Intro to adult learning

1. Intro to adult learning How our students think, and how we can help them learn

2. Why have a resident-as-teacher curriculum?

3. Scope • Residents estimate up to 20% of time devoted to teaching • Residents recognize responsibility in teaching • Residents spend more time with bedside teaching than do attendings • Medical students attribute up to 1/3 of knowledge to resident teaching

4. Impact • Resident perceptions • Focused and high impact interactions • Satisfying encounters • Gain enthusiasm for subject matter • Medical student perceptions • Engage student not interested in pursuing field • Resident experts in field • Resident excellent teachers

5. Let’s start with some basic principles of adult learning

6. Basic Principles of Adult Learning • Activating a student's prior knowledge enhances learning • How students organize knowledge affects learning • Students' motivation determines how effectively they learn • Repetition is key to learning

7. Building on Prior Knowledge

8. Building on Prior Knowledge • Students have prior knowledge • Advantages • Motivation • Varying contexts • Building on strengths • Disadvantages • Inaccuracies • Continuum of knowledge • Time

9. How do we assess prior knowledge? • Ask the student to demonstrate a skill • Ask the student to tell you what they know • Pretest/Posttest

10. How Do We Do This? • Set very specific goals • Encourage students to become active participants in the process • Provide context • Set aside time • Strengthen connections with correct prior knowledge • Faculty lectures

11. Let’s Practice!!

12. #2: How students organize knowledge affects learning

13. Experts and novices organize knowledge differently • Novice learners: superficial, sparse connections • Experts: complex, deep connections Novice Expert Expert

14. Knowledge structures help • Deeper, more meaningful knowledge structures facilitate: • Memorization • Learning new material • Solving problems

15. How can we help students organize knowledge? • Any ideas that worked or didn’t work? • Provide an overall structure • Streghthen connections • Identify outliers • Encourage understanding of multiple organizing structures

16. Summary • Experts organize knowledge in deeper, more complex ways • This facilitates memorization, learning, and problem-solving • Elicit your own and your students’ knowledge structures • Provide a structure before teaching • Ensure the structure will accomplish the right task • Reinforce this structure throughout teaching

17. #3: Students’ motivation determines how effectively they learn

18. What motivates students to learn? • What kind of goals do students have? • How do students decide which goals are most important? • How does the learning environment factor in? • Discussion

19. Motivation Learning environment Learning and Performance Goal-directed behavior Values Motivation Self-expectations

20. So how can we improve motivation? • How can we improve the value they place on the material? Self-expectations? Learning environment? • Discussion

21. Summary • Students’ goals provide motivation to their learning • Students might have a variety of different goals • Motivation is influenced by self-expectation, value, and the learning environment • We can use these factors to understand why students behave the way they do • We can manipulate these factors to improve motivation

22. Repetition, Repetition, Repetition

23. Repetition is key to learning

24. Again, please • Massed distribution vs Spaced • Massed distribution • Ex: lectures, skills labs, conferences • Advantage- high short term return • Disadvantage – lack of persistence • Spaced learning • Ex: “Spaced Ed”, memory exercises • Advantage – persistent memory • Disadvantage – marginal time commitment

25. Repetition is Key! • Sisti et al. Neurogenesis and the spacing effect: learning over time enhances memory and the survival of new neurons. Learn Mem 2007:14:368-375

26. Let’s Practice !!

27. What our students need to know

28. APGO medical student educational objectives • https://www.apgo.org/binary/Final%20EDUC%20OBJ.pdf • 17 broad educational objectives • 58 educational topic areas (with associated Uwise cases) • Intended learning outcomes

29. APGO medical student educational objectives • Develop competence in the medical interview and physical examination of women and incorporate ethical, social, and diversity perspectives to provide culturally competent health care • Apply recommended prevention strategies to women throughout the life-span • Recognize his/her role as a leader and advocate for women • Demonstrate knowledge of preconception care including the impact of genetics, medical conditions, and environmental factors on maternal health and fetal development • Explain the normal physiologic changes of pregnancy including interpretation of common diagnostic studies • Describe common problems in obstetrics • Demonstrate knowledge of intrapartum care • Demonstrate knowledge of postpartum care of the mother and newborn

30. APGO medical student educational objectives • Describe menstrual cycle physiology, discuss puberty and menopause, and explain normal and abnormal bleeding • Describe the etiology and evaluation of infertility • Develop a thorough understanding of contraception, including sterilization and abortion • Develop a knowledge of common benign gynecological conditions • Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain • Describe common breast conditions and outline the evaluation of breast complaints • Demonstrate knowledge of perioperative care and familiarity with gynecologic procedures • Describe gynecological malignancies including risk factors, signs and symptoms, and initial evaluation • Provide a preliminary assessment of patients with sexual concerns

31. Resources • Bing-You RG, Tooker J. Teaching skills improvement programmes in US internal medicine residencies. Med Educ1993;27:259Y265. • Female Pelvic Med ReconstrSurg 2010;16: 268Y271) • Brown RS. House staff attitudes toward teaching. J Med Educ 1970;45:156Y159. • D Parnell Why do I have to lean this: Teaching the way people learn best; Waco, Center for occupation research and development, Inc, 1995 • Ambrose, SA et al. “How Learning Works: Seven Research-Based Principles for Smart Teaching.” 2010 • APGO’s Resources for Residents (Effective Preceptor Series, TALENTED lectures) https://www.apgo.org/resident.html