Neglect Unknown

Male

Female

1958 351 1607 125

2318 474 1844

Conclusion Currently Jamaica’s Major Crime Reports do not include relationship to Aggressor/Perpetrator, however the JCF acknowledges the importance of such information and has started to retrieve perpetrator information.

The Jamaica Constabulary Force Statistics and Information Management Unit (2012b) Executive Summary on Rape addresses the issue of relationship to perpetrator by including the information “that of the 228 rape incidents from January to April 22, 2011, approximately 167 or 73% of the offenders were known to the victims”. This is a terrific start, however further refinement is required in order to adequately address the perpetrator. The 73% of perpetrators known to the victim needs to be further broken down into Grandfather/Grandmother, Father/Mother, Stepfather/Stepmother, Partner (Spouse/Common Law), Ex-Partner, Sibling, Son/Daughter, Grandson/Granddaughter, Relative, Visiting Relationship, Friend or Acquaintance, while the remaining 27% of perpetrators need to be further broken down into stranger, state authority or Other Organization/Enterprise (e.g., community based leader, faith based leader).

Once formally adopted, the revised ICVIS form (see Appendix for working copy) will form the basis for all data acquisition involving violence in Jamaica. The associated agencies, including the JCF and OCR, will be mandated to complete the ICVIS form in all cases of violent crime.

The goals of this manuscript were to develop a reliable, repeatable measure of violence that includes the categories Gender-based, Domestic and Intimate Partner and to illustrate methods for measuring and assessing violence in Jamaica. In addition the manuscript illustrated several shortcomings in the JCF’s data acquisition which they are currently addressing. Please note that a) data provided by the JCF comes with the warning “Figures included in this document are 24

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subjected to change due to discoveries from on-going investigations” and b) both OCR data and population figures for 2011 are denoted as “provisional”.

References Jamaica Observer (2012). Horror in St. James! 8-y-o among five females brutally raped by gunmen. Jamaica Observer, Jamaica, WI. The Gleaner (2012). Pregnant woman shot dead in police confrontation, another injured. The Gleaner, Jamaica, WI. United Nations Economic and Social Council (2008). Friends of the Chair of the United Nations Statistical Commission on the indicators on violence against women.

E/CN.3/2009/13.

United Nations Department of Public Information (1996).

Women and Violence. http://www.un.org/rights/dp1772e.htm.

United Nations (2012). United Nations Secretary-General’s coordinated database on violence against women, Questionnaire to Member States, April, Secretary-General’s in-depth study on all forms of violence against women. A/61/122/Add.1.

BBC News: Science & Environment (2012).

Harrabin's Notes: Safe assumptions. www.bbc.co.uk/news/science-environment-18020432.

United Nations Fund for Population Activities (2005). State of World Population, Chapter 7. http://www.unfpa.org/swp/2005/english/ch7/.

UN Special Rapporteur (1996). Violence Against Women, its causes and consequences. http://www1.umn.edu/humanrts/commission/thematic52/53-wom.htm .

Jamaica Constabulary Force Statistics and Information Management Unit (2012a). Age Group and Gender for Victims of Major Crimes 2007-2011.

Jamaica Constabulary Force Statistics and Information Management Unit (2012b). Executive Summary-Rape.

Jamaica Constabulary Force Statistics and Information Management Unit (2012c). Jamaica Constabulary Force Annual Major Crime Statistics Review (Provisional).

Office of the Children’s Registry (2012). Statistics on the total number of reports received by the OCR by type, gender, month and year, 2007 to 2011.

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APPENDIX Working

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Copy

of

ICVIS

Sexual

Assault

Form

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International Journal of Humanities and Social Sciences p-ISSN: 1694-2620 e-ISSN: 1694-2639 Volume 3, No 1, pp. 28-37, ŠIJHSS

A framework for mainstreaming patient-centered communication in community-based healthcare organizations Dr. Dina Refki1 University at Albany, U.S.A Dr. Stergios Roussos2 Alliance for Healthcare Research & Quality, U.S.A Dr. Grace Mose3 Family Planning Advocates of New York State, U.S.A Abstract This study examines the improvement of health centers’ organizational ability to reach and serve communication vulnerable patient populations (i.e. defined as patients who are Limited English Proficient (LEP) and do not speak the dominant language of providers). The objectives are to develop a Language Access Framework tailored to the needs of community-based health centers.

Outcome of the study includes a portrait of challenges and opportunities for language assistance in community-based health centers and a replicable model for language assistance that is applicable to similar settings. We conducted a cross-sectional study of family planning administrators on language assistance policies, practices and programs and a quasi-experimental study of organizational development intervention on language assistance policies, practices and programs. The study took place in New York State from September 2009 – August 2012.

Keywords: Language Assistance, communication vulnerable patients, healthcare Introduction Communication Vulnerable patients are a marginalized minority in society. They face significant barriers in accessing culturally and linguistically competent services. They are a growing segment of the population that experience disparities. There is significant evidence that when communication is hindered because of lack of language and cultural concordance, the ability of the healthcare system to provide quality care to Limited English Proficient (LEP) patients is seriously compromised (Hale, 2008). Poor communication due to language and cultural non-concordance results in lack of access to preventive services (Derose & Baker, 2000); denial of and/or receipt of wrong benefits and services; misunderstanding of treatment; significant delays in treatment; poor shared decisionmaking; ethical compromises; difficulty obtaining informed consent, not being given all available options for care (Commonwealth Fund, 2003); increased risks for medical errors; misdiagnoses, legal liabilities, malpractice and negligence; compromised comprehension of required treatments and medication instructions; decreased ability to manage chronic conditions with appropriate 1 Refki is the Director of the Center for Women in Government & Civil Society, Rockefeller College of Public Affairs &

Policy, University at Albany 2 Roussos is the Director of the Alliance for Community Research & Development 3 Mose was the Director of the Diverse Communities Health Initiative at Family Planning Advocates of New York State

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follow-up care (Youdelman, 2003), and unnecessary and expensive diagnostic testing (Hampers et. al.1999).

Moreover, women’s reproductive healthcare is highly sensitive in many cultures. Candid discussions are often obstructed by cultural taboos. There is often a reluctance to speak about sexual matters. Bodily exposure and touch are taboo in certain cultures (US Department of Health & Human Services, 2000). Homosexuality and STDs are stigmatized. There are varying views on contraceptive methods, and some cultures use traditional medicines. Women who are survivors of rape, sexual torture and/or female genital mutilation may be reluctant to seek care or speak openly. These are factors that may cause great complications and require effective linguistic and cultural mediation.

The healthcare system in the U.S. struggles to provide patient-centered culturally and linguistically competent care to its LEP patients. Organizational level interventions that are not patient-centered do not always yield improvement in patient health outcomes - There are significant gaps in the provision of effective linguistic and cultural mediation. Despite the existence of legal frameworks and policies that mandate the provision of language services in healthcare facilities, a recent study in New York State points to the existence of major disparities in the application of laws and regulations (Center for Popular Democracy, 2013), with less than half of this segment of the population able to access linguistically sensitive information. Currently providing language services is the law in New York State. There is, however, wide variation between healthcare facilities we studied in the quality and quantity of the services provided (Rand, 2007 ; Rudmin, 2007). Practices range from the provision of dedicated bilingual staff interpreters who serve as patient advocates and cultural bridge builders, to the provision of an impersonal and time limited telephone interpretation that serves as a translator machine. The latter has become the default for many healthcare facilities especially for non-Spanish speaking LEP patients.

Overcoming linguistic and cultural disparities demands a deliberate proactive patient-focused approach - Among LEP patients there is need for health advocates/coaches who will guide them, redress power imbalance and empower their voice (Morris, 2010; Bahadir, 2010; Apostolou, 2009). They also are in need of linguistic and cultural mediators. Having effective linguistic and cultural mediation decreases communication errors, increases patient comprehension, equalizes healthcare utilization, improves clinical outcomes, and increases satisfaction with communication and clinical services for LEP patients (Karliner, Jacobs, Chen & Mutha, 2007).

Barriers to these patient-centered care approaches include funding limitations. Healthcare providers are under extreme pressure to cut costs and increase patient visits and volume so they can stay financially viable. Serving LEP patients is a complex effort that requires longer visit time and increases service costs. Institutionalization of LEP interventions may be hindered by the perception that they place an undue financial and/or human resource burden on the organization. There is strong evidence, however, that these interventions actually reduce medical costs and improve the bottom line (Youdelman, 2003). Facilitative factors of language access intervention uptake include an ability to capture a bigger share of the patient market; ability to comply with existing legal requirements and accreditation policies; and a high degree of leadership awareness of the changing patient demographics and commitment to the need to address disparities affecting LEP patients.

Methods The study sought to understand how implementation of organizational level language access intervention may improve the organizational management system with the potential of 29

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improving patient health outcomes. Enhanced management system was measured by ability to achieve 3 outcomes: identify/document language of communication; secure language assistance to enable communication and monitor and evaluate language assistance and health outcomes of LEP. Patient outcomes were measured through increased testing for STD with Latina patients.

We defined increased testing as an indictor of success since language barriers hinder the provision of prevention services such as STD testing. An increase in testing is considered increased provision of preventive services.

Participants Participants in the study were members of Family Planning Advocates of New York State, a statewide organization with approximately 200 member health centers throughout the State.

Design and Procedures The study was conducted in two phases. In Phase 1, a Baseline Survey was administered to deepen understanding of the operating systems, policies, protocols and procedures related to communicating with LEP patients at family planning clinics in New York State. The survey also assessed perceptions of whether clinics thought that language access was important and whether they felt satisfied with the way language assistance is provided at their clinics. Staff knowledgeable about language assistance within each clinic completed the survey instrument.

In Phase 2, six clinics purposively selected from the pool of survey respondents were invited to participate in developing and testing a language access organizational intervention at their clinic.4 These clinics were selected based on the following criteria: interest, Limited English Proficient Latina Patient volume; having a service area with sizable population of LEP residents. The 6 clinics were divided into two groups; A and B. A delayed intervention methodology was used.

Group A received the intervention 4 months before Group B receives its intervention. Delayed intervention allowed an opportunity to use Group B as a control Group for the initial 4 months.

Data collection in phase 2 included, observational site visits; key informant interviews, action plan development sessions, technical assistance sessions, patient chart reviews and review of organizational records.

Social Learning Theory and Behavioral Ecological Model guided the study (Glanz et. al., 2008).

The study emphasized factors in the physical environment (e.g., healthcare system, time and staff pressures) as well as history of personal and organizational performance (e.g., clinic policies) that may shape patient-centered communication. We also used prior work in the area of language access including Refki et. al, 2007, 2012, and Wilson-Stronks& Galvez, 2006. The analysis plan examined relationships among variables related to the quantity and quality of language assistance.

The University of Albany Institutional Review Board reviewed conduct of the research.

Results 1. Cross-sectional study of family planning administrators

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Development and implementation of the Language Access Intervention used the following process: (a) each clinic established a Language Access Team composed of staff members who are serving in key and different roles in the organization; (b) using an organizational self-assessment, each team individually and collectively rated the organization on the patient centered communication scale; (c) the team then collectively identified gap areas that are of priority to the organization and created an action plan which included the following components: goals, measurable, quantifiable objectives, activities, organizational resources that are needed to accomplish each objective, timeline for each activity; and an evaluation plan that clearly delineates process efficiency and outcome effectiveness measures. The Team selected strategies from a toolbox of possible interventions that the authors developed based on a review of literature, and executed the action plan.

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The Family Planning project is aimed at understanding how family planning organizations can use language assistance services to improve preventative services for limited English proficient (LEP) patients. The current cross-sectional interview study was conducted with administrators of family planning clinics to investigate factors, organizational history, resources, and availability to participate in this research, as well as quantity and quality of language assistance services offered.

Sixty family planning clinics from 11 New York State Regions participated. A variety of organization factors were observed, such as number of staff, languages spoken at the clinic, number of bilingual staff, staff training, number of patients seen per week, etc. Community factors included racial make-up of surrounding community, languages spoken in the community, political climate, etc. 
 Descriptive analyses were run to examine frequencies of specific variables across clinics. Table 1 describes the number of patient languages and ethnicities/races that clinics serve. Patients could choose more than one language and ethnicity/race, so percentages may not add up to 100%.

Over half (59%) of the clinics reported having patients who spoke Spanish, with other (44%) and Chinese (44%) being the next two popular patient languages spoken. All clinics served patients who identified themselves as other with respect to ethnicity/race. 76% of clinics served White patients and 75% of clinics served Black patients. Table 2 describes the availability of funding sources and availability of staff at clinics.

A few number of clinics reported receiving funding, outside of Title X, for language assistance services. None of the clinics reported receiving County Council Office funding, 9% reported receiving state funding, and 7% reported receiving federal funding. 93% of the clinics had full time staff, 88% had employed part time staff, and 29% of clinics used volunteers. 64% of clinics had bilingual staff and 76% of clinics provided an incentive to bilingual staff to interpret. Table 3 describes the specific types of language services provided, funding for each service, and the number of patients who use particular services.

Ninety-eight percent of clinics provided language assistance services. The types of services provided had little variation between clinics. More than 90% of clinics had bilingual providers/nurses, bilingual staff, telephone interpreters/language line, professional interpreters, translated educational material, multilingual signs/pictograms, and multilingual videos. 85% of clinics provided language assistance services for deaf and hard of hearing patients. With respect to funding for specific types of language assistance services, 75% of clinics received funding for both bilingual providers/nurses and telephone interpreters/language lines. 73% of clinics received funding for bilingual staff, translated educational client material, and multilingual signs/pictograms. Only 68% of clinics received funding for multilingual videos and professional interpreters. Further, 70% of clinics received funding to provide language assistance services to the deaf and hard of hearing.

The number of LEP patients who used specific services across clinics varied. All of the clinics reported patients using translated educational materials and support for deaf and hard of hearing.

66% of clinics reported patients using bilingual staff and 61% of clinics reported telephone interpreters/language lines being used by LEP patients. A little more than half (53%) of the clinics reported LEP patients using professional interpreters. However, less than half of the clinics reported multilingual signs/pictograms and multilingual videos being used by LEP patients. 75% of the clinics reported that their strategic plan included goals for language assistance services, but only 64% confirmed that their strategic plan measures the success of these services. 98% of clinics reported using language posters, language signs, and bilingual

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staff/providers to identify a patient’s language. Table 4 describes the reported barriers that clinics face when serving LEP patients.

There was little variability between clinics and perceived barriers. The majority of clinics felt that all barriers affected their ability to serve LEP patients, with language differences being the highest reported barrier among clinics. Eighty percent of clinics reported hiring bilingual staff to speak Spanish, 76% of clinics reported using language lines, and 70% of clinics reported working with professional interpreters. Table 6 describes the ways clinics monitor LEP patients’ use of their language assistance services.

Sixty-eight percent of clinics reported having hard copy access to patient charts and 20% reported having electronic access. Only 12% of clinics used both. 95% of the clinics verified that they collect information on LEP patients getting some form of help to communicate and document the patient’s language. All of the clinics reported document LEP patient use of their language assistance services. More than half (78%) of clinics evaluated their staffs’ ability to speak the languages for which they interpreted. Tables 7 and 8 describe the different language assistance services offered for common and rare languages. Table 9 illustrates the different assistance/training that clinics provide to their staff to enable them to better serve LEP patients.

Ninety-three percent of clinics reported training staff on identifying LEP patients, helping staff correctly and consistently getting patients the right type of help they need to communicate, and assisting staff in using the interpreter services offered. 85% of clinics verified that they helped their staff learn how to communicate best through an interpreter and 81% of clinics train staff who interpret know how to interpret correctly.

Bivariate correlations were run on three main dependent variables: 1) how are different types of languages identified by the clinics, 2) how the clinics provide language assistance services, and 3) whether or not clinics track/monitor the use of these services. Several predictors were expected to be correlated with each of these dependent variables.

For the outcome “identifying different languages” we examined number of patients by race/ethnicity, languages in the community, and number of people in the community by race/ethnicity. Bivariate correlations were run examining the relationship of these predictors with what languages were spoken at the clinics. As expected, a significant correlation emerged between languages spoken at the clinic and number of patients by race/ethnicity. Significant relationships were also found for all languages in the community, except Spanish, and languages spoken in the clinic. The number of people in the community by race/ethnicity was also significantly correlated with the types of languages spoken at clinics.

Next, analyses were run to investigate the outcome “how are language assistance services provided” with various predictors. A dichotomous variable was created to account for whether or not a clinic provided any type of language assistance service. Bivariate correlations were run to examine whether a significant relationship existed between if a clinic offered language assistance services and several predictors. We expected several clinic demographic factors to be correlated with a clinic’s language services such as what languages exist at the clinic, number of staff, funding for each form of language service, the number of bilingual staff, number of patients of different ethnicities, number of patients who use language services in an average week, date the clinic hired bilingual staff, and if the clinic offers an incentive to bilingual staff to interpret. Clinic factors related directly to serving LEP patients were also predicted to be correlated. These included if the clinic has written procedures for staff working with LEP patients, date the clinic began serving LEP patients, what actions a clinic takes to serve LEP 32

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patients, if the clinic has written policies for helping LEP patients, clinic’s perceived barriers in serving LEP patients, and whether or not the clinic includes providing language assistance services in their strategic plan.

In addition, several community factors, such as the number of people in the community of different ethnicities, availability of bilingual staff in the community, and the public policy climate of the surrounding community, were also predicted to be significantly correlated with a clinic’s availability of language assistance services. Training opportunities provided by clinics were also expected to be related. These included if the clinic trains staff on helping LEP patients, if the clinic evaluates staff’s ability to speak the language they interpret, and clinic’s perceived barriers to training staff. Results suggest that funding is the only predictor significantly correlated with a clinic’s availability of language services, but only for the telephone interpreters/language line (p<.0001, r=.567) and translated client educational materials (p<.001, r=.431). All other predictors were not significantly correlated with whether or not language assistance services were provided at clinics.

Lastly, we examined relationships with the outcome “how language assistance services are tracked.” The number of staff, availability of patient charts, if clinics collect any information LEP patients, the methods staff use to identify LEP patients, and if clinics prepare reports on language difference outcomes were expected to be predictors. The number of staff (p<.05, r=.345), availability of patient charts (p<.05, r=-.377), and method used to identify LEP patients (p<.05, r=.367) were significantly correlated with whether or not a clinic tracks language services.

Whether or not clinics prepare reports on language outcomes and collect of information on LEP patients were not significantly related to a clinic’s likelihood of monitoring the use of language services.

Taken together, the descriptive results suggest that all of the clinics provide language assistance services, with some providing several different kinds. All clinics reported offering language assistance services for both common and rare languages (see Tables 7 and 8). Very few of the clinics receive funding beyond Title X, but the majority of clinics receive funding for the different types of language services (see Table 2). Further, all clinics reported that LEP patients use their translated educational material and that they provide language assistance services for the deaf and hard of hearing. All clinics also reported using various methods to identify patients’ languages (see Table 3). Various barriers to serving LEP patients were shared among the majority of clinics, with language differences, cultural differences, and limited availability of bilingual staff/interpreters being the three biggest barriers (see Table 4). In addition, all clinics reported document LEP patients use of their language assistance services and documenting patients’ languages (see Table 6). Lastly, the majority of clinics provide training and assistance to their staff on serving LEP patients (see Table 9).

The correlational results reveal that the types of languages that exist in the surrounding community of a clinic significantly influences what kinds of languages are spoken at that clinic.

Similarly, the ethnic make-up of the community and clinic patients also significantly affects what languages are spoken at the clinic. In addition, results indicate that only funding significant impacts whether a clinic offers language assistance services, particularly funding for telephone interpreters/language line and translated client educational materials. The more funding a clinic has, the more likely it is to offer these types of services to LEP patients. Further, whether a clinic monitors the use of their language services depends on the number of staff, availability of patient charts, and the method used to identify LEP patients. Two reasons for the lack of significant correlations in this study are its small sample size and low variability among clinics who offer language assistance services. It is possible that the 70% of clinics that did not respond 33

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to the survey were less likely to provide language assistance services. All, but one of the clinics, provides at least two kinds of language assistance service to LEP patients. In addition, only 59 clinics participated in this study that may further contribute to low variability among clinics.

Future research should strive to include a greater number of clinics.

2. Quasi-experimental study of organizational development Language Access Intervention Table 10 shows the types of interventions employed by four of the participating clinics. Two of the clinics involved failed to produce consistent data reports. Measurement of intervention impacts for those clinics relied on key informant interviews. The decision to examine how the organizational interventions may have influenced STD rates was driven by our work with family planning clinics for the past 10 years. Clinic administrative leaders and other staff who have been working on linguistic disparities have been struggling to understand if changes in language access influence patient clinical outcomes. This analysis of patient outcomes was a secondary aim of the study because the time period and resources of the study were not designed for a comprehensive and rigorous assessment. Given prior research and the study teamâ&#x20AC;&#x2122;s experiences with organizational interventions, it did not seem that 6 months to 1 year of time would be sufficient to all most clinics to fully establish comprehensive interventions with the potential of influencing patient outcomes. However, we designed an approach that might be most sensitive to changes related to the organizational interventions. The target patient group was LEP Latinas aged 40 years or younger. This patient group would be most common of LEP groups across the participating clinics. STD rates were selected as the common outcome because both our clinical advisors and prior research indicated that they may be sensitive to improvements in language assistance services.

Analyses were based on patient records from the participating clinics from December 2010 thru March 2012. This period would provide a long enough baseline (at least 3 months) and long enough follow-up (6 months or more) for both Groups A and B to determine potential changes due to each clinics organizational intervention. STDs included chlamydia and gonorrhea.

Clinics were asked to provide monthly STD rates for Latinas in the target age group. If the clinic had information on LEP status, they were asked to provide that information too. Analyses examined each month during the target period as a cross-sectional sample. Given this design, it is possible that some Latinas are represented more than once during the target period, but this was considered to be relatively rare (less that 10%) by the participating clinics. Of the six clinics, four were able to provide all the necessary information for the analysis. Of the two clinics that were not included in this analysis, one grouped chlamydia and gonorrhea along with other conditions into one category called â&#x20AC;&#x153;STIâ&#x20AC;? and the other clinic used a reporting system that could only provide semi-annual aggregate data for the target STDs and not separately for Latinas.

Descriptive analyses were run to examine frequencies of specific variables across clinics. Tables 11 and 12 describe the number of patients, patient languages, races, and ethnicities that clinics serve by site for each STI. Patients could choose more than one language and ethnicity/race, so percentages may add up to greater than 100%.

The two larger sites (Clinic 3 and 4)) had a larger proportion of Latinas among their overall patient population for patients with chlamydia and gonorrhea than the two smaller sites. The examination of the descriptive data for the participating clinics indicate that there were differences in how some clinics categorized Latino and Hispanic patients that may have resulted in an undercount of actual patients of that ethnicity.

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Analysis of Change in Monthly STD Rates was conducted by running one-way repeated measures ANOVAs to examine significant relationships across and within sites for patient monthly STD screening rates. No significant relationships (P> 0.05) were found within each site. The rates across participating sites are described in Tables 13 and 14.

Discussion The language access intervention induced efficiencies in some participating clinics evidenced by perceptions of staff at the clinics that reflected on improved management of patient flow and increased patient volume. However since the intervention coincided with some of the clinics transitioning to electronic medical records that undoubtedly contributed to increased efficiencies.

However, none of the participating clinics showed improvement in patients’ outcomes measured by increased testing for STDs for Latina CVP patients.

We attribute the results to the fact that interventions selected by participating clinics did not take into account the interconnectedness of the levers of change in an organization (its internal infrastructure, people and external environment). Action steps implemented in one domain needed reinforcing and supporting actions in the other two domains to ensure effectiveness. For example, when a clinic chooses to develop language access goals, measurable objectives (internal infrastructure), such action became useless because it was not accompanied by equal efforts to incorporate evaluation of disparities by language in its patient population as well as in the external environment, and staff accountability and oversight to achieve those goals.

An integrated mainstreaming approach of language access need to introduce change on a multidimensional level and language access considerations must be integrated within each level in order to be effective. In our study, none of the clinics targeted all three leverage points of intervention; internal environment, people and external environment. Interventions targeted only one or two leverage points without taking into consideration the interplay between these three dimensions in an organization: internal infrastructure, people and external environment.

There is a dynamic interplay between situational and personal factors within an organization as well. So to effect change within an organization, there is a need to integrate efforts that are staffcentered and target modification of behaviors and practices with environmentally-focused interventions that enhance organizational systems. Similarly, when instituting policies and procedures to identify, document and assist patients who are communication-vulnerable (internal environment) a clinic must ensure training of staff about these policies, enforcing implementation by including benchmarks in staff performance evaluations (People), and reaching out to the community to disseminate affirmative messages that these policies exist and the clinic provides a welcoming environment. A clinic which institutes language access policies and affirmative patient’s Bill of Rights but fails to fortify and reinforce such action in the internal infrastructure with similar actions in the people domain and external environment so as to neutralize the impacts of hostile local policies on access of patients and behavior of its staff is unlikely to see improvement in patient’s overall health outcomes or a realization of its mission to provide quality care. The community climate can have tremendous impact on a health center’s ability to attract and retain foreign-born patients and the extent these patients can access healthcare services. In recent years, several New York municipalities have considered or enacted local ordinances intended to force undocumented immigrants and their families to leave.

Immigrants have become distrustful of local government and fearful of accessing services.

Reinforcing and supporting measures may include training, sensitizing, oversight, accountability measures for staff and consistent linguistically and culturally appropriate outreach programs that 35

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address fear and apprehension to access services in its communities. A clinic that continues to capture data on language assistance needs ought to incorporate evaluation mechanisms that use this data collected to assess disparities in communication vulnerable patient population and implement corrective actions when disparities exist. It needs to incorporate staff training to assess patient satisfaction. Clinics do not exist in a bubble but are significantly affected by the context in which they operate. The high level of satisfaction expressed by clinics in their ability to serve patients is both gratifying and troubling; gratifying because there is a sense of self efficacy, but troubling because such sense of efficacy is misleading when considering the health indicators in communities some of which suffer the worst health indicators in the State in terms of teen pregnancy and STD infections. High levels of disparities exist in ethnically diverse and communication vulnerable residents. A clinic needs to measure its success in relation to the health of the communities it serves.

Overcoming linguistic disparities entails a deliberate proactive approach that consistently and systematically evaluate CVP’s outcomes before, during and after services are provided.

Mainstreaming occurs at the point of intersection of the three levers of change: internal infrastructure, people and external environment. Access can only be mainstreamed or weaved into the fabric of an organization when the three levers of change support and reinforce each other. Language access interventions need to be institutionalized within three domains; internal organizational infrastructure; people who drive the organization and the external environment.

A framework for mainstreaming language access includes the following components: Internal Infrastructure:  Leadership commitment to develop clear language access goals and measurable objectives; reinforce staff accountability; identify gaps through integrating language access in audits, quality improvement programs and patient satisfaction surveys, and include language access in budgets.  Solid policies and protocols that direct planning and actions, set priorities and guide dayto-day operations. They are widely used, accepted and periodically evaluated and updated. Communication and monitoring strategies ensure that staff understands and consistently implements them.  Data captured, analyzed and used to implement corrective actions. Data systems record provision of language services during each visit; patients’ decision to decline or refuse an interpreter, patients’ satisfaction, and patients’ health outcomes. Baseline data on LEPs are monitored and evaluated over time.

People  Staff reflects the communities served.  Staff interpreters are proficient in the languages used as well as in medical terminologies.

External Environment  Linkages with the external health economy. “Learning organizations” do not exist in a bubble, but proactively engage their communities (O’Conner et. al., 2008). Community partnerships leverage resources, and enables service of hard to reach communities through trusted cultural and linguistic brokers. Outreach and service levels must be responsive and tailored to the magnitude of need in a community. Health indicators of community members must inform levels of outreach and service.

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Conclusion The language access intervention introduced and tested in this study induced efficiencies in some participating clinics in the area of patient flow and management, but none of the participating clinics showed improvement in patients’ outcomes measured by increased testing for STDs for Latina CVP patients. This is attributed to the limited focus of the interventions that each clinic opted to adopt. An integrated mainstreaming approach of language access must introduce change on a multi-dimensional level. Language access considerations must be integrated in three leverage points of intervention; internal environment, people and external environment. The interconnectedness between these three dimensions means that the positive impacts of reforms in a single domain can be thwarted by lack of positive interventions in other domains.

References Apostolou, F. (2009). Mediation, manipulation, empowerment: Celebrating the complexity of the interpreter’s role. Interpreting: International Journal of Research and Practice in Interpreting, 11(1), 1–19.

Bahadır, Ş. (2010). The task of the interpreter in the struggle of the other for empowerment: Mythical utopia or sine qua non of professionalism? Translation and Interpreting Studies, 5(1), 124-139.

Derose, K., Baker, D. (2000). Limited English Proficiency and Latinos’ use of physician services.

Medical Care Research and Review, 57(1), 76‐91.

Glanz, K., Rimer, B and Viswanath, K. (2008) Health Behavior and Health Education: Theory, Research and Practice. Jossey Bass.

Hale, S. (2008, March). The use of interpreters in courts and tribunals. Paper presented at the AIJA Conference.

Retrieved from http://www.aija.org.au/Interpreters%2009/Papers/Hale%20PPT.pdf Hampers LC. et. al. (1999). Language barriers and resource utilization in a pediatric emergency department. Pediatrics, 103(1), 1253.56.

Morris, R. (2010). Images of the court interpreter: Professional identity, role definition and self‐image.

Retrieved from http://www.ruth-morris.info/wpcontent/uploads/2010/03/ImagesTIS2010.pdf O’Connor, Nick, Kotze, Beth. (2008). Learning Organizations: A Clinician’s Primer. Australasian Psychiatry. Vol. 16, No. 3.

Rand Corporation. (2007). Language Access Services for Latinos with Limited English Proficiency: Lessons Learned from Hablamos Juntos. California, United States.

Refki, D; Anderson, K. and Gany, F. (2007). Conference Proceedings: New York State Conference on Increasing Language Access to Healthcare: Toward Effective National and State Policy Refki, D; Avery, M.; Dalton, A. (2013). Core Competencies for Healthcare Interpreters.

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Rudvin, M. (2007). Professionalism and ethics in community interpreting: The impact of individualist versus collective group identity. Interpreting, 9(1), 47–69.

The Common Wealth Fund. (2002). Providing Language Interpretation Services in Health Care Settings: Examples from the Field. New York, New York: Youdelman, M., Perkins, J. Retrieved from http://www.commonwealthfund.org/usr_doc/youdelman_languageinterp_541.pdf U.S. Department of Health and Human Services. (2000).Family Planning Services for Iowans from Diverse Cultures. (Family Planning” Healthy People 2010). Iowa, United States: Kahler, S. and Leeper, K. Youdelman, M. (2003, October). Providing Language Access in Healthcare Settings. Presented at the Working Together to Increase Immigrant Women’s Access to Reproductive Healthcare. Retrieved from www.albany.edu/womeningov/publications 37

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International Journal of Humanities and Social Sciences p-ISSN: 1694-2620 e-ISSN: 1694-2639 Volume 3, No 1, pp. 38-51, ©IJHSS

Effective Teaching in History: The Perspectives of History Student-Teachers Gideon Boadu Department of Arts and Social Sciences Education, University of Cape Coast, Ghana Abstract The effective teaching of History is a prime area of concern for most History teacher-educators.

This is because most History teachers do not adopt appropriate methods in teaching the subject.

Owing to this, most students describe History as a boring and dull subject. The study investigated the perspectives of History student-teachers on effective teaching of History. A focus group discussion was held with five final-year prospective History teachers. The findings revealed that at the pre-engagement phase, student-teachers perceived effective teaching as comprising the acquisition of content knowledge, knowledge of learners, adequate planning, and collaboration with other teachers. At the engagement phase, effective History teachers demonstrate mastery over content, show enthusiasm, relate lessons to students‟ prior knowledge, use multiple instructional methods and resources in conveying content, create a supportive learning environment, and use alternative assessment techniques. Also, at the post-engagement phase, it was found that effective History teachers are open to students‟ concerns after class, seek feedback from students, and update their knowledge in content and pedagogy. It was thus concluded that History student-teachers possess an appreciable level of understanding of what constitutes effective teaching of History.

Keywords: effective teaching, history, student-teachers.

Introduction Teachers are crucial elements in education, and effective teaching is the hallmark of every good teacher. Opinions, however, differ on what constitutes effective teaching. As such, there is grave difficultly in giving an apt portrayal of an effective teacher as opinions on who an effective teacher is are many and varied. The difficulty that arises in describing and measuring teacher effectiveness may partly relate to the “multidimensional, highly individualized, and seldomly observed” nature of teaching (Lumpkin & Multon, 2013, p. 288). Lumpkin and Multon (2013) argue there is no universally accepted stand on how effective teaching should be defined and how it should be measured. A possible causative factor for this “difficulty” is that different subjects are organised differently and also have differing approaches as regards inquiry and analysis (National Academy of Sciences, 2000). For example, the approach a History teacher may use to teach the 1948 Riot in Ghana, will certainly differ from how a Mathematics teacher would teach Algebra or how a Science teacher will teach Cell Division. In light of this, Oppong and Quan-Baffour (2014) affirm that History differs from most other disciplines in that its major preoccupation lies with the action of past people, and the significance and effects of those actions: a feature of History which apparently informs History teachers‟ instructional practices 38

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and decisions in the classroom. Again, different school and/or classroom environment as well as student characteristics can really make “effectiveness” a subjective phenomenon. For instance, a teacher who is said to be effective in one school setting may not attain a similar feat in another school due to situational differences which impact directly on the teacher. This presupposes that effective teaching is not attributable to only innate characteristics and abilities of teachers, but also to a supportive and conducive physical climate. Thus, the notion that subject matter knowledge and knowledge about methods of teaching alone is enough to ensure effective teaching cannot hold. Even though some teachers are naturally inclined to teach a variety of disciplines, their ability to do so goes beyond the possession of a set of general teaching skills (National Academy of Sciences, 2000).

The teaching of History can be a challenging experience due the abstract nature of the subject. The abstractness lies in the fact that events in the past cannot be reproduced and reexamined for authenticity, and motives for which actions were taken are not open to physical examination and scrutiny. As such, Taylor and Young (2003) contend that History is a complex task encompassing the transformation of subject matter into a form that enables learners to gain meaning, while at the same time, retaining the integrity of the subject. It is for this reason Aggarwal (as cited in Ghansah, 2009) notes that the teaching of Social Studies and History for that matter requires more ingenuity from teachers as these subjects demand well prepared conscientious teachers of sound knowledge. Again, teachers of History need to possess a sound professional training in the theory and art of teaching and assessing the learning outcomes of students (Ghansah, 2009) so as to equip students with the “intellectual toolkit that will allow them to make connections with the past and make informed decisions about their lives in the present and in the future” (Taylor & Young, 2003, p. 177). Sadly, most teachers of History do not portray the subject as an exciting and interesting field of learning during lessons periods (National Academy of Sciences, 2000). Studies have shown that most History teachers are tied to using the traditional mode of delivery, with little or no innovation (Adeyinka, 1989, 1990; Oppong, 2009; Boadu et al., 2014). This could possibly be as a result of the fact that most History teachers are not exposed to, or trained on the tenets of handling the subject effectively, or that, teachers lack the commitment towards teaching the subject as it should be taught.

Effective teaching of History connotes, among other things, bringing the subject to life and making it appealing to the intellectual and emotional faculties of students. It goes over and beyond oral presentation or narration of events, or the use of lectures, but embraces a complex mix of overarching understanding of content and the art of teaching. This understanding is paramount in creating an environment in which students can gain mastery over historical concepts as well as improve their skill of thinking historically. Thus, the uniqueness of the subject is that which should feed and inform teachers to adopt innovative approaches towards making their teaching effective.

Dimensions of Effective History Teaching Effective teaching is a much sought-after hallmark in education the world over. The high stakes in education and the unperturbed growth of knowledge presents a much more arduous challenge for teachers of all fields of academic scholarship to rise up to the changing trend by revamping their teaching strategies in order to add innovative and creative dimensions to their mode of delivery. Effective instruction has a bearing on the interest of students and their motivation to learn History, influences students to make critical judgment on Historical issues, and understand current events in the appropriate historical context (Noboa, 2013). This notwithstanding, it can be multifarious, demanding, frustrating and energy-sapping. To quote Grant and Gradwell (2009), effective teaching “…is challenging, nuanced, and highlycontextualized work” (p. 19). Fogo (2014) observes that effective teaching of History is less likely to occur in a traditional History classroom setting “where curriculum covers wide expanses of 39

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time, teachers provide content-heavy lectures, and students take notes and scour textbooks to put facts to memory” (p. 153). It is more than knowing how to teach „anything‟, but calls on History teachers to be proactive and goal-oriented in the discipline.

This notwithstanding, teachers need not become experts in teaching before they can teach effectively. This is because expertise can sometimes mar teaching as many experts lose sight of what is easy and what is difficult for students (National Academy of Sciences, 2000).

Being an expert, thus, does not guarantee effective teaching. World Health Organisation (WHO) (2005) is of the view that effective teaching is acquired through learning but not inherent at birth.

Arguably, the basic step towards effective History teaching is knowledge about the concepts underpinning the subject. As Yilmaz (2008) argues, History teachers should possess a firm grasp of the concepts that form the foundation of the History subject. Teachers‟ knowledge must cut across the “substantive” and “syntactic” aspects of History, that is, “the structure of the discipline, its different modes of historical explanations, and the historical procedures and skills needed to construct explanations about the past” (p. 41) as well as the “generic and subjectspecific pedagogical knowledge that helps the teacher transform the subject matter knowledge into effective learning experiences for students” (Yilmaz, 2008, p. 42). This understanding is necessary as it would make students appreciate the different dimensions of the subject, as well as help them understand the complexities of past human experiences. An effective History teacher, therefore, deeply understands the structure and epistemologies of the discipline, and also knows the activities to adopt to aid students‟ understanding of the subject (National Academy of Sciences, 2000). Stated differently, effective History teachers‟ knowledge and beliefs about the subject and its structure deeply correlate with their instructional strategies. Rather than a simplistic introduction of a heap of facts to be memorised, such teachers help students to make meaning out of the problem of interpretation and analysis in History in order for students to gain appreciation of the relevance of History in their daily lives (National Academy of Sciences, 2000). Therefore, “teachers need to give students good reasons for learning, help them define what they need to learn, help them organize and make sense of what they should learn, ensure student participation, make the learning environment interesting, give students plenty of opportunities for practice, and let them know how they are progressing” (WHO, 2005, p. 9).

Taylor and Young (2003) underscore three outstanding characteristics of effective History teaching. According to them, effective History teaching encompasses knowing History, doing History, and scaffolding learning. This means that understanding the theoretical and conceptual underpinnings of the subject, the processes of historical reconstruction, as well as projecting the discipline in a context and manner that facilitate subsequent learning are at the core of historical pedagogy. Again, effective teaching requires that teachers become ambitious.

Ambitious teachers, as Grant and Gradwell (2009) observe, have a good depth of understanding regarding their subject matter and consciously seek ways of connecting the subject matter to students‟ experiences. They employ “new teaching methods, alternative assessments, and flexible student groupings” (p.7), but these in themselves do not make teaching effective if they are not linked to vigorous learning among students. This view confirms the assertion that teaching is said to have taken place only after learning has occurred. Effective History teaching thus involves teaching in no single pattern, taking no single shape in teaching, and assessing students in no single fashion (Grant & Gradwell, 2009).

Owoyemi and Adesoji (2012) allude to three key characteristics of effective teachers; personal qualities, teaching skills and subject matter mastery. They write; When personal qualities are emphasized, effective instructors are described as enthusiastic, energetic, approachable, open, imaginative and possessing a high sense of humour. When teaching skills and mastery of 40

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subject matter are emphasized, effective instructors are described as being masters of the subject matter, organized and emphasizing important concepts, able to clarify ideas and point out relationships, able to motivate students, able to pose and elicit useful questions and examples, creative or imaginative, and reasonable and fair (p. 169).

Hoge (1988) observes that sensitive History teachers are abreast with the difficulties that come along with the over-reliance on textbooks. He however contends that even when the textbook dominates instruction, it is still possible for students to relish and appreciate History lessons. According to him, teachers who are successful with this method put in place “steps to accommodate the varied reading abilities of their students; make sure that vocabulary, conceptual, and experiential foundations are laid prior to reading; and vary reading assignments and routines to help break the boredom of needless repetition” (p. 2). Going on, Hoge argues that teaching about the past would be very much enhanced with the careful and meaningful integration of sounds, images of videotapes, films, filmstrips, and trips to historical sites. Noboa (2013) sought from History teachers the methods and approaches that made them effective.

Responses indicated, among other variables, that the use of a wide variety of approaches such as group or collaborative work; real-world projects; a variety of visual aids; interactive assignments and technology tools (computers, the internet, and the interactive white board) were effective means of teaching the subject. Other approaches such as straight lecturing, reading, and answering questions from textbooks were regarded as less effective means of teaching the subject. Young and Shaw (1999) studied the profiles of effective college and university teachers and revealed that effective communication, comfortable learning atmosphere, concern for student learning, motivation, course organization and course value were the criteria used to measure teacher effectiveness.

In a summary of an extensive literature review on effective teacher practices, Lumpkin and Multon (2013) described effective teachers as those who “(a) use a variety of instructional approaches, (b) engage in professional endeavors and developmental activities to enhance their teaching, (c) seek feedback from students and made changes in instruction in response to this feedback, and (d) value the interrelationship between teaching and research…” (p. 292; 293).

Similarly, Feldman (1976) reviewed literature on college students‟ views on superior college teachers and made the following conclusion on the characteristics of superior teachers: (a) ability to stimulate students‟ interest, (b) presentation clarity, (c) subject matter knowledge, (d) preparedness, (e) enthusiasm, (f) relationship/interaction with students, and (g) availability.

Studying Asian students‟ perceptions of a good college or university teacher, Lee et al. (2009) discovered three categories of dimensions that students used to assess a quality teacher. Teachers in the first category showed characteristics such as subject matter knowledge, preparation and organisation of subject content, and fairness towards students. The second category of quality teachers were found to show concern and respect for students, exhibited clarity of presentation, and showed enthusiasm and helpfulness to students. Presenting material in an interesting way; encouragement of independent thought; frequent feedback; clear statement of objectives; friendliness, and approachability were the characteristics of teachers in the third category.

Though the study concluded that quality teachers are those whose possess mastery over subject matter, Lee et al (2009) were of the view that knowledge itself does not make one a good teacher but rather, the combination of knowledge of subject matter with other variables such as preparation of teaching material, setting of clear objectives, enthusiasm, and ability to present learning materials clearly, that make an effective teacher. This implies that effective teaching involves a multiplicity of variables, but all these variables rest, and are highly dependent on the depth of the teacher‟s knowledge.

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In another study by Koutrouba (2012) on the profile of an effective teacher in Greek secondary schools, it was found, among other variables, that effective teaching occurs in classrooms where teachers involve learners in multiple learning procedures; implement effective modes of communication to convey content in an understandable manner; respond to students‟ needs during instruction; build a rich teacher-student interaction; ensure productive classroom management; and exhibit compassion, concern, helpfulness, and a sense of humour. Again, effective teachers, according to the study, have interest in students‟ prior knowledge, simplify learning materials to meet students‟ individual needs, respect diversity, employ democratic procedures, and encourage feedback. Similarly, Lumpkin and Multon (2013) studied faculty perception about effective teaching. They found that building respectful relationships with students; showing enthusiasm; being humorous; being responsive to student‟s needs; knowing students‟ names; and being sensitive to time through class organization, are instances of effective teaching practices. Again, responses indicated that teaching fellows emphasized student learning by taking into account the learning styles of students. They achieved this by setting clear expectations and goals; providing timely feedback; using varying approaches for presentations, as well as using a multiplicity of instructional methods. Faculty members amended their instruction based on comments received from students during course evaluations. They also offered encouragement to students regarding assignments and examinations through personal interactions to provide constructive feedback. The study concluded that multiple methods of teaching are effective for teaching, and that, highly effective teachers use different instructional strategies in teaching to boost learning among students.

In a survey on the core practices for teaching History in Delphi, Fogo (2014) found several practices that could enhance effective teaching. These included the selection and adaptation of historical sources; supporting historical writing; supporting historical reading skills; utilising historical questions; assessing students‟ thinking about History; facilitating discussion; engaging students in historical research; using historical concepts; and making connection to individual cultural experiences. In the face of the rapid growth of knowledge, it is germane that History teachers continuously update their knowledge in both content and pedagogy in order to be at par with the new development (Yilmaz, 2008). Yilmaz (2008) explains that since content and pedagogy constantly change and grow, it is necessary for History teachers to be part of professional organisations, read research papers, and participate in professional gatherings such as workshops and seminars so as to be abreast with the latest developments in theory and research.

The preceding literature gives enough credence to what constitutes effective History teaching. It could be gathered that the core of effective teaching of History is the possession of a firm knowledge base in History and the skill to convey this knowledge in ways that are meaningful to students. Other dimensions include creating an atmosphere to enforce students learning; using a variety of student-centered methods; use of appropriate instructional materials (films, filmstrips, audio-visuals); use of appropriate assessment procedures; use of technology tools; provision of feedback; efficient classroom management; instructional clarity; active engagement of students; catering for students‟ varying needs; supporting students‟ progress; building on students‟ prior knowledge or personal experiences; building a healthy relationship with students; enhancing students‟ imaginative abilities; having a sense of humour; and being at par with knowledge growth. These dimensions are proved by prior studies as contributing positively to effective teaching.

Research Focus Knowledge about what constitutes effective History teaching is fundamental to the formation and training of prospective History teachers. This is because their effectiveness on the 42

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field after their training will depend on how they perceive their roles as effective teachers of History. It has been established that different subjects have differing approaches as regards inquiry and analysis. As such, even though the concept of effective teaching may be deemed applicable to most disciplines, different disciplines may require different approaches to teaching.

This study holds that the teaching process begins before the classroom encounter and continues even after classroom instruction. As such, the study operates with the implicit rationale that effective teaching is not tied to only the lesson delivery stage, but embraces other teacher activities which take place within and without the classroom and school environment. The study therefore explores History student-teachers views on what effective History teaching entails in three stages of teaching, that is, pre-engagement phase (before class hour), engagement phase (during class hour), and post-engagement phase (after class hour). The findings of the study would inform History teacher-educators on strategies to adopt to restructure and consolidate the training of History student-teachers in such a manner that they would be better placed to teach the subject effectively after their training. By this, there is every possibility that the subject which is becoming increasingly unpopular among Ghanaian students would be resuscitated to take its rightful place in the school curriculum.

The Method The study adopted an interpretive constructivist approach to investigate History studentteachers‟ perceptions of effective teaching of History. The intention for adopting this approach was that it helps researchers to discern the views, perceptions, and reactions of participants towards the phenomenon under study (Fraenkel & Wallen, 2006). By this, the researcher was able to understand the meaning of participants‟ experiences and how they made sense of such experiences (Grbich, 2007). Consequently, the approach helped to “develop a more overtly interpretative analysis”, which helped to position “the initial description in relation to a wider social, cultural, and…theoretical context” (Larkin et al., 2006, p. 104). The population for the study comprised all final-year History teacher trainees in the University of Cape Coast. The rationale behind the choice of the final-year students was that they have had adequate exposure to the content, concepts and theories underlying the teaching of History as a subject. Again, they had undergone the field experience in teaching (practicum) and experienced the practicality of teaching the subject. The simple random sampling technique (lottery method) was employed to select five (5) final-year students to serve as the sample size for the study. This was in line with Boyd‟s (2001) position that participants ranging from 2 to 10 are enough to make a qualitative study saturated.

Since the study was qualitative in nature, data was collected by means of focus-group discussions with the five student-teachers, guided by a semi-structured discussion guide. The instrument was designed by the researcher, based on the key issues emerging from the literature. In all, the discussion guide was made up of three sections, each section addressing one of the key stages of teaching. Also, under each section, major and sub-questions which were mainly open-ended were outlined to address issues which were of specific interest to the study. This helped to keep discussions within the scope of the study. Apart from this, probing questions were employed to further obtain thorough understanding of participants‟ views and experiences. The discussions were held at the closing stage of the second semester of the 2014/2015 academic year. A convenient time was fixed at which all participants were present to take part in the discussions. All discussions were taped and transcribed into text so that the exact expressions of participants could be preserved.

Thematic analysis was then used to present the findings. The findings were backed with inferences drawn from the literature.

Results and Discussion

Effective Teaching Practices at the Pre-engagement Phase 43

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The perspectives of History teacher-trainees on effective teaching practices at the preteaching stage were sought. Responses showed that student-teachers perceived the acquisition of subject content knowledge and its philosophical basis, knowledge about students‟ characteristics, as well as good planning as comprising effective teaching practices before classroom engagement. In relation to content, respondents indicated that for effective teaching of History to take place, teachers must acquire adequate levels of content knowledge before they go to class.

A respondent remarked that “a History teacher has to read thoroughly before going to class so that he or she would be abreast with what he or she is going to teach”. Another respondent said that “at the pre-engagement phase, as a History teacher, you have to read a lot about what you are going to teach and gather all the available resources to make the teaching effective”. These responses suggest that effective teaching of History implies that History teachers should arm themselves with the subject matter even before the class hour. This entails reading far and wide around the subject. With History in particular, History teachers need to read from a variety of sources and accounts in order for them to be well positioned to integrate the different historical accounts to make students gain understanding and appreciation of the past. Beside the subject content, respondents conveyed that there is the need for History teachers to understand the rationale and philosophy of teaching the subject as well as possess knowledge about other disciplines before they go to teach. They intimated that knowledge about the concepts, principles, theories and philosophies governing the subject is crucial for effective teaching to take place. In response, one participant noted; “The philosophy behind History teaching should come to bear. The teaching of the subject involves some technicalities and so teachers should know the philosophies so that they can really teach well”. One other respondent said that it is also necessary for History teachers to know their personal philosophies of teaching, and combine them effectively with the content to be taught. In her own words; “Every History teacher must have his or her philosophy of teaching. Understanding content is important, but understanding content in a way that buttresses their own conception and theorisation of the teaching of History is more important to ensure teacher effectiveness”. This affirms the position of Yilmaz (2008) who argued that History teachers must possess a firm understanding of the concepts that form the foundation of History, as well as the “generic and subject-specific pedagogical knowledge that helps the teacher transform the subject matter knowledge into effective learning experiences for students” (p. 42). This means that effective History teachers are those who know History, do History, and scaffold learning (Taylor &Young, 2003).

On knowledge about other disciplines, respondents were of the view that since History integrates knowledge from other subject areas, teachers should have knowledge of other disciplines like Geography and Economics in order to be well placed to teach certain topics effectively. This view is buttressed by Oppong and Quan-Baffuor (2014) who put forward that the facts of History are integrated with the facts of other related subjects like Geography, Sociology, Government and Economics in the use of concepts, knowledge, generalisation, theories and skill such that there is no way History can be taught without elements of other subjects. Again, respondents revealed that History teachers must get to know the various methods of teaching, the type of learners, and the context within which learning is to take place.

“The teacher has to know the variety of teaching methods available and which of them is effective in what situation. One also has to know the learners and the society in which the learning is taking place as well as the country’s own context. The knowledge of the content, knowledge of learners, and knowledge of methods should all come together to give the teacher a collective understanding of what he is supposed to teach in the classroom”, a respondent remarked. The forgoing results indicate at the pre-engagement phase, History teachers have to gain a broad view of the subject, “a firm understanding of its concepts, principles, values, theories, generalizations” (Ababio, 2013, p. 42), the various schools of thought on the subject, how the subject is integrated with other disciplines, the methods of teaching, learners and the context in which learning will take place. Effective History teachers, thus, understand the structure of the discipline, and also know the activities to outline to aid students‟ 44

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understanding of the subject. Their knowledge and beliefs about the subject and its structure match with their instructional strategies (National Academy of Sciences, 2000). This, therefore, means that it is necessary for teachers to read and study far beyond the level required for their lessons (Colin, 1969). This would “give students good reasons for learning, help them define what they need to learn, and help them organize and make sense of what they should learn” (WHO, 2005, p. 9). In relation to planning, respondents were of the view that effective planning during the pre-engagement stage will culminate in effective teaching of History. According to them, planning will bring orderliness in classroom procedures, make lesson presentation systematic, and maximize instructional time. One respondent indicated that “planning will make the History teacher deliver the content systematically. The History teacher should plan on the specific objectives to be set so that the students would know where they started and where they are going”. Another respondent remarked; “planning helps a lot in the teaching process because …you know the amount of time you spend with each topic and it makes you move on smoothly… such that before you move on to another topic, the students would have grabbed what you are teaching”. Responses further revealed that as part of planning, teachers should set clear lesson objectives and select appropriate teaching resources to accompany instruction. These objectives should be stated in ways that will help measure the achievement levels of learners at the end of the lesson, and should cover broad areas such as the cognitive and affective domains as well as help improve the writing skill of students. In the words of one respondent; “Teachers should set clear, measurable and achievable objectives and also give projects that will bring to bear the writing skill of students”. This means that planning of instruction, in the view of the student-teachers, is crucial to effective teaching of History. The finding, thus, reinforces Friesen‟s (2009) assertion that effective teaching is initiated by thoughtfully designing lessons that stimulate students intellectually and academically. On teaching resources, there was a unanimous view that planning on resources will help reduce the abstractness associated with the teaching of History. This means that making decisions on which objectives to set for a lesson is important to effective teaching since objectives serve as the pointers that guide the teaching process. Also teaching resources serve as vehicles by which teachers can effectively convey content knowledge to students. Respondents moreover disclosed that before class hours, it is germane that History teachers consult other teachers on strategies to enhance teaching. This was deemed very important, especially, for new History teachers, because of the multi-dimensional character of History. “History is the mother of many disciplines and so teachers should tap from the knowledge of other teachers on various topics on which such teachers have expert knowledge”, a respondent remarked. Doing this will invariably contribute to making History teaching effective. This concurs with Friesen‟s (2009) view that teachers must improve their practice in the company of other teachers.

The above discussions reveal that in the view of student-teachers, effective teaching of History begins at the period before classroom engagement. Here, History teachers acquire adequate subject matter knowledge, understand the philosophical and theoretical positions on the subject, understand learner characteristics, plan adequately in terms of lesson objectives, methods of teaching, resources to use, and also consult other teachers on strategies to improve instruction. These, in the perspective of History student-teachers would present the necessary conditions for the effective teaching of History.

Effective Teaching Practices at the Engagement Phase

The views of the respondents indicated that at the engagement phase of teaching, History teachers are supposed to show that they have in-depth understanding of the content they are charged to deliver. It was revealed that having acquired content knowledge at the preengagement phase, teachers are to demonstrate that they have mastery over the subject matter by looking at historical events from different viewpoints, and by citing relevant examples to season the points they discuss in class. This was made evident in the words of one respondent; “During 45

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the engagement stage, the teacher has to demonstrate that he or she has acquired mastery over the subject matter.

He or she should be able to cite relevant examples to buttress his or her points, and apply multiple perspectives in teaching the subject”. This suggests that History student-teachers conceived effective teaching of History as involving the application of a multi-perspective approach to view past events. By this, teachers explore the different perspectives historians have about certain historical events in order to enable students appreciate the varieties of interpretations on historical actuality. It was again found that effective teachers demonstrate zeal and enthusiasm in delivering the subject matter to students. A respondent asserted; “I think the way the way the teacher is happy teaching the subject also contributes to effective teaching. History teachers should be enthusiastic and optimistic in teaching. It should not look like the course has been forced on them to teach”. Respondents further revealed that for teachers to demonstrate that they have acquired content knowledge, they must be able to respond to students‟ questions effectively and also redirect questions back at students. The point here is that History teachers must be able to communicate content in ways that facilitate students‟ understanding. Additionally, the content that is taught in class must be related to students‟ background knowledge and experiences. One respondent disclosed that “it may be that students have some knowledge about the lesson. So it is necessary for students’ knowledge to be sought when teaching”.

Effective teaching, in this case, implies seeking the prior knowledge of students in order to make the lesson proceed form the known to the unknown. This is in line with Grant and Gradwell‟s (2009) observation that ambitious teachers have a good depth of understanding regarding the content of the subject and consciously strive to connect the subject matter with students‟ experiences. It also confirms the findings of Koutrouba (2012) and Fogo (2014) that effective teachers are those who care about students‟ prior knowledge and connect lessons to students‟ personal or cultural experiences. Respondents thus perceived that effective History teaching involves integrating students‟ experiences and tailoring lessons along the things students already know.

Regarding the methods and resources for teaching, respondents were of the view that effective teaching connotes the use of multiple methods and resources to convey content to students. Most of the respondents revealed that during the teaching period, effective teachers use methods that cater for the involvement of students in the classroom interaction. Teachercentered pedagogies, according to respondents, make students passive in class. As such, if a teacher realizes that one particular methodology is not helping students‟ assimilation, he or she has to switch over to other methods that will make students participate “fully, actively and consciously in what transpires during the period of teaching” (Boadu et al., 2014, p. 208). A respondent intimated; “…as a teacher, you should know that your students have diverse ways of learning and different levels of conceptualisation. Sometimes when you use only the lecture method, students find it difficult to understand. So you have to vary your teaching methods, reinforcement strategies, and teaching resources so that it will cater for diversity in the classroom”. This points to the fact that effective teaching of History involves the use of learner-centered pedagogies to make students identify with past events and motivate them make personal judgments based on evidence. The function of the teacher is to act as a guide to help students to explore and share the past in a manner that appeals to the emotions and intellectual faculties of the learner. The use of multiple methods to enhance History teaching, hence, conforms with the findings of Koutrouba (2012) and Lumpkin and Multon (2013) that multiple methods of teaching are effective for teaching, and that effective teachers use multiple instructional strategies in teaching subject content in order to meet students‟ individual needs and cater for diversity. It also relates to the view that effective teaching of History is less likely to occur in a traditional History classroom setting where teachers give “…content-heavy lectures, and students take notes and scour textbooks to put facts to memory” (Fogo, 2014, p. 153). On the use of multiple resources, respondents asserted that multiple resources reduce the abstract nature of History. “They help the students to have a feel of how past incidents actually happened. For instance, taking student to the castle when teaching on the slave trade creates a 46

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live situation for them. So the varying of resources is important for the effective teaching of History”, a respondent remarked. Hoge (1988) shares a similar view that teaching about the past is enhanced with the careful and meaningful integration of sounds, images, films, and field trips to historical sites. Noboa (2013) also confirms that the use of a wide variety of approaches is indispensable to effective teaching of the subject.

It was again revealed that effective teaching connotes ensuring a conducive, comfortable, and supportive learning environment. This is because effective teaching cannot take place when the class is noisy or when there is a disruptive behaviour of some sort. “The environment in which the interaction takes place is very necessary so teachers have to make sure that the place is conducive and good enough for students to participate in the lesson”, a respondent disclosed. This relates directly to classroom management. Respondents pointed out that effective History teachers are democratic in managing their classrooms. Such teachers set rules with students to guide the behaviours of students. Therefore, if History teachers are able to manage the classroom effectively, there will be less disruptive behavior and effective teaching can take place because all attention will be directed toward the teaching and learning process. This falls in line with Young and Shaw‟s (1999) position that conducive learning environment and learner enthusiasm are key to measuring teacher effectiveness. Similarly, the result consolidates the finding of Koutrouba (2012) that building a rich teacher-student interaction, and ensuring productive classroom management contributes to effective teaching.

Regarding the forms of assessment in History, student-teachers posited that in order to ensure effective teaching of History, there should be class exercises and assignments at the end of every lesson to inform teachers on whether what they taught has been assimilated or not.

Responses showed that to the student-teachers, assessment in History should be based on both multiple choice and essay-type tests. They explained that multiple choice tests will make students read wide in an attempt to score high marks while essay-type tests are necessary to improve the writing skills and communicative skills of students as well as develop students‟ critical thinking abilities and imaginative faculties. This is because one of the important dimensions of effective teaching of History is that it must activate the imaginative ability of the student. In the words of one respondent; “Effective History teachers vary their assessment strategies and procedures. The questions they ask are not always the recall type. They also ask High order questions to make students add their own judgments to what is given them in class”. This implies that student-teachers perceived that effective History teachers use alternative assessment strategies and combine low and high order questions to create a balance and ensure a holistic development of students. This, in their view, ensures learning on the part of students and thus contributes to effective teaching of History. Hence, Friesen‟s (2009) assertion that assessment practices must clearly focus on enhancing students‟ progress in learning, is confirmed.

From the foregoing, it is evident that History student-teachers perceived that effective teaching of History at the engagement phase embraces demonstrating mastery over the subject matter, teaching events from multiple viewpoints, demonstrating enthusiasm in content delivery, responding to students‟ questions effectively, relating lesson to students‟ prior knowledge, and using multiple learner-centered methods and resources in conveying content. Again, studentteachers opined that effective teaching of History involves managing the classroom effectively in order to ensure a conducive and supportive learning environment, as well as varying assessment techniques to cater for all levels of learner abilities in the classroom. The above confirms the view of Lee et al. (2009) that subject knowledge itself does not make one an effective teacher but a combination of knowledge of subject matter with other variables such as preparation of teaching material, setting of clear objectives, enthusiasm, and the ability to present learning materials clearly, that come together to make teaching effective.

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Effective Teaching Practices at the Post-engagement Phase

History teachers‟ work continues even after the classroom interaction has taken place.

The effectiveness of the teacher outside the classroom environment can therefore be brought to scrutiny. At the post-engagement phase of teaching, respondents mentioned that teachers should continue to show love and pay attention to students‟ concerns. They said that where there is a genuine need, History teachers have to attend to those needs since all the needs and concerns of students cannot be met in the classroom. One respondent, for instance, intimated that “sometimes, the period is not enough to achieve all objectives, so if students come after class, the teacher has to show them care, concern and attention by explaining the lesson more or giving them some task to do”. This means that effective teachers make time after instructional periods to give extra attention to students who have concerns on the lesson taught or to even discuss non-academic issues. By this, students feel a sense of belongingness and are encouraged to approach the teachers on any problems they might face. This is closely tied to how approachable teachers are. Effective teachers convey a warm and positive outlook such that students feel at ease to approach them. A respondent disclosed that “as a teacher, you serve as a parent in the school and so you have to be approachable. When students like a teacher, they do very well in the teachers’ subject but once you make yourself inapproachable, students lose interest in your subject”. This suggests that an open and healthy interaction with students can lead to positive attitude towards the subject, meaning that likeness for a teacher can result in likeness for the teacher‟s subject. The self-image that is conveyed by teachers therefore serves as an additional motivation for students to put up better performances in order to continue winning the attention and care of teachers. In the view of the respondents therefore, effective teaching, at the post-engagement phase, connotes opening up for students and attending to their concerns after class hours. This affirms the standpoints of Young and Shaw (1999) and Koutrouba (2012) that effective teachers show concern for student learning, and exhibit kindness, mindfulness, helpfulness, warmth, patience, and responsiveness to students‟ needs and interests. Furthermore, this finding corroborates Feldman‟s (1976) view that teacher availability and relationship or interaction with students is key to effective teaching.

Responses further revealed that it is necessary for History teachers to seek feedback from students in order to restructure instruction. A respondent underscored the value of feedback by stating that, “sometimes, after teaching, it seems students have understood what you taught but when you give them exercises, assignments, and projects, you get to know their responses and decide to refine your teaching methods or resources… So feedback is necessary to ensure effective teaching”. This is an indication that effective teachers seek constant feedback from students in order to be well informed on how to strategise for their subsequent lessons. Lumpkin and Multon (2013), in this light, describe effective teachers as those who seek feedback from students and make changes in instruction in response to this feedback. At post-engagement stage also, respondents pointed out the necessity for History teachers to update their knowledge in terms of content and pedagogy. “As the world is evolving, things keep changing and new History books get published, So as a teacher, you need to update yourself constantly so that you will be abreast with time and at all times put your students at the forefront in terms of knowledge”, a respondent remarked. Another respondent said that “History teachers need to update themselves because the syllabus is updated very often with some topics removed and others added. When they update themselves History teachers, they will be abreast with these issues and prepare students to be at par with the tempest of the time”. This suggests that History teachers need to join associations that would inform them on the changing trends in teaching, and also attend conferences, seminars and workshops to be exposed to research findings on History teaching in order to upgrade their knowledge in content and pedagogy. This reflects Yilmaz‟s (2008) explanation that it is necessary for History teachers to be part of professional organisations, read research papers, and participate in career conferences in order to be abreast with the latest developments in theory and research. Likewise, it corroborates Lumpkin and Multon‟s (2013) description that effective teachers are those who engage in professional endeavors and developmental activities to enhance their teaching.

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Findings in relation to the post-engagement phase of teaching indicate that studentteachers conceived of effective teaching of History in the following ways: attending to students‟ concerns after class, being open and having an unconditional positive regard toward students, seeking feedback from students to revise instruction, and updating teachers‟ knowledge in content and pedagogy. Student-teachers, therefore, viewed effective teaching as a process that continues even after instruction has ended in the classroom.

Conclusion The study has revealed that in the view of History student-teachers, effective teaching practices occur at all three levels or stages of teaching. At the pre-engagement phase, it was found that student-teachers view effective teaching as involving the acquisition of subject matter knowledge, knowledge about the philosophies and theories on the subject, and knowledge about students‟ characteristics. Also, teachers are supposed to plan adequately in terms of lesson objectives, methods of teaching, teaching-learning resources, and also consult other teachers on how to improve instruction. This leads to the engagement phase, where according to studentteachers, effective History teachers demonstrate overarching mastery over the content, teach events from multiple perspectives, show enthusiasm in content delivery, respond to students‟ questions effectively, relate lessons to students‟ prior knowledge, and use multiple instructional methods and resources in transmitting content to students. Furthermore, at this stage, studentteachers opined that effective teaching of History embraces effective classroom management, creating positive and supportive learning environment, and using a variety of assessment techniques to cater for all domains of learning. At the post-engagement phase, it was found that effective teachers attend to students‟ concerns after class, are open and positive towards students, seek feedback from students, and constantly update their content and pedagogic knowledge.

The findings indicate that the perception of History student-teachers on effective teaching of History is linked to four out of the seven knowledge-base areas espoused by Shulman (1987). These are; content knowledge, general pedagogical knowledge, knowledge of learners and their characteristics, and pedagogical content knowledge. Using Shulman‟s Knowledge base as the standard, one could say that student-teachers understanding of effective teaching of History is somewhat deficient. However, care must be taken in drawing such a conclusion because the concept of effective teaching is in itself a broad one, involving the interplay of a multiplicity of variables, some of which are implicit. From another direction, when the findings are examined in connection with the input, process, and product variables (Goe et al., 2008), student-teachers‟ perception on effective History teaching could be seen as tilted towards the input and process variables. This is because the findings relate to how factors such as teaching methods, teaching resources, assessment procedures, classroom management, teacher personal qualities, teaching skills, and subject matter mastery impact on teaching both in and out of class. Thus, every desired and observed change in behaviour of learners achieved at the end of the teaching-learning process is the result of certain input and process variables employed by teachers in the teaching process (Sekyi-Acquah, 2009). It is these input and process variables that make it possible for a History teacher to be effective in carrying out the teaching mandate, and not only product variables. From the foregoing findings and argument, History student-teachers could be said to be possessing an appreciable level of understanding regarding what constitutes effective History teaching.

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