Orthopaedic Surgeon as Educator   Guiding principles &  A few words about learning Dan Pratt Ph.D. University of British C...
Why principles?  <ul><ul><li>Very few randomized controlled trials </li></ul></ul><ul><ul><li>Difficult to control for var...
Eight Guiding Principles <ul><li>Focus on learning </li></ul><ul><li>Zone of development </li></ul><ul><li>Active vs. pass...
Handout on Guiding Principles <ul><li>Condensed the article </li></ul><ul><li>Formatted for easy reference </li></ul><ul><...
1. Focus on Learning <ul><li>‘ What is learned is more important than what is taught.’  </li></ul><ul><ul><li>What is taug...
A simple example <ul><ul><li>Listen to a presentation on a familiar topic.  This should be easy.  But first  …  </li></ul>...
What’s the problem?  Memory is part of the problem
Mr. Anderson, May I be excused? My brain is full. Every added demand hurts learning (cognitive overload) Working Memory   ...
Long Term Memory   Symbolic memory  is when  you try to remember something  without an organizing framework. Episodic memo...
But there’s another problem  Prior beliefs or assumptions that are resistant to change
<ul><ul><li>Strings cannot move enough air to make sound </li></ul></ul><ul><ul><li>Pointed inside to show how strings  </...
Question to students: <ul><li>Question to class (15 minutes later) </li></ul><ul><li>The sound you hear from a violin come...
What % of students got it right? 0%   10%   30%   50%   80%
Results: A. Mostly by strings B. Mostly by wood in back of violin   A   B  C D
What’s going on here? Students (at all levels) often have prior knowledge, beliefs or assumptions that influence their lea...
The Process of Learning is  …   <ul><li>A search for meaning:  </li></ul><ul><ul><li>Learners search for familiar associat...
Clinical Reasoning <ul><li>Compare a Jr. and a Sr. Resident on: </li></ul><ul><ul><li>Taking a history </li></ul></ul><ul>...
Clinical Reasoning <ul><li>Form initial impressions Depends on experience </li></ul><ul><li>Focused data acquisition  Diff...
For teaching  clinical judgment … Bowen, J.  Educational Strategies to Promote  Clinical Diagnostic Reasoning   ( NEJM , N...
1. Focus on Learning ‘ What is learned is more important than what is taught.’
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Orthopaedic Surgeon As Educator

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Slides from Prof Dan Pratt presented at the Teaching to Teach Conference, May 1-2, 2009.

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  • Orthopaedic Surgeon As Educator

    1. 1. Orthopaedic Surgeon as Educator Guiding principles & A few words about learning Dan Pratt Ph.D. University of British Columbia
    2. 2. Why principles? <ul><ul><li>Very few randomized controlled trials </li></ul></ul><ul><ul><li>Difficult to control for variables </li></ul></ul><ul><ul><li>Evidence is often context specific </li></ul></ul><ul><ul><li>Difficult to generalize across variations </li></ul></ul><ul><ul><li>What works for one, may not work for others </li></ul></ul><ul><ul><li>Principles apply across variations in context </li></ul></ul>
    3. 3. Eight Guiding Principles <ul><li>Focus on learning </li></ul><ul><li>Zone of development </li></ul><ul><li>Active vs. passive learning </li></ul><ul><li>Cognitive overload </li></ul><ul><li>Self-esteem </li></ul><ul><li>Big picture </li></ul><ul><li>Hidden curriculum </li></ul><ul><li>Perception of assessment </li></ul>
    4. 4. Handout on Guiding Principles <ul><li>Condensed the article </li></ul><ul><li>Formatted for easy reference </li></ul><ul><li>Quick access and review </li></ul><ul><li>References from both med/educ </li></ul><ul><li>Bold … where to start </li></ul><ul><li>Principle No. 1: The most important </li></ul>
    5. 5. 1. Focus on Learning <ul><li>‘ What is learned is more important than what is taught.’ </li></ul><ul><ul><li>What is taught is not necessarily what is learned </li></ul></ul><ul><ul><li>Teaching is much more than mere telling </li></ul></ul>
    6. 6. A simple example <ul><ul><li>Listen to a presentation on a familiar topic. This should be easy. But first … </li></ul></ul>
    7. 7. What’s the problem? Memory is part of the problem
    8. 8. Mr. Anderson, May I be excused? My brain is full. Every added demand hurts learning (cognitive overload) Working Memory Guiding Principle No. 4: Capacity is very limited. Remember/process max.4-7 unrelated items
    9. 9. Long Term Memory Symbolic memory is when you try to remember something without an organizing framework. Episodic memory is when you remember something by translating it into narrative. Episodic memory uses existing frames of reference to store new experiences.
    10. 10. But there’s another problem Prior beliefs or assumptions that are resistant to change
    11. 11. <ul><ul><li>Strings cannot move enough air to make sound </li></ul></ul><ul><ul><li>Pointed inside to show how strings </li></ul></ul><ul><ul><li>are attached to the sound post </li></ul></ul><ul><ul><li>Told them strings cause back of violin </li></ul></ul><ul><ul><li>to move and that’s what makes the sound </li></ul></ul><ul><ul><li>Told them to use the idea of moving air </li></ul></ul><ul><ul><li>as they reason their way through a problem. </li></ul></ul>Carl Wieman <ul><ul><li>Explained basics of sound </li></ul></ul><ul><ul><li>Showed class a violin and explained … </li></ul></ul>Consider this: Introductory course to non-science majors
    12. 12. Question to students: <ul><li>Question to class (15 minutes later) </li></ul><ul><li>The sound you hear from a violin comes : </li></ul><ul><ul><ul><li>Mostly from the strings </li></ul></ul></ul><ul><ul><ul><li>Mostly from wood in back of violin </li></ul></ul></ul><ul><ul><ul><li>Equally from both wood and strings </li></ul></ul></ul><ul><ul><ul><li>None of the above </li></ul></ul></ul>
    13. 13. What % of students got it right? 0% 10% 30% 50% 80%
    14. 14. Results: A. Mostly by strings B. Mostly by wood in back of violin A B C D
    15. 15. What’s going on here? Students (at all levels) often have prior knowledge, beliefs or assumptions that influence their learning. [positively or negatively]
    16. 16. The Process of Learning is … <ul><li>A search for meaning: </li></ul><ul><ul><li>Learners search for familiar associations </li></ul></ul><ul><ul><li>Prior experience influences their search </li></ul></ul><ul><ul><li>Attempt to build mental abstractions </li></ul></ul><ul><ul><li>Move back-and-forth between defining and discriminating (key) features </li></ul></ul><ul><ul><li>Construct an ‘illness script’ from parts </li></ul></ul><ul><ul><li>Present as accurate, succinct representation </li></ul></ul>
    17. 17. Clinical Reasoning <ul><li>Compare a Jr. and a Sr. Resident on: </li></ul><ul><ul><li>Taking a history </li></ul></ul><ul><ul><li>Conducting physical examination </li></ul></ul><ul><ul><li>Early impressions/assumptions </li></ul></ul><ul><ul><li>Problem representation (symbolic memory) </li></ul></ul><ul><ul><li>Related illness scripts (episodic memory) </li></ul></ul><ul><ul><li>Succinct summary of findings </li></ul></ul><ul><ul><li>Ability to ‘reason aloud’ about their diagnosis </li></ul></ul>
    18. 18. Clinical Reasoning <ul><li>Form initial impressions Depends on experience </li></ul><ul><li>Focused data acquisition Differentiation of key features </li></ul><ul><li>Generation of hypothesis Diagnosis, alternatives, & why </li></ul><ul><li>Problem representation Succinct summary </li></ul><ul><li>Treatment plan Commitment </li></ul><ul><li>Rationale and justification Feedback </li></ul>Reasoning process : Teaching process:
    19. 19. For teaching clinical judgment … Bowen, J. Educational Strategies to Promote Clinical Diagnostic Reasoning ( NEJM , Nov. 2006)
    20. 20. 1. Focus on Learning ‘ What is learned is more important than what is taught.’

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