Intro to adult learning How our students think, and how we can help them learn
Feb 07, 2016
Intro to adult learningHow our students think,
and how we can help them learn
Why have a resident-as-
teacher curriculum?
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
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
Let’s start with some basic
principles of adult learning
Basic Principles of Adult Learning1. Activating a student's prior knowledge enhances learning
2. How students organize knowledge affects learning
3. Students' motivation determines how effectively they learn
4. Repetition is key to learning
Building on Prior Knowledge
Building on Prior Knowledge• Students have prior knowledge
• Advantages• Motivation
• Varying contexts
• Building on strengths
• Disadvantages• Inaccuracies
• Continuum of knowledge
• Time
How do we assess prior knowledge?• Ask the student to demonstrate a skill
• Ask the student to tell you what they know
• Pretest/Posttest
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
Let’s Practice!!
#2: How students organize
knowledge affects learning
Experts and novices organize knowledge differently• Novice learners: superficial, sparse connections
• Experts: complex, deep connections
ExpertExpert
Novice
Knowledge structures help• Deeper, more meaningful knowledge structures facilitate:
• Memorization
• Learning new material
• Solving problems
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
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
#3: Students’ motivation
determines how effectively they learn
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
Motivation
Learning environment
Values
Self-expectations
Motivation Goal-directed behavior
Learning and
Performance
So how can we improve motivation?• How can we improve the value they place on the material? Self-
expectations? Learning environment?
• Discussion
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
Repetition, Repetition, Repetition
Repetition is key to learning
Analyze Evaluate Create
Apply
Understand
Remember
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
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
Let’s Practice !!
What our students need to
know
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
APGO medical student educational objectives1. Develop competence in the medical interview and physical examination of women and
incorporate ethical, social, and diversity perspectives to provide culturally competent health care
2. Apply recommended prevention strategies to women throughout the life-span
3. Recognize his/her role as a leader and advocate for women
4. Demonstrate knowledge of preconception care including the impact of genetics, medical conditions, and environmental factors on maternal health and fetal development
5. Explain the normal physiologic changes of pregnancy including interpretation of common diagnostic studies
6. Describe common problems in obstetrics
7. Demonstrate knowledge of intrapartum care
8. Demonstrate knowledge of postpartum care of the mother and newborn
APGO medical student educational objectives9. Describe menstrual cycle physiology, discuss puberty and menopause, and explain normal and
abnormal bleeding
10. Describe the etiology and evaluation of infertility
11. Develop a thorough understanding of contraception, including sterilization and abortion
12. Develop a knowledge of common benign gynecological conditions
13. Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain
14. Describe common breast conditions and outline the evaluation of breast complaints
15. Demonstrate knowledge of perioperative care and familiarity with gynecologic procedures
16. Describe gynecological malignancies including risk factors, signs and symptoms, and initial evaluation
17. Provide a preliminary assessment of patients with sexual concerns
Resources• Bing-You RG, Tooker J. Teaching skills improvement programmes in US internal
medicine residencies. Med Educ1993;27:259Y265.
• Female Pelvic Med Reconstr Surg 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