How Medical Students Learn

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This is a copy of my presentation at the 2009 SnoDocs Conference.

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How Medical Students Learn

  1. 1. Deirdre Bonnycastle SnoDocs Conference January 17, 2009 How Medical Students Learn
  2. 2. Objectives <ul><li>Upon completion of this workshop, you will be </li></ul><ul><li>able to: </li></ul><ul><li>define learning </li></ul><ul><li>describe how retention of memorized material can be improved </li></ul><ul><li>describe how to help students improve clinical reasoning and problem solving skills </li></ul><ul><li>describe the Skill Learning Cycle . </li></ul>
  3. 3. Case of Professor Click <ul><li>Professor Click has been </li></ul><ul><li>teaching for 35 years and </li></ul><ul><li>prides himself in his ability to </li></ul><ul><li>keep the attention of his </li></ul><ul><li>students through a mixture of </li></ul><ul><li>lectures and storytelling. His </li></ul><ul><li>students find him immensely </li></ul><ul><li>entertaining and rate him </li></ul><ul><li>highly on the class evaluations. </li></ul>
  4. 4. Question <ul><li>If the goal of teaching is to improve learning, </li></ul><ul><li>how does Professor Click know that students </li></ul><ul><li>are learning? </li></ul>
  5. 5. Educational Principle #1 <ul><li>Just because </li></ul><ul><li>you said it, </li></ul><ul><li>doesn’t mean it will be remembered. </li></ul>
  6. 6. Definition of Learning <ul><li>Learning is viewed here as developing a way of </li></ul><ul><li>thinking and acting that is characteristic of an </li></ul><ul><li>expert community. Such a way of thinking </li></ul><ul><li>consists of three important elements: </li></ul><ul><li>the knowledge that represents phenomena in the subject domain </li></ul><ul><li>the thinking activities that construe, modify and use this knowledge to interpret situations in that domain </li></ul><ul><li>and to act in them. </li></ul><ul><li>Billet, 1996 </li></ul><ul><li>Situated learning: bridging sociocultural and cognitive theorizing </li></ul><ul><li>Learning and Instruction, 6 </li></ul>
  7. 7. Memory <ul><li>1. the knowledge that represents </li></ul><ul><li>phenomena in the subject domain </li></ul>It’s only when your memory is engaged in the learning process that your brain is really challenged Dr. Michael Merzenich
  8. 8. Working Memory Long Term Storage Memory Retrieval
  9. 9. Working Memory Attention Rule of 7 Relevance <ul><li>Focus attention </li></ul><ul><li>Questions </li></ul><ul><li>Change activity every15 minutes </li></ul><ul><li>Teach < 7 steps </li></ul><ul><li>Numbers aide memory </li></ul><ul><li>Importance </li></ul><ul><li>Make connections </li></ul>
  10. 10. Long Term Storage <ul><li>If information is not stored </li></ul><ul><li>as part of a pattern, it can </li></ul><ul><li>be slow to impossible to </li></ul><ul><li>retrieve. </li></ul><ul><li>Expert Physicians have </li></ul><ul><li>100,000’s of constantly </li></ul><ul><li>renewed patterns that </li></ul><ul><li>help them make decisions </li></ul><ul><li>quickly. </li></ul>
  11. 11. Illness Scripts
  12. 12. Repetition Wozniak, 2006
  13. 13. Memory Retrieval <ul><li>Use Retrieval Devices </li></ul><ul><ul><li>Mnemonics, songs, rhymes, flash cards http://www.ichi2.net/anki/ </li></ul></ul><ul><ul><ul><li>http://www.medicalmnemonics.com/ </li></ul></ul></ul><ul><li>Reinforce the Use of Illness Scripts </li></ul><ul><ul><ul><li>http://www.medmaps.co.uk/ </li></ul></ul></ul><ul><li>Repetition </li></ul><ul><ul><li>Games, questions, cases, connections </li></ul></ul><ul><ul><ul><li>http://jc-schools.net/tutorials/PPT-games/ </li></ul></ul></ul>
  14. 14. Educational Principle #2 <ul><li>Just because </li></ul><ul><li>you remember </li></ul><ul><li>something </li></ul><ul><li>doesn’t mean </li></ul><ul><li>you </li></ul><ul><li>understand it! </li></ul>
  15. 15. Clinical Reasoning <ul><li>2. the thinking activities that construe, modify and use this knowledge to interpret situations in that domain. </li></ul>Learning depends on the transformation of information into knowledge Dr. Frank Papa
  16. 16. CASE Curriculum Model <ul><li>C ooperative </li></ul><ul><li>A ctive </li></ul><ul><li>S elf directed </li></ul><ul><li>E xperiential </li></ul>See http://medicaleducation.wetpaint.com/page/CASE+Curriculum+Model for more information
  17. 17. Top 4 Techniques <ul><li>Cases, Cases, Cases </li></ul><ul><ul><li>Cases Journal http://casesjournal.com/ </li></ul></ul><ul><li>Socratic Questions </li></ul><ul><ul><li>http://medicaleducation.wetpaint.com/page/Using+Questions+to+Stimulate+Thinking </li></ul></ul><ul><li>Intentional Role Modeling </li></ul><ul><ul><li>http://medicaleducation.wetpaint.com/page/Intentional+Role+Modelling </li></ul></ul><ul><li>5 Minute Preceptor </li></ul><ul><ul><li>http://www.practicalprof.ab.ca/teaching_nuts_bolts/one_minute_preceptor.html# </li></ul></ul>
  18. 18. Acting Like a Physician <ul><li>3. and to act in them. </li></ul>A survey of 181 doctors, has shown that from ten of the procedures medics are officially required to be competent at, most are only confident of their ability to perform five. -Graeme Baldwin, BMJ Journal
  19. 19. Skill Learning Cycle Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence Awareness Explicit Teaching Practice Reassurance New Challenges
  20. 20. <ul><li>Thank You </li></ul><ul><li>Enjoy the Conference </li></ul>

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