Intro to adult learning How 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 Learning 1.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

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 Expert 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:

Let’s Practice !!

What our students need to know

APGO medical student educational objectives 17 broad educational objectives 58 educational topic areas (with associated Uwise cases) Intended learning outcomes

APGO medical student educational objectives 1.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 objectives 9.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)