Unit 3: Guiding student performance


Guidance vs. Instruction

Guidance is central to Cognitive Apprenticeship. Although you are all instructors, incorporating cognitive apprenticeship into your instruction will place you in a position to offer more guidance than instruction. Sound confusing? Let's define guidance and instruction in their most basic terms so that we can understand that these two words are not interchangeable.

Guidance is freer and has less structure; it is what a mentor gives you when they know you don't have to listen. A guide is a person who advises or shows the way to others.

Instruction is more direct and specific; it is what bosses or teachers make you do. To instruct is to direct, command, or teach someone to do something.

I know what you're thinking: I AM a teacher.

Yes, you are. :-)

Military hat confused meme1.jpg

The challenge in assimilating Cognitive Apprenticeship into your instructional strategy is that it is asking you to behave more like a mentor and less like a teacher. While there may be a need for more direct instruction at the beginning of students' learning, Cognitive Apprenticeship urges an immediate, yet gradual, transition from instructor to guide through modeling, coaching, scaffolding, articulation, reflection, and exploration. You will break down tasks to encourage in-depth understanding. This will enable you to assess: A. what the student already knows about the task at hand and B. what they need to know to successfully complete the task. Breaking down the task will guide students from point A to point B. Your guidance will eventually fade, allowing students to act independently (during the exploration phase of CA). You will be creating an environment conducive to student-led learning. You are the guide on the side.

Guide on the Side

In the world of education, sage on the stage is a phrase that’s sometimes used to describe the all-too-familiar scene of the knowledgeable teacher delivering lectures to passive students who memorize information for the sake of spitting it back out again on testing day. This method of teaching assumes that the student is an empty vessel, waiting to be filled with information, and doesn’t give the student much opportunity to think for themselves. As you can probably imagine, the problem with this type of instruction is that while the student may appear to “know” information, he or she doesn’t really learn all that much.

In order to really understand something, humans need the motivation to generate knowledge and meaning through their own experiences, rather than regurgitate information that’s been fed to them. In the world of healthcare professional education, you have the opportunity to provide students with clinical experiences, under your observation, that mimics authentic real-life experiences. This is a great opportunity to act as a guide on the side, preparing them for independence in the real world.

How can you transition from sage on the stage to guide on the side? Below are a few simple concepts to keep in mind:

  • Take a step back. If you find yourself on the teaching soapbox,” find opportunities to guide rather than instruct.
  • Be an active listener. Listen to your students and respond to their interests, questions, concerns, and ideas.
  • Ask open-ended questions such as “tell me about this patient's medical history". This will empower students to think independently.
  • Follow their lead. This makes students' thinking and reasoning visible to you and will allow you to adjust your guidance if necessary. Remember, making mistakes and following the wrong path encourages learning. Students should feel free to make mistakes along their educational journey; you are there to guide them to the right path if necessary. If you don't let them lead, how can you know which path they would choose?


The following YouTube videos may provide more insight and perspective on the benefits of guidance vs. instruction:



The following article discusses how the cognitive apprenticeship model can offer valuable guidance in structuring clinical teaching activities:


Discussion: On the Soapbox


Please discuss either:

1. A specific instance in your career as a healthcare professional educator when you were on the soapbox (meaning you were in straight instruction mode). After learning about the benefits of guidance, how could you have adjusted your approach to align with the tenets of Cognitive Apprenticeship? What would you do differently?


2. A specific instance when you were a student and your teacher was on the soapbox. After learning about the benefits of guidance, how could your teacher have adjusted his or her instructional approach to align with the tenets of Cognitive Apprenticeship? What could he or she have done differently?

Discussion area:


Activity: Reflective Journal


This unit discussed the transition from instruction to guidance, from teacher to mentor. Have you had any teachers in your past who acted more like mentors? What influence did they have, if any, on your life? Do you think that the "guide on the side" approach to instruction is beneficial in your field of health care professional education?

Please email your journal entry to me upon completion of Unit 3.


Can you differentiate guidance from instruction?? Can you use the Cognitive Apprenticeship model in your role as mentor and guide?


Move on to Unit 4: Modeling, coaching, scaffolding, articulation, reflection, and exploration

Go back to Unit 2: Creating tasks and projects that support competency in health professional education

Go back to Unit 1: What is cognitive apprenticeship?

Go back to the home page: Cognitive Apprenticeship in Health Professional Education

Portfolio Page : Rosalie Forrester