Deirdre BonnycastleSnoDocs 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.

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.

Question

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.

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:

1. the knowledge that represents phenomena in the subject domain

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

3. and to act in them.Billet, 1996

Situated learning: bridging sociocultural and cognitive theorizingLearning 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

WorkingMemory

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

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.

Illness Scripts

Repetition

Wozniak, 2006

Memory Retrieval

1. Use Retrieval Devices Mnemonics, songs, rhymes, flash cards

http://www.ichi2.net/anki/http://www.medicalmnemonics.com/

2. Reinforce the Use of Illness Scripts http://www.medmaps.co.uk/

3. 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!

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

CASE Curriculum Model

C ooperative

A ctive

S elf directed

E xperiential

See http://medicaleducation.wetpaint.com/page/CASE+Curriculum+Model for more information

Top 4 Techniques

1. Cases, Cases, Cases Cases Journal http://casesjournal.com/

2. Socratic Questionshttp://medicaleducation.wetpaint.com/page/Using+Questions+to+Stimulate+Thinking

3. Intentional Role Modelinghttp://medicaleducation.wetpaint.com/page/Intentional+Role+Modelling

4. 5 Minute Preceptorhttp://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

Skill Learning Cycle

UnconsciousIncompetence

ConsciousIncompetence

ConsciousCompetence

UnconsciousCompetence

Awareness

Explicit Teaching

Practice

Reassurance

New Challenges

Thank YouEnjoy the

Conference