"Should we go get our pencils?" a Pittsburgh Perry High School student asked.
"Yes, we definitely need to write," answered teacher Tia Ellis.
The class is health careers technology -- one of 18 career and technology programs offered by Pittsburgh Public Schools. Some students earn workforce certifications or college credits in the programs.
The students need to learn hands-on skills such as how to take vital signs and transfer a patient from a bed to a wheelchair and back.
But if they don't learn writing and math skills, they won't be able to pass tests of their technical competencies in the spring of their senior year. Half of such tests are performance, and half are written.
According to Pittsburgh Public Schools, only 37 percent of the city students who took the test, called NOCTI, in 2009-10 passed it.
Students had more trouble on the written portion than on the performance side, said Linda Wolfgang, a career and technology education supervisor for city schools.
By 2011-12, performance had improved dramatically, with 80 percent passing the NOCTI, which amounts to 72 of 90 test-takers, according to the district.
About 500 students -- about 10 percent of students in grades 10, 11 and 12 -- are enrolled in career and technical education classes.
Angela Mike, executive director of career and technical education for the district, said the district has made efforts to improve the program, including correcting deficiencies in following state and federal mandates.
Where the courses sometimes previously had been offered as a high school elective, they are now a program, offered three periods every day for three years, although students are permitted to take them the last two years of high school.
An occupational advisory committee with 221 members has been set up.
Another important change, Ms. Mike said, has been "co-teaching."
In this model, English teacher Darcy Tyhonas and math teacher Mike Metikosh work districtwide with career and technology teachers -- who typically come from industry -- to help them relate English and math to the vocational and technical skills.
Each brings specialized strategies to the table.
"They can make it more explicit," said Ms. Mike.
In cosmetology, Ms. Mike said, students weren't making the connection between the ratios they use to mix hair color and the ratios on state tests.
She said the math teacher "was able to connect it for them."
In addition, students in their senior year take a pretest to see what where their strengths and weaknesses are before the official NOCTI.
The career and technical, English and math teachers help each student develop a plan to fill in the gaps.
In the health careers program, Ms. Ellis has had 100 percent of her students pass the NOCTI even before the extra help.
She talked with her students about NOCTI from the start, pretested her students and emphasized reading and math.
"No matter what, they're going to be reading it, writing it in my class," she said.
Even so, she said the English and math teachers are "wonderful" in helping to provide the foundation.
Ms. Tyhonas said, "There's a lot of theory they have to learn before they can even do the hands on."
Strategies on how to read difficult text can help with that, she said.
Mr. Metikosh tries to show students different ways to solve math problems.
Dejah Blackwell, an 11th-grader in her first year of the health careers program at Perry, wants to go to college and become a nurse.
"This program is one of the best programs," she said, pausing from working on a puzzle that required matching various equivalencies, such as metric and English measurements.
Given the data nurses must track on patients, Dejah, who also takes Algebra 2, sees math "as one of the most important parts, and I never knew that about nursing."
With additional teacher explanations, she said, "You can find a way you're more comfortable with."
Sharice Manuel, an 11th-grader in her first year of the program at Perry, also wants to go to college and become a nurse. She said the math in health careers is helping her with Algebra 2 and vice versa.
The health careers program moved to Perry this school year from Pittsburgh Langley High School, which was closed.
Of the 15 in the morning program and 11 in the afternoon program, only three were in the program at Langley. Some former Langley students continued on to the health careers program at Carrick High School.
A career counselor will administer the written portion to the three soon.
They took their hands-on exam a few weeks ago, with registered nurses watching them wash their hands and take vitals. Ms. Ellis couldn't be in the room.
"Let's hope and pray they did well," she said.
Education writer Eleanor Chute: firstname.lastname@example.org or 412-263-1955.