When we all returned from lunch break, I suggested that the next time we had the blood pressure equipment out for practice that everyone try what Michelle had success with.

I stood while picking up a small pile of papers, "I am going to distribute these papers which are to be placed face down on your desk. This is not and I stress not a test. When instructed I want you to turn the paper over and for the next thirty minutes label the diagram. It has been color coded to match the one in your text book. I suggest doing it in pencil, I have extras. When done we will review and you can change your answers as needed. This was designed as a learning tool for you to use."

There were collective sighs as held breaths were released. Several hands were raised for offered pencils. And they all began completing their diagrams.

It was interesting to watch them. Some focused on the paper. Others searched the ceiling as if the answer would appear there. The pencil chewers were the most fascinating. They would munch away at the end of their pencils, then have to pick the small pieces off their tongues.

Time was up so I pulled down the screen and added the unlabeled diagram to the projector.

"We will go down the right-hand row first then cross over and come back to the front, similar to roll call. As I point to an area on the screen, each student will identify it. If it is incorrect, the next person will identify it. Everyone will be given time to erase and correct if needed. I suggest that you put a small star or check mark next to it so that you will know it was one you had difficulty with. Ready?"

It took almost an hour to go through the diagram. I watched the occasional erasure that also included their frustrated sigh, the silent sea of smiles when they all got an answer correct. I gave them the time needed. When finished, I instructed them to keep them and use for studying. I also offered extra blank copies to anyone who wanted them. I suggested another break. No one needed directions and the room was briefly filled with silent activity.

"Okay, if no one has any further questions regarding blood flow, the heart, pulses or blood pressures; I propose we move ahead to breathing."

Text books and note pads opened, they were ready. I slid the projector to the side of the desk and raised the screen. I drew a quick sketch of the lungs on the chalk board.

"How long do you take a pulse reading?"

All hands were raised, I placed a hand behind my ear and was rewarded with the echo of "one minute."

"Great and that is how long to take a respiration or breathing reading. Does anyone know if you count the in breath, the out breath or both? Shawn, what do you think?"

He was quick to respond, "I know you don't count both but I don't think it matters if you count in or out, does it?"

"Absolutely correct. You can count either in or out but not both. Over the years you will find that you may have to change your choice depending on the patient themselves. Some people are mouth breathers but they can also be noteworthy inhalers or exhalers. So while you are thinking about that, let's first learn the parts of the body involved, Turn to page 14."

I listened as pages were turned. It was refreshing to see such eagerness.