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J chiropr humanit2006-13-2-11
1. Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp2 Applications of the Mind Map Learning Technique in Chiropractic Education: A Pilot Study and Literature Review Anthony V. D’Antoni, DC, MSa , Genevieve Pinto Zipp, PT, EdDb ABSTRACT Objective: To present a review of the literature and survey results of student satisfaction after using the mind map learning technique. Methods: Fourteen third-year physical therapy students enrolled in a doctoral neurorehabilitation course were required to create a mind map based upon the lecture presentation and assigned reading for 6 diagnoses. The students were asked to complete a post-course survey to assess their perceptions of the usefulness of the mind map learning technique in improving organization and integration of course material. Results: Although the subject pool was limited to 14 students, 10 out of 14 agreed that the mind map learning technique enabled them to better organize/integrate material presented in the course, while only 2 disagreed. The final 2 students responded neutrally when asked if the mind map learning technique assisted them in organizing/integrating course material. However, these 2 students did agree the technique enabled them to recognize areas in which further study was necessary for them to adequately master the course material. Conclusion: While the data obtained from this limited educational experience offers some support for the use of the mind map learning technique in promoting course material integration and learning in physical therapy education, further work is needed to explore its usefulness in chiropractic education. (J Chiropr Humanit 2006;13:2-11) Key Indexing Terms: Chiropractic; Education, Professional; Learning; Problem- Based Learning INTRODUCTION Recently there have been numerous publications on learning strategies used in chiropractic education that include case- studies,1 information technology,2 didactic learning, and problem-based learning (PBL).3 These approaches have been implemented in chiropractic education to various degrees. For example, case-studies a. Assistant Professor, Department of Morphological Sciences and Department of Medical Sciences, New York College of Podiatric Medicine, 1800 Park Ave, New York, NY 10035, and a PhD student, Department of Graduate Programs in Health Sciences, School of Graduate Medical Education, Seton Hall University, South Orange, NJ. Email: firstname.lastname@example.org b. Chair and Associate Professor, Department of Graduate Programs in Health Sciences, School of Graduate Medical Education, Seton Hall University. Source of support: none declared. Paper submitted April 24, 2006, in revised form August 10, 2006.
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp3 have been used to enhance integration skills in chiropractic students; whereas, PBL has been used to teach students to become lifelong, self-directed learners.4 One learning strategy, which at present, has not been widely used in chiropractic education is the mind map learning technique, despite recent research5 suggesting that mind mapping improves long term memory in medical students. Mind mapping is a learning technique that was developed by Tony Buzan.6 The inspiration for this technique arose from the notebooks of Leonardo da Vinci.7 Unlike most learners, da Vinci’s notes were not linear but elliptical—he used pictures and text to illustrate ideas and often connected different concepts together on the same page. While this method of note taking was confusing to read (especially since he wrote backwards), it provided an opportunity to integrate ideas, which allowed da Vinci to effectively use both hemispheres of his cerebrum to problem solve. Mind maps, like da Vinci’s notes, are multi-sensory tools that use visuospatial orientation to integrate information and therefore help students organize and retain information.8 Mind maps are different than concept maps. The latter are flow charts that use branch-like architecture, usually in a superior-to-inferior orientation, to organize information.9 In addition, concept maps are devoid of pictures and color. Since problem solving is integral to the practice of chiropractic, the mind map learning technique can be an important learning strategy to use in chiropractic education. However, the efficacy of this approach has yet to be demonstrated in chiropractic education. Because chiropractic students are considered adult learners, learning strategies such as the mind map technique may be applicable to this group of students. Figure 1 illustrates how adults acquire new knowledge; this knowledge can be learned while reading a Previous factual knowledge Non- academic life experiences Linear approach to learning Non-linear approach to learning Acquisition of new knowledge Figure 1. Adults learn most effectively when they form a connection between newly and previously acquired knowledge.11 The model above illustrates how previous factual knowledge (acquired from academic pursuits) and life experiences (acquired from non-academic pursuits) overlap to form a learning foundation. The learner will then use either a linear or non-linear approach to acquire new knowledge. An example of a linear approach is the traditional outline and an example of a non-linear approach is the mind map learning technique, which relies upon visuospatial relationships. As depicted above, the learner may use both a linear and non-linear approach to learn, and the percentage of each differs with each learner.
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp4 textbook during self-study, listening to a lecture, or reviewing data obtained from a patient history in the clinical setting.1,10,11 Factual knowledge obtained in academia and life experiences of a non-academic nature form a foundation for learning. The overlap between these 2 components differ among learners. For example, take 2 students enrolled in a doctor of chiropractic (DC) program: one is 40 years old and the other 20 years old. The 40-year-old chiropractic student, who has worked as an administrator for 2 decades, has a broader repertoire of life experiences and potentially less factual knowledge because he has been out of academia for 2 decades. As a result, his learning foundation for integrating new knowledge is more likely to be based upon life experiences rather than academic knowledge. In contrast, the 20-year-old student has been in academia for most of his life and has limited work experience; therefore, he may use more factual knowledge and less life experiences as a learning foundation. With their learning foundations in place, both students will then use either a linear or non-linear approach to acquire new knowledge. The predominant technique used by students to learn is a linear approach, whereby the student outlines information into categories in a superior-to-inferior and left-to-right spatial pattern. The mind map learning technique is an example of a non-linear approach to learning that forces the learner to think radially using visuospatial relationships.6,7 Some learners may use both approaches to varying degrees to acquire new knowledge whereas others may only use one or the other. In this paper, we describe how the mind map learning technique can be used to teach chiropractic students to become more balanced thinkers and problem solvers.7,8 METHODS The primary focus of this project was to integrate the use of mind map learning techniques into a professional education program in an attempt to obtain pilot data regarding the ability to enhance the integration of knowledge through mind mapping. In this initial attempt to utilize the mind map learning technique, the doctor of physical therapy (DPT) program at Seton Hall University was utilized due to feasibility. Specifically, post-lecture format of mind mapping was introduced into the neurorehabilitation course, which is offered in the 3rd year of the professional DPT program. This format was chosen because it allowed the students to gain knowledge of the diagnosis from both lecture and assigned readings, which theoretically, would make the process of creating mind maps easier. The fourteen students (n=14) enrolled in the course were required to create a mind map on the topic of stroke from the chapter in their textbook12 and class notes. All students were provided with reading materials and a PowerPoint presentation on the mechanics of creating a mind map (Fig 2). Students were required to read all assigned readings pertaining to the topic of stroke as outlined in their syllabus and attend the lecture series covering the topic of stroke rehabilitation which was presented over a 3-week period. Students were then instructed to complete their mind maps after the lecture series and submit them for review by the course instructor. The course instructor reviewed the mind maps to ensure that major concepts presented in the readings and lecture series were represented in the student mind maps regardless of their chosen format to display them.
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp5 A secondary objective of this pilot study was to record the students’ perceptions of the usefulness of mind maps in integrating their thoughts, as well as, to document any resistance on their part to the technique. Because no surveys to assess the effectiveness or usability of mind maps exist in the literature, we created a non-validated survey to address these issues. Students were asked to complete the survey in an attempt to secure feedback from the students on the following items: 1. Did the mind map technique allow you to think about the material in a more integrated fashion? 2. Did the mind map technique help you to organize the material presented in class? 3. Did the mind map technique help you to organize the material presented in the textbook? 4. Did the mind map technique enable you to recognize areas in which further study is necessary to master the material? 5. Did the effort expended to create the mind map exceed the benefits of its usage in promoting material integration? 6. Was the mind map technique superior in promoting material integration when compared to previous learning strategies used? 7. Would the mind map technique be useful in devising effective treatment plans?13 8. Would you recommend that other professors utilize mind maps in their courses for material integration? A MEDLINE search for articles published between 1970 and 2005 was performed using the combined terms education, methods, and mind map. A total of 5 articles were retrieved and 2 were retained because of their relevancy to the topic.5,13 A manual search of the Journal of Chiropractic Education revealed 1 abstract published on the topic of mind maps.14 RESULTS Appendix A is an example of a student’s initial mind map. Mind maps should contain key words instead of sentences. It is interesting that this student still incorporated notes in a list-like fashion under the heading “Vascular Syndromes” and this highlights the difficulty that some students have re- organizing information in a novel way. As the semester progressed, so did the complexity of the mind maps, such that by the end of the semester, the mind maps were more consistent with traditional mind maps. Upon review of the surveys, the instructor was able to obtain a more objective analysis of the students’ overall perceptions about the technique and its effectiveness in integrating material, which may lead us to further assess its potential use in chiropractic education. Figure 2. Guidelines for creating a mind map. a. Begin with blank paper (preferably greater than 8 ½ by 11 inches) in landscape format b. Draw an image in the center of the paper that represents the theme of the mind map c. From the central image, draw main branches with accompanying key words that represent the major headings of the topic d. Further divide the main branches into sub- branches that each contains key words e. Begin to find associations between different areas of the mind map and draw connections between these associations f. Always print 1 key word per line, allowing the word to be the same length as the line upon which it rests g. Use different colors throughout the mind map and include as many pictures as possible
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp6 Although the subject pool was limited to 14 students, 10 out of 14 agreed that the mind map learning technique enabled them to better organize/integrate material presented in the course, while only 2 disagreed. The final 2 students responded neutrally when asked if the mind map learning technique assisted them to recognize areas in which further study was necessary for them to adequately master the course material. DISCUSSION How to Construct a Mind Map According to Buzan and Buzan,6 a mind map should be drawn on blank paper that is larger than standard 8 ½ by 11 in paper. However, if this is impractical, then standard size paper can be used. The rationale behind using larger paper is to allow the student to break away from the boundaries inherent in standard size paper and thus propagate creativity. The use of lined paper is discouraged because it theoretically restricts thought.7 Once suitable paper is obtained, a medium for drawing the mind map is necessary, namely, colored pens or pencils. The student begins by drawing an image in the center of the paper that reflects the central theme, or topic, of the mind map. For example, a mind map on the rules of mind mapping could have an image of the cerebrum in the center of the page. This central image allows the student 360 degrees of freedom to develop the mind map. Next, the student would draw the main branches with key words extending from the central image and these branches represent the different categories relevant to the content of the mind map. In the previous example, some of the key words are start, connect, print, and association. It is important to print the words and ensure that their length is the same as the lines underneath them so that the completed map will be easier to comprehend. From these main branches, relevant sub-branches are created. Each of the branches and sub-branches should contain accompanying pictures to aid the student in recalling the information. The data of Farrand et al5 show that visuospatial arrangement enhances recall more than simple note taking. As more sub- branches are created, the student will recognize patterns between key words that should be connected, resulting in the integration of different parts of the mind map. Appendix B illustrates one type of mind map on the assessment and treatment of stroke from a rehabilitative perspective. The central image is an inferior view of the brain emphasizing the circle of Willis. This image is appropriate because stroke is a result of either ischemia or hemorrhage of an artery that supplies blood to the brain. There is a connection between the tests important in the diagnosis of stroke, such as urinalysis (UA), complete blood count (CBC), and epidemiology. The sensitivity and specificity of these tests are statistical concepts, which are a basis of epidemiology. Therefore, this connection reminds the student that epidemiology not only has global applications, but it also affects decision making in the clinical setting. Another link was made between a risk factor for stroke (heart disease) and the proposed reasons for the differences in prevalence of stroke between the US and other countries. This connection highlights the role of life- style choices in the genesis of heart disease. These are 2 examples of patterns that emerge when a student begins to construct a mind map and this is the most powerful aspect of the mind map technique because it promotes integration, which is a basis for critical thinking. We hypothesize that the
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp7 mind map technique can assist chiropractic students in integrating their course material. Use of Mind Maps in Health Professions Education Michelini13 discussed potential uses of mind maps in nursing practice, and suggested that mind maps could be used by home health care nurses to teach patients how to take their medications. While the efficacy of the mind map technique has not been investigated in chiropractic education, a recent study by Farrand et al5 addressed this issue in medical education. In order to study whether or not the mind map technique leads to greater factual recall of written information, 50 medical students were exposed to a 600 word sample of scientific text and given 3 short tests based upon the text. The purpose of the first test was to establish baseline data. The students were then randomly divided into 2 groups: half were assigned to a mind map group and the other half to a self-selected study group. After a 30 minute interval, both groups were again exposed to the text and they were told to use either mind map or self-study techniques to learn the material depending on their particular group. The mind map group was trained in the technique during the 30 minute interval, whereas the self-selected study group was simply told to return to the classroom on time. Following a mental arithmetic task to prevent rehearsal of the text, the students were given a second test. The students reconvened a week later to take a third test, which was used to evaluate the effects of both techniques on long-term memory. Recall of factual material by both groups were nearly the same at the first test (baseline), as determined by the number of correct answers, and recall was only slightly higher in the mind map group after the second test. However, 1 week later the mind map group had statistically significant higher factual recall when compared to the self-study group, suggesting that the mind map technique improved long-term memory of factual information in these medical students. Potential Uses of Mind Maps in Chiropractic Education Although Farrand et al5 investigated the efficacy of mind mapping in medical students and not chiropractic students, we suggest that because similarities exist between these 2 health care professions and their academic preparations,15 the benefits of mind mapping demonstrated in medical education may also be observed in chiropractic education. The mind map learning technique can be used in numerous ways by chiropractic school faculty in an attempt to provide diverse educational experiences. The authors offer several options for utilization including: 1) pre-lecture format: integrating concepts from assigned readings prior to material review by instructor; 2) post-lecture format: integrating concepts from assigned readings and material previously reviewed by instructor; and 3) case presentations to integrate knowledge to process through a clinical case. Some guidelines for implementing the technique in chiropractic education are: 1) Spend ample time explaining the theory and rules of mind mapping prior to implementation so that students clearly understand that the images in their mind maps do not have to be of the highest quality but are nonetheless mandatory. 2) Cultivate a positive learning environment by utilizing alternate learning strategies (including mind mapping) which address
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp8 different student learning styles and thus improve motivation for learning. Limitations Since the mind map technique was incorporated into a single course with a small student pool, at this time applicability across a chiropractic curriculum cannot be justified. Moreover, the results cannot be applied to chiropractic education because the subjects were physical therapy students. While the data obtained from this survey of student perceptions does not lend support for the hypothesis that the use of the mind map learning technique promotes course material integration, through visual analysis of the student mind maps we can infer that as a result of the depth of integration between the lecture material and course readings, students did engage in active learning and thus the use of the mind map learning technique may be beneficial in promoting integration of course material. CONCLUSION While the data obtained from our survey of this limited educational experience offers some support for the use of the mind map learning technique in promoting course material integration and learning, further work is needed to explore its efficacy throughout chiropractic curricula and across a larger more diverse student population. Contrary to the findings of Farrand et al5 that most of the medical students in the mind map group were initially hesitant to use the technique and unmotivated to learn it, the physical therapy students in this neurorehabilitation course responded positively towards using this technique. The physical therapy students’ positive responses may be due to the fact that ample time was provided to explain the theory and rules of mind mapping before requiring the students to create their own maps. Based upon our experience with the physical therapy students and utilization of the mind map technique, we recommend that chiropractic educators begin to incorporate mind maps into their curricula since it is easy to use and involves no cost.14 REFERENCES 1. Talmage DM. Teaching with cases to enhance the clinical problem-solving skills and integration skills of fourth-term chiropractic students. J Chiropr Educ 2001;15:53-60. 2. Jamison JR. The use of information technology to teach differential diagnosis to chiropractic students. J Manipulative Physiol Ther 2002;25:277-82. 3. Jiang B. Implementation of basic disciplines into a problem-based learning curriculum for first trimester chiropractic students. J Chiropr Educ 1997;11:60-8. 4. Barrows HS. Practice-based learning: problem-based learning applied to medical education. Springfield: Southern Illinois University School of Medicine; 1994. 5. Farrand P, Hussain F, Hennessy E. The efficacy of the ‘mind map’ study technique. Med Educ 2002;36:426-31. 6. Buzan T, Buzan B. The mind map book. London: BBC Books; 1993. 7. Gelb MJ. How to think like Leonardo da Vinci: seven steps to genius every day. New York: Dell; 1998. 8. McDermott P, Clarke DN. Mind maps in medicine. Edinburgh: Churchill Livingstone; 1998. 9. Pinto AJ, Zeitz HJ. Concept mapping: a strategy for promoting meaningful learning in medical education. Med Teach 1997;19:114-21. 10. Russell IJ, Caris TN, Harris GD, Hendricson WD. Effects of three types of
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp9 lecture notes on medical student achievement. Acad Med 1983;58:627-36. 11. Bellezza FS. The spatial arrangement mnemonic. J Educ Psychol 1983;75:830-7. 12. O’Sullivan SB, Schmitz TJ. Physical rehabilitation: assessment and treatment. 4th ed. Philadelphia: FA Davis Co; 2001. 13. Michelini CA. Mind map: a new way to teach patients and staff. Home Healthc Nurse. 2000;18:318-322. 14. D’Antoni AV, Pinto Zipp G. Applications of the mind map learning technique in chiropractic education. J Chiropr Educ 2005;19:53-4. 15. Coulter I, Adams A, Coggan P, Wilkes M, Gonyea M. A comparative study of chiropractic and medical education. Altern Ther Health Med. 1998;4:64-75.
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp10 AppendixA.Studentmindmap.Themaphasnopicturesandlittlecolor.Althoughthere issufficientdetailinthemap,thereistoomuchinformation.
Journal of Chiropractic Humanities 2006 © NUHS Mind Map D’Antoni and Pinto Zipp11 AppendixB.Instructormindmapregardingassessmentandrehabilitationtreatmentforstroke.Themapcanbe visualizedashaving4quadrantsinaclockwisefashion:quadrant1focusesonepidemiology,quadrant2onanatomy, quadrant3onrehabilitation,andquadrant4onhistory,physicalexamination,andimpairments.
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