The presentation by Brian S. McGowan focuses on the cognitive load that impacts learning effectiveness in continuing medical education (CME) across different generations. It emphasizes the importance of understanding natural learning actions and implementing agile educational design to reduce extraneous load and enhance the learning experience. Key takeaways include the necessity to measure, analyze, and adapt educational strategies for improved outcomes.

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Brian S McGowan, PhD
Chief Learning Officer
ArcheMedX, Inc.
@briansmcgowan
Do CME Learners Really
Differ Across Generations?

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Objectives:
Following this session attendees should be prepared to:
1. explore (through an interactive discussion) the question, how do CME
learners really learn?
2. describe 4 natural actions learners rely on while consuming educational
content
3. identify best practices to mitigate the extraneous load learners confront in
traditional learning environments
4. design critical strategies that can be incorporated into your educational
program/activities to support more effective and efficient learning
5. recognize similarities and differences of learners across generations

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Critical Take-Aways:
1. The Cognitive Load of learners is a critical bottleneck that limits
the impact of educational interventions or learning experiences.
2. The Learning Actions Model is an novel instructional design
technique that frees up working memory by minimizing
extraneous load
3. Leveraging Agile Education Design ensures that the learning
experience and the learning environment are refined and
optimized over time
4. …apply these insights to decide whether generational differences
materially impact learning effectiveness

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The Evolution of Educational Interventions

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The Evolution of Educational Interventions

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The Evolution of Educational Interventions

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The Evolution of Educational Interventions

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The Evolution of Educational Interventions

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The Challenges of Cognitive Load

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Subsystem model of memory (1968)
+ or -

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Working Memory and Cognitive Load (1988)
1. Working memory can only process seven elements
of information at any given time.
2. Working memory creates a ‘‘bottleneck’’ for
learning.
3. When the cognitive load associated with a task
exceeds the learner’s WM capacity, performance
and learning is impaired.

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Deconstructing the “Load” Bottleneck
Schemata construction:
1. Activating prior knowledge;
2. Comparing new information
with what they already know
3. Elaborating knowledge

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Understanding why the firehose fails…

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What’s load got to do with it…
Intrinsic load: relationship
between content and learner
Extraneous load: environment
of learning/teaching
Germane load: attention or
motivation

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Overcoming the “Load” Bottleneck
Intrinsic Load:
“intrinsic load cannot be altered by
instructional interventions without
either simplifying the task to be
learned or first enhancing the
expertise of the learners by
providing preparatory training prior
to the task.”
Extraneous Load:
1. Instructional Design
2. Structured Information
3. Content Presentation
4. Learning Environment

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Pacing Information Consumption: Rhythm
Rate and rhythm science
• Density
• Intensity
• Dead-spots
• Complexity

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Reflection Point #1
Do you believe that the memory
science is affected by
age/generational differences?

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Extraneous Load and
The Natural Learning Actions

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One outstanding (undermining) assumption

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Do Learners Know
How to Learn?

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RESEARCH: How do learners learn?
Interviewed ~300 clinician*
learners to:
1. Deconstruct the‘process of
learning’
2. Explore the how and when
3. Assess how effective and efficient
learners were at the‘process of
learning’ * Cohort included physicians, residents, medical students,
specialists, generalist, & allied health professionals

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What Did We Find?
= The Natural Learning Actions
There are 4 generally
acknowledged actions learners
believe drives effective learning
Education planning, development,
and delivery that does not support
the 4 Natural Learning Actions is
at risk of remaining ‘minimally
effective’
(2013)

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Natural Learning Actions: Note Taking
Learners acknowledge a
jerry-rigged system of
notebooks, index cards,
post-its, and spare
paper/pads.

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Natural Learning Actions: Reminders
Learners acknowledge a
failed framework that
includes calendars, to-do
lists, dogged-eared
notebook pages, and
emails.

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Natural Learning Actions: Search
Learners acknowledge that
as new questions arise
within the learning process
their attention becomes
fragmented as they struggle
to search for answers.

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Natural Learning Actions: Nudges
Learners acknowledge that
they often look to faculty
and/or other learners to
nudge their own process of
learning (how/when they
take notes, set reminders,
and search).

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The Natural Learning Actions:
A Requisite, But Unevolved, Skillset
4 Natural Learning Actions

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Impact on Educational Planning
Experience must be structured to
simplify learning and centralize the
natural learning actions
Planners MUST measure if and how
learning is occurring
Planners MUST react to what is or
isn’t working…
Learning Actions Model

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Reflection Point #2
Do you believe that the process of
learning is affected by
age/generational differences?

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Getting Better Over Time:
The Advent of Agile Educational Design

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Educational Planning
Is educational planning an “end point” or a “process”?
VERSUS

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There’s never been a perfect activity…
Given the challenges of the cognitive learning
process (i.e., intrinsic load, extraneous load,
germane load…)
Given the complexity of instructional design,
structured information, content presentation,
learning environment, and unevolved natural
learning actions
Given the heterogeneity of audiences, teams,
and/or culture
Our activities will NEVER be perfect right out
of the gate… ergo, it is a process!

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The Importance of “Agile Education Design”?
Agile Planning Loops
An umbrella term for
a planning/operations
approach that is
viewed as ‘on-going’
and broken into
smaller pieces
flexible enough
to be refined as data
dictates…
Learning Actions Model

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1. You must be able to measure
2. You must be able to analyze
3. You must be able to adapt
3 Critical Elements of Agile Education Design
1. You must be able to measure
2. You must be able to analyze
3. You must be able to adapt

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1. The more (good) data, the better…
Pre- and post-test data
Intra-activity polling
Follow-on survey
Question-specific data
• Answer-option specific data
Learning action data
Social learning data
Team performance data?

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2. Data is not informative without analysis!
Predefine your intended datasets
Operate within your limitations.
Identify the requisite resources and
competencies
Can you claim causality?
Are you generating new hypotheses?

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3. How ‘agile’ are your activities?
Is change possible?
1. Content
2. Experience (environment)
3. Measurements
Do you have requisite
resources/competencies?
Productivity/Efficiency?
VERSUS

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Agile Design Ensures Improved Outcomes
Launch
Adapt 1
Adapt 2
Adapt 3
SMART Goal
Reconciliation
TIME
IMPACT

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Summarize Agile Education Design in IPE
1. Measure – the more (good) data, the better
2. Analyze – but only if you are prepared to
analyze and interpret these data
3. Adapt – and only if you are able to refine and
enhance the activities

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Agile Design Ensures Optimal Load Reduction
Is extraneous load being
minimized?
• Better design
• Better structure
• Better content
• Better environment
Are learners’ intrinsic loads
being optimized?

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Reflection Point #3
Do you believe that an agile
educational planning process can be
used to identify, verify, and address
age/generational differences
(efficiently)?

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(my) Summary and (your) Conclusions
Memory Science Deconstructed
Process of Learning
Agile
Educational Design
+
  
Generational Differences?

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Brian S McGowan, PhD
Chief Learning Officer
ArcheMedX, Inc.
@briansmcgowan
Do CME Learners Really
Differ Across Generations?