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 theorizing
Learning 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
Working Long Term Memory
Memory Storage Retrieval
Working Memory
•Focus attention
Attention •Questions
•Change activity every15 minutes
•Teach < 7 steps
Rule of 7 •Numbers aide memory
•Importance
Relevance •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 Questions
http://medicaleducation.wetpaint.com/page/Using+Questions+to+Stimulate+Thinking
3. Intentional Role Modeling
http://medicaleducation.wetpaint.com/page/Intentional+Role+Modelling
4. 5 Minute Preceptor
http://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
New Unconscious
Awareness
Challenges
Incompetence
Unconscious Conscious
Competence Incompetence
Practice
Conscious
Explicit Teaching
Competence
Reassurance