Deirdre Bonnycastle SnoDocs Conference January 17, 2009 How Medical Students Learn

Objectives Upon completion of this workshop, you will be able to: define learning describe how retention of memorized material can be improved describe how to help students improve clinical reasoning and problem solving skills describe the Skill Learning Cycle .

Upon completion of this workshop, you will be

able to:

define learning

describe how retention of memorized material can be improved

describe how to help students improve clinical reasoning and problem solving skills

describe the Skill Learning Cycle .

Case of Professor Click Professor Click has been teaching for 35 years and prides himself in his ability to keep the attention of his students through a mixture of lectures and storytelling. His students find him immensely entertaining and rate him highly on the class evaluations.

Professor Click has been

teaching for 35 years and

prides himself in his ability to

keep the attention of his

students through a mixture of

lectures and storytelling. His

students find him immensely

entertaining and rate him

highly on the class evaluations.

Question If the goal of teaching is to improve learning, how does Professor Click know that students are learning?

If the goal of teaching is to improve learning,

how does Professor Click know that students

are learning?

Educational Principle #1 Just because you said it, doesn’t mean it will be remembered.

Just because

you said it,

doesn’t mean it will be remembered.

Definition of Learning Learning is viewed here as developing a way of thinking and acting that is characteristic of an expert community. Such a way of thinking consists of three important elements: the knowledge that represents phenomena in the subject domain the thinking activities that construe, modify and use this knowledge to interpret situations in that domain and to act in them. Billet, 1996 Situated learning: bridging sociocultural and cognitive theorizing Learning and Instruction, 6

Learning is viewed here as developing a way of

thinking and acting that is characteristic of an

expert community. Such a way of thinking

consists of three important elements:

the knowledge that represents phenomena in the subject domain

the thinking activities that construe, modify and use this knowledge to interpret situations in that domain

and to act in them.

Billet, 1996

Situated learning: bridging sociocultural and cognitive theorizing

Learning and Instruction, 6

Memory 1. the knowledge that represents phenomena in the subject domain It’s only when your memory is engaged in the learning process that your brain is really challenged Dr. Michael Merzenich

1. the knowledge that represents

phenomena in the subject domain

Working Memory Long Term Storage Memory Retrieval

Working Memory Attention Rule of 7 Relevance Focus attention Questions Change activity every15 minutes Teach < 7 steps Numbers aide memory Importance Make connections

Focus attention

Questions

Change activity every15 minutes

Teach < 7 steps

Numbers aide memory

Importance

Make connections

Long Term Storage If information is not stored as part of a pattern, it can be slow to impossible to retrieve. Expert Physicians have 100,000’s of constantly renewed patterns that help them make decisions quickly.

If information is not stored

as part of a pattern, it can

be slow to impossible to

retrieve.

Expert Physicians have

100,000’s of constantly

renewed patterns that

help them make decisions

quickly.

Illness Scripts

Repetition Wozniak, 2006

Memory Retrieval Use Retrieval Devices Mnemonics, songs, rhymes, flash cards http://www.ichi2.net/anki/ http://www.medicalmnemonics.com/ Reinforce the Use of Illness Scripts http://www.medmaps.co.uk/ Repetition Games, questions, cases, connections http://jc-schools.net/tutorials/PPT-games/

Use Retrieval Devices

Mnemonics, songs, rhymes, flash cards http://www.ichi2.net/anki/

http://www.medicalmnemonics.com/

Reinforce the Use of Illness Scripts

http://www.medmaps.co.uk/

Repetition

Games, questions, cases, connections

http://jc-schools.net/tutorials/PPT-games/

Educational Principle #2 Just because you remember something doesn’t mean you understand it!

Just because

you remember

something

doesn’t mean

you

understand it!

Clinical Reasoning 2. the thinking activities that construe, modify and use this knowledge to interpret situations in that domain. Learning depends on the transformation of information into knowledge Dr. Frank Papa

2. the thinking activities that construe, modify and use this knowledge to interpret situations in that domain.

CASE Curriculum Model C ooperative A ctive S elf directed E xperiential See http://medicaleducation.wetpaint.com/page/CASE+Curriculum+Model for more information

C ooperative

A ctive

S elf directed

E xperiential

Top 4 Techniques Cases, Cases, Cases Cases Journal http://casesjournal.com/ Socratic Questions http://medicaleducation.wetpaint.com/page/Using+Questions+to+Stimulate+Thinking Intentional Role Modeling http://medicaleducation.wetpaint.com/page/Intentional+Role+Modelling 5 Minute Preceptor http://www.practicalprof.ab.ca/teaching_nuts_bolts/one_minute_preceptor.html#

Cases, Cases, Cases

Cases Journal http://casesjournal.com/

Socratic Questions

http://medicaleducation.wetpaint.com/page/Using+Questions+to+Stimulate+Thinking

Intentional Role Modeling

http://medicaleducation.wetpaint.com/page/Intentional+Role+Modelling

5 Minute Preceptor

http://www.practicalprof.ab.ca/teaching_nuts_bolts/one_minute_preceptor.html#

Acting Like a Physician 3. and to act in them. 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

3. and to act in them.

Skill Learning Cycle Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence Awareness Explicit Teaching Practice Reassurance New Challenges

Thank You Enjoy the Conference

Thank You

Enjoy the Conference