How Medical Students Learn

1. How Medical Students Learn

2. 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.

3. 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.

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

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

6. 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

7. 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

8. Working Memory Long Term Storage Memory Retrieval

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

10. 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.

11. Illness Scripts

12. Repetition Wozniak, 2006

13. 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/

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

15. ClinicalReasoning 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

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

17. 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#

18. 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

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