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Getting through the implementation dip: Find and hold onto your inspiration!

Holly and I just finished a 2 day skills-based health education workshop with some amazing educators in Maine. People left feeling excited, energized  . . . and a little overwhelmed. Making a significant change in the way you are teaching can be a daunting task, no matter how committed, passionate and ready you are! This can be particularly hard due to the “implementation dip” that we know occurs after learning new material.

The implementation dip refers to the phenomenon of the fact that you leave a professional development feeling confident and ready to make a change but then . . . when you go to implement your new learning, it isn’t as clear or as easy as it was in your head after you left the conference. In other words, you experience a dip. You begin to try out your new ideas and confidence drops a bit. Or you weren’t able to get started right after the PD and now you aren’t really sure where you should start or even how to start. This is the implementation dip.

implementation dip

The good news is, this is temporary – and you can move through it. Not only that, once you move through this dip, you often come out more confident in your new learning. Hold steady – it is important to not let this dip prevent you from moving forward! With all new learning and trying a new strategy comes bumps in the road. Just like we tell our students – you just keep trying, you will get there. Whether you recently attended a PD or are pulling from an event you attended before and are now trying to make the shift to a skills-based approach and are hitting some bumps along the way – read on!

One thing you need to remember is that change is hard and often uncomfortable because we are pushing ourselves outside of where we have become comfortable. This means you may feel overwhelmed, have lessons flop, look at an assessment you gave students and think “well – that didn’t go quite as planned”. You may find that you have trouble getting student buy in at first because they are unfamiliar with your new approach, or have difficulties convincing a co-worker about this new(er) way of teaching health. Don’t get discouraged!


Here are some strategies to overcome the implementation dip:

  • Find Your Inspiration – No matter what obstacles you face – it is key to find your inspiration and to leverage the support of your #SkillsBasedHealth #HealthEd community to keep moving forward!
  • Write Down your Goal/Plan – Maybe your inspiration is your students, your own professional growth, the approach itself, the challenge of making a change . . . whatever it is, write it down! We know from research that writing down and intention makes up far more likely to achieve it. Stick it somewhere that you can see it often so that it can serve as a reminder to keep going!
  • Seek out Support – There is no need to suffer alone. Reach out to us, join (or create) a learning network of teachers who are embracing a skills-based approach, review the materials, use social media such as twitter, Facebook, or Voxer to ask for support. There are lots of people willing to help and offer ideas.
  • Try something new – Sometimes the hardest part of getting started is to just DO IT. Be willing to be open with yourself and your students. Let them know you are trying something a little different and that you are all in this together. They will feed off of your confidence
  • Keep Skills as the Primary Focus – While this may seems like a no brainer (we know, we know), it is easy to get pulled back into the land of content because that is where we are/were comfortable. Refer back to the skill cues, consider the outcomes you want from your students, and then make a plan. If you keep in mind that everything you do in the classroom leads to student outcomes you are more likely to be thoughtful in the activities and assessments you select.

We can all get bogged down by life, dwell on our mistakes or failures and feel that we aren’t going to be able to actually make a change. But when we push through and persevere – that is the good stuff – that is progress, and growth and expanding our limits!

No matter where you are in the process, remember:

“Start where you are. Use what you have. Do what you can.” ~Arthur Ashe

Every change you make will lead to more changes and eventually you will reach your goal of being a kick@ss skills-based health educator!


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Fact or Fiction: Can Students Tell the Difference?

A recent article from NPR ( describes some startling new research about students’ inability to discern “fake news” from “real news”. It is really interesting how little awareness students seem to have – and not just younger students – all the way through college about finding valid and reliable information.

You probably see the connection coming already . . . this is yet another example of why it is so critical that we teach the skill of accessing valid and reliable information. Not only for their health but also for their roles as citizens! We cannot underestimate the importance of helping our students become informed consumers of information – all kinds of information.

Interestingly, I just completed an assignment with my undergraduate students in which I asked them to do research and advocate for their position on the ballot question of legalizing marijuana (it was timely as we did this the week before we voted on this ballot question in Massachusetts).  They chose their side and did their “research”. I noticed a few things from this activity:

  • • Their “research” involved finding things on news sites or other potentially biased websites
  • • They freely used “facts” that they found – whether or not they could verify those facts as actual truth or just “spin”
  • • There is a LOT of engaging, eye catching, funny, easy-to-read, easy-to-find information that is essentially someone’s opinion or version of truth and my students didn’t worry too much about using it

To be fair . . . in this case I was asking them to focus more on the advocacy side of things than the accessing valid and reliable information side of things . . . but still.

Then, I read one student’s reflection about the activity. Their rationale used the argument that when you try to advocate for something you say whatever you think your audience wants to hear in order to prove your point.

Huh . . .

This isn’t really wrong . . . but this also wasn’t the take away I was hoping for. I hoped it would help them see how easy it is to find information that confirms our own ideas, that sometimes “facts” aren’t facts, and that it can be hard to find actual truth as opposed to just versions of the truth spun to meet an agenda. We all should CARE that it is this hard to be informed consumers who are making choices informed by truth not versions of it.

In another interesting connection to this article, I use an activity in which I have students Google a health related question and  examine and evaluate the websites that come up on the Google search.

One of the criteria is “Accuracy” in which students have to justify why the information from the source is accurate. Do you know what almost 100% of them said was their justification?

Prior knowledge or hearing the information before.

Yes, it was that they heard that information before or it aligns with prior knowledge/learning so that must be a reason to believe it. Now, in some cases, this may be OK. If you are a college student taking (hopefully) courses that are providing the most current, evidence-based content then maybe, maybe, this is an appropriate justification. But is it? If we can only judge accuracy based on our own prior knowledge – is this really accurate? Are we really taking an opportunity to find the truth? Or just the truth as we know it?

And of course, we could go into a whole dialogue about what “truth” even means . . . but lets move on to Facebook – if that isn’t truth what is?

Within a week of the advocacy activity I did with my undergraduate students, the NPR article showed up on Facebook (seriously  . . . how does Facebook do that?) and in some ways I felt validated. These students DO need more support in developing skills around finding truth in an era where “information” is all around. We DO need to ensure that our students are thoughtful, engaged consumers who do not just stop when they find things that confirm what they already know, who go the next step to verify and search out facts, not just information.

Teaching the skill of accessing valid and reliable information IS important, I would argue, critical for our students. We have a duty to our students to help them become active, engaged, thoughtful, discerning, critical consumers of all information.

Take a look at other support for the work you are doing! Be sure to check out the resources at the end of the NPR article. Here are some others if you haven’t seen them:

How do you teach the skill of accessing valid and reliable information? Share your stories about the need to develop this skill and any other resources to justify just how important this skill is!

Values in Health Education – The Role of the Health Educator

It is often said that our job as health educators should be values neutral. We shouldn’t let our personal values and beliefs sway our teaching or be used to get students to see it “our” way.

Is this accurate though? Should we really be values neutral? Should we avoid talking about how values and beliefs influence behavior because we don’t want to run the risk of appearing to impart our personal beliefs and values onto our students?  I’m not so sure…

Saying this, I realize, may raise some eyebrows. You may be thinking – “of course it is our job to keep our values out of it. As educators, we cannot persuade our students to our way of thinking.”

I would agree with you.

In fact, I often tell my students that I am not here to tell you whether your beliefs and values are right or wrong. Rather, I will ask you to think critically about  how your values form a foundation for the choices you make concerning your health. I will have you reflect on whether or not your values and beliefs align with choosing health enhancing behaviors. I will ask you to determine if your health behaviors align with your values. If your values and beliefs do not align, I may ask you to consider whether you need to rethink your beliefs…but never require you to change them.

I will ask my students to open their minds and be willing to discuss health behaviors in ways that are honest and respectful recognizing that others make health choices for reasons that are very personal to them. I will also ask my students to consider health from multiple perspectives to better understand how values and beliefs do not fit into a box that looks the same in all situations. For example, take the value of safety. Would all of your students think about this in the same way? For some, it may mean physical safety, others it is emotional safety, while others still may think of safety in terms of social settings.

Where I ask you to stretch your thinking is in how we use/teach the concept of values and beliefs in our curriculum. I do believe it is our job as health educators to have our students think critically about the behaviors they engage in, the beliefs and values that guide those behaviors and whether or not those behaviors are a true reflection of how they see themselves (or want to see themselves).

What does this look like in the classroom?

I recently asked my students to complete an assignment to identify their top values. Once the top 5 were identified we discussed how those values shaped their behavior – health and otherwise in various dimensions. They had to identify indicators that demonstrate they are acting in accordance with their values. Finally, students were asked to identify a current health behavior that is out of alignment with their values. This was the hard part for many of them.

Many students initially defaulted to “my behaviors align with my values”, until I had them dig a little further and consider what it means to act in a way that aligns with your personal values. I had them consider the following questions:

  1. If you were to ask your family or friends, would they know these values are important to you?
  2. Is there a behavior that you recently engaged in that an outsider might not consider aligned with your values? Would you agree or disagree with their view?
  3. Think of a health behavior you would like to change or improve, how could your beliefs and values support improving this behavior to enhance your health?
  4. Are their any health beliefs you need to reconsider in order to live a healthier life?

After asking these questions, many students reflected on the behavior they want to improve and noted that it was this behavior that was most out of alignment with their values. Many gave ideas or strategies they could employ to improve their health in a way that brought them into alignment with what they value most and some even noted that they needed to change their beliefs about what health looks like in that context to become healthier.

So, where do we, the health educators, come in?

Health educators provide the opportunity for this to happen. In order for this to be successful, I knew that I couldn’t jump in day one and ask students to do an activity like this. I needed to create the space and environment for my students to let this happen. I had to allow students to struggle with their personal feelings in order to determine their values. Most of all, I had to put aside my notion of what is important in terms of behavior change. At the end of the day, whether your top value is faith, life, integrity, humor, beauty, etc, a key component of behavior change is a personal desire to make a change…and often a change that aligns with personal beliefs and values.

I encourage you to create that space and be a safe zone for students to explore their values and beliefs. Allow students to consider how those values and beliefs align with their health behaviors and becoming the person they want to be. Encourage your students to share their values and beliefs with trusted adults in their life, help them to embrace what makes them who they are.

While I will still argue that it isn’t appropriate to impart our values on our students, we do have a role to play in supporting our students  becoming the best version of themselves – and part of that includes understanding what we value and why.


Do you talk about values or have students consider how values influence their health choices? Let us know and be part of the conversation below.

There’s no such thing as wasted time . . .

No such thing as wasted time ….


I’d like to start this post by acknowledging that the idea for this entry was sparked by Claudia Brown (@cbrown_t on Twitter). With her permission, I am exploring the ways that we can take advantage of what might sometimes be seen as “wasted time”.


Claudia has shared two ideas which inspired me! First was what she did when her students had to miss health class because of height and weight data collection. Sadly, it often happens that when things come up in schools, it is health class that students get pulled from or that gets cancelled. However, instead of letting this stop her students from practicing skills, Claudia saw this as an opportunity to practice interpersonal communication. She encouraged students to practice the skills they had learned about effective communication to greet the nurse, and if desired, ask about their height and weight. She further connected this experience to their lives outside of school by discussing the fact that interacting with a medical provider can be intimidating but that it is important to ADVOCATE for yourself and to COMMUNICATE with the provider so that you can have an active role in your healthcare.


Lightbulb! Don’t miss the chance to connect to real world practice opportunities. There are probably so many times in school that can we have students practice skills. Not only that, but then think of all the opportunities we could find for students outside of school. You could talk to local store owners and get feedback on how students act in their stores. Visit a local restaurant and talk to wait staff, cashiers, even bus drivers …. so many people who could all be a chance for students to practice and apply effective communication!


Then Claudia went on to share another example of yet another day that students were going to miss out on health class. But did that stop her? Nope!


On this day, she had students practicing refusal skills out in the hallway as they were waiting their turn. Another lightbulb! There is no such thing as “no health class” because the skills we are helping them develop extend far beyond the health classroom. We can take these unexpected, and often unwanted, moments as opportunities …. opportunities to extend learning beyond the walls of the classroom. Whether it is to practice or apply, we can work on these skills wherever and whenever!


The important thing to keep in mind is that, for me, this isn’t exciting because it means we don’t have as much wasted time. It is exciting because it opens up a world of possibilities and has me explore a new perspective about how we can think about the skills we are teaching and to see interruptions and unexpected events as opportunities.


Do you already do this? Take advantage of the unexpected to provide practice or application of skills? If so, we would love to hear your stories! Even if you don’t, can you think of other ways to extend learning beyond the classroom? Please share ideas in the comments.


Have a happy, healthy week!



Thoughts from ASHA

I got in from ASHA about an hour ago! Wish I could have stayed for the final day . . . what a great conference filled with so many people committed to supporting the health and wellness of students. Conferences are such an amazing opportunity to learn from each other, network and to get reinvigorated about the work we are doing.

Holly and I had the opportunity to facilitate a pre-conference workshop, “All About Those Skills”, on Thursday and to do a brief presentation about skill development today! We know our post is two days late (sorry) but we thought it would be great to share some of the ideas (and hopefully excitement) about SKILLS.

During the two days that we were at the conference, Holly and I kept commenting on how excited and (we admit) pleasantly surprised about the buzz around skills-based health education. There are SO MANY people who are getting onboard and who are enthusiastic and committed to enhancing their current skills-based practice or to make the shift. At our pre-conference workshop we had health educators, but we also had people from community based health programs, from Departments of Education and some school nurses and school staff – it was an amazing group that represented many of the stakeholders involved in educating and support our youth.

There were many awesome ideas discussed and shared, but here are some highlights:

  • At the end of the day, health education aims to help students ACT in order to support or enhance their health. Think of the verbs: avoid, engage, increase, decrease, enhance, maintain, access . . . these are just some of actions we want our students to be able to take. No matter how you look at it, health education is about ACTION – what students can DO!
  • Determining functional information can be difficult but we found that even when looking at different topic areas (avoiding alcohol and e-cigarettes, decreasing stress and increasing physical activity) there were themes that emerged in all of these areas: consequences, effects (short- and long-term, positive and negative), relevance, barriers and resources. Maybe we are on to something . . .
  • There are many data sources that we can use to help inform our decisions about our curriculum. The pictures included here show the groups hard at work and their brainstorm about data sources.
  • Participatory methods requires balancing student engagement with off-task behavior as well as finding methods to support active participation (i.e. how to avoid the crickets we often hear when we try large group discussions). This is not easy! Fostering a positive learning environment is critical for success in a skills-based approach. We included a picture below of some of the ideas the group came up with to support a positive learning environment and participatory teaching/learning.
  • We hope that the “powers that be” will get on board and move toward proficiency based assessment and evaluation for students (yes – as we have been doing in health education). We discussed the challenges of assessment especially in systems that haven’t embraced standards- or proficiency-based assessments.
  • People are ready to take action and make positive changes – whether it was bringing information back to help shape new frameworks or enhancing practice in their classrooms – Holly and I were inspired by the many ways people are planning to affect change.

Attending ASHA reminded me that there are so many of us out there “fighting the fight” and there is no end to what we can accomplish – especially when we support and encourage each other.

THANK YOU for all that you do! And thank you to ASHA for a great conference – looking forward to next year.

Along with the pictures, we are including PDF versions of our PPT presentations. We hope you find these resources useful.

~Sarah and Holly



Functional Information – What do students REALLY need to know?

In a skills-based health ed program a lot of emphasis is placed on making sure that students are able to apply the skills of the National Health Education Standards (and rightly so!) but in order to do that, we also have to think about the context in which our students develop and apply the skill.

Functional information is defined as:

Information that is useable, applicable, and relevant. It is not arbitrary, traditional, or extensive. Functional information is the context in which the skills will be taught and the base for students’ developing functional knowledge. (Benes & Alperin, 2016)

In fact, making sure that students have the most appropriate information is so important that CDC included it in the Characteristics of Effective Health Education. Specifically, CDC states that health education curriculum should include “functional knowledge that is basic, accurate, and directly contributes to health-promoting decisions and behaviors”. Given this the above definition, it seems simple enough to determine functional information – right? I mean, if we teach students what they need to know and how to use that information while applying any of the skills, then it should be a fairly straight forward task of determining what is functional (or essential to know) and what is “nice to know”.

Unfortunately, things get muddled once we start thinking about what students really NEED to know in order to apply a skill in real-world situations. The reality is that the idea of “need to know” is subjective. For example, if you are a person who has been impacted by a sexually transmitted infection, has a severe food allergy, or has a loved one with diabetes you may believe that students need to know how to prevent contracting an infection, how to ensure you (or your loved one) doesn’t go into anaphylaxis, or how to eat healthy and exercise to ward off diabetes. You may be right – and the big question to ask is – What is the specific information to be taught and how will that information help my students to achieve skill proficiency?

Do students need to know all of the signs and symptoms of potential infections? How about the body’s response to anaphylaxis? What about target heart rate and portion sizes? Suddenly, the task becomes more challenging than originally thought…and these are just a few examples.

To bring this conversation into the real world, I have been talking with my undergrad students (who are mostly nutrition majors and health/PE majors) about this concept and how we need to include information as a frame and a context for learning, and at the same time be sure that it is the skill that we are keeping as our primary focus. They struggle. My students have had to work really hard to understand not only what each skill is and what is required of it in order to demonstrate proficiency, but also how to fit in enough (but not too much) information to ensure their students walk away with a good foundation.

Unfortunately, their struggle is a common struggle among educators – we all know far more than we can (or should) pass onto our students. So, what can you do about it? One thing I tell my students pre-service teachers is that there isn’t a perfect combination of information, rather it is the information that is relevant and most likely to help them their students effectively apply the skill that is most relevant that should be included. The information should be data driven and fill any gaps in knowledge that students may have. For example, when teaching students about goal-setting and specifically setting a goal to reduce their sugar intake, knowing about the sugar content in beverages or how sugars can be hidden on food labels may be important to know. Whereas if they are charged with analyzing the internal and external influences on their sugar intake they might not need to how to read a food label but will rather need to consider how their home environment impacts their food choices, how media ads play a role in our behavior, or alternatives when we are in a situation where we are feeling pressured.

I am happy to report, they are getting it. It will take some practice and we have set up a “quick check” for them to consider if the information they want to include is functional – they ask themselves:

  • Is it necessary for my students to learn?
  • Will the student be able to use this information to demonstrate skill application?
  • If I had to teach this topic in a shorter amount of time, would this information make the cut?

How about you? What strategies have you used to determine what functional information you include in your curriculum? Also, in a changing world, how often do you review the information you are teaching to ensure it remains current?

We would love to hear from you – feel free to post below!


The Power of a Positive Learning Environment

Creating a safe, positive and inclusive learning environment is one of the most critical aspects for supporting learning and to build a classroom community. This is particularly important in a skills-based health education classroom where participatory methods (the use of modeling, observation and social interactions) are the primary instructional strategy. There are many ways to achieve a positive learning environment. Throughout this post we provide suggestions for activities that can be implemented in the classroom and we encourage you to start integrating participatory methods from the very beginning of the year or term so that expectations are set from the moment students enter the classroom.

This is more than the beginning of the year name games and “get to know ya” activities. Creating a positive learning environment is an ongoing process that requires investment from you and your students. You need to continue to work on creating and supporting the classroom community throughout your time with students. Here are some ideas to get you started!

Do you have activities that you use in your classroom? If so, please share in the comments and we will include in future posts!


Getting to Know You/Team Building Activities:

Getting to Know You Survey: I always send out a survey at the beginning of a class. I ask a number of questions but I make sure to always include a space for their preferred name (as it may be different than what is on an official class list) and their preferred pronouns (to provide an opportunity for students to share their gender identity in a way that does not single them out in front of class). I also include questions such as what they are nervous about for the school year, what they are looking forward to, something they are proud of that they have done and a song that makes them happy (that is appropriate for class). I end by asking them what they want to tell me that will help them be successful in my class; I often share some of the ideas to help establish commonalities among the group. I also use the “happy songs” during the year at transitions, during group work, etc. It always lightens the mood in the room and I know that at least one person is happier having heard it!


Group Juggling: This is an activity that I have used for years – I don’t remember where it came from but it is by far one of the best ways for me to learn names (and have a some fun and provide a safe space for students to be a little uncomfortable).

Here’s how to play:

  • Have students stand in a circle (you should be in the circle too).
  • Toss a beanbag around the circle so that everyone gets the beanbag. Make sure that students remember whom they throw to.
  • When the person catches the beanbag, they say their name. Then the WHOLE group repeats that person’s name.
  • Repeat as necessary before proceeding to the next step. Make sure that students are always throwing to the same person.
  • Continue to toss the beanbag around (to the same people) but this time, when the person catches the beanbag everyone says their name (without waiting).
  • Repeat as necessary.
  • The final part of this activity is the “juggling.” Add beanbags to the circle. People still throw to the same people that they have been the whole time but in this round, the beanbags will start at the same time. The goal is to have the beanbags make their way all the way around the circle without being dropped, crashing in the air, etc. Names do not need to be included (except as needed to make a successful catch).



Cult of Pedagogy has some great resources for “Ice Breakers that Rock”. Concentric Circles is a great format not only for getting to know you activities, but any time that you want to engage the entire class, at the same time in discussions. I have used it as a review strategy and for general discussions.


If you have the time, I have had success with The Marshmallow Challenge. It is a great way to have students working together right from the start and when they see spaghetti and marshmallows within the first few lessons – they are intrigued about what they will doing. I also inevitably have groups that take pictures of their successful designs (of their own accord because they are proud of their work!).


Setting Expectations:

 Creating classroom expectations or norms (as opposed to rules – students will tell you that rules feel like they are imposed upon you. Norms/expectations are agreed upon as a class) as a group. Allow students to brainstorm and create norms for their classroom. Create a document or visual that has the agreed upon norms. You may want to have students sign or “formally” agree to meet these expectations. It can be helpful to have these displayed so that they can be referred to throughout the year.


Establishing classroom routines is also important in supporting a positive learning environment – students benefit from routine and can also benefit from understanding why certain activities are included. For example, I have begun to include 1-2 minutes of meditation at the start of every class. I explained to students that I am on my own mindfulness journey and I will be integrating activities during the year, including the start of class meditation to provide them opportunities to explore this practice as well. The meditation ends up being one of the activities that students comment on at the end of the term – they love it! They tell me that they enjoy it not only for the time to focus but also because it shows them that I care about them and their wellness beyond just what I teach in the classroom.

We look forward to hearing your ideas and your feedback!

Have a great start to the year.


“I have always been delighted at the prospect of a new day, a fresh try, one more start, with perhaps a bit of magic waiting somewhere behind the morning.” J. B. Priestley


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