1. Learning Styles: Teaching Techniques to Adapt to Your Learners
Jerica Johnson

2. Outline Index of Learning Styles What is your learning style?
Teaching techniques
Practice cases
Discussion

3. Index of Learning Styles
Learning style: How do you take in information?
Most learning style assessment instruments are not validated 1
Felder-Soloman Index of Learning Styles: validated for internal consistency and temporal stability 2
Learning styles are characteristic preferences for alternative ways of taking in and processing information. This has been a hot topic in education for many years. There is also a lot of money in this as learning style assessment instruments can be sold to educational institutions. Think of Sylvan Learning Center. Since the introduction of learning styles, the number of studies using them has also grown dramatically. Unfortunately, the evidence to back up learning style assessment tools is slim. Most tools are not validated and cannot provide any concrete recommendations for learning. However, one tool has been validated and has specficially been validated in medical students.

4. Index of Learning Styles
The Index of Learning Styles is an on-line survey instrument used to assess preferences on four dimensions (active/reflective, sensing/intuitive, visual/verbal, and sequential/global) of a learning style model formulated by Richard M. Felder and Linda K. Silverman in 2007.

5. What is your learning style?
PollEv.com/jericajohnso943

6. Teaching Techniques One minute preceptor SNAPPS
Activated demonstration
Think aloud
Variances
Arrow in the Quiver
Reflection

7. One minute preceptor
Get a commitment, then probe for supporting evidence. Teach general rules. Reinforce what was right. Correct mistakes. For example, when you are rounding with your intern on intpatient, you could ask them for a commitment on a diagnosis of heart failure exacerbation. Probe for supporting evidence (orthopnea, elevated BNP, history of exacerbations). Then teach a general rule (such as heart failure exacerbation is a clinical diagnosis). Correct mistakes (such as that BNP is not the definitive diagnosis of heart failure, symptoms are the most important diagnostic criteria).

8. SNAPPS Summarize Narrow Analyze Probe Plan Select
This teaching technique is directed by the learner. The learned summarizes their patient case, narrows down their differential, analyzes the data and then probes the TEACHER for more information. The teacher and learner then make a plan and then selects another learning topic for the future. For example, I am precepting with Dr. Bettler in clinic and I summarize about a case of an infant who has some symptoms of GERD. I then narrow my differential to GERD and intestinal malrotation. I analyze the situation and determine that malrotation is less likely given the patient’s overall normal abdominal exam and no bilious emesis. I then probe doctor Bettler for treatment strategies. He says that the Choosing Wisely campaign says to NOT routinely treat infants with GERD with acid suppression. Instead we plan to tell the patient’s parent to do smaller more frequent feeds and to keep the baby upright for ~20 minute after feeds. We then select GERD in infants as a future learning topic to talk about in clinic.

9. Activated demonstration
This is where the teacher will have the learner watch him/her perform a task. The teacher demonstrates, but actively includes the participant. An example of this is when Dr. Stulberg will show you percussion of a patient’s lungs during rounds to determine if the patient has a pleural effusion. He will demonstrate effective auscultation and percussion of the lungs and then will have you try. You then will discuss whether or not you will get a CXR based on the activated demonstration.

10. Think aloud
Think aloud is exactly how it sounds. This allows your learners to track your thought progression and develop a similar problem solving pattern.

11. Variances
Variances are changing up the situation. For example, your senior resident asks you what medication you should give to the diabetic female with high blood pressure. You might suggest an ACE-inhibitor. Your senior resident agrees with you and now asks, “what if she were pregnant?” You both then discuss blood pressure treatment in pregnancy women.

12. Arrow in the Quiver
Arrow in the Quiver is a term for pearls that you have packaged up and neatly tied for specific situations. For example, you might have a pearl like that systemic corticosteroids should be used in COPD exacerbations because they have a NNT of 10, but there is no difference in mortality if someone receives steroids during an exacerbation

13. Reflection
Reflection is different than thinking aloud. It is the practice of reviewing something that has already occurred. An example of this would be a debriefing session with Dr. Grant after having a shoulder dystocia. You may review the things that were done correctly and then the things that could have gone smoother. This allows for learning for the next time.

14. Practice!
Alternate between person #1 and person #2 for the cases. Then go ahead and fill out the back page worksheet.

15. Discussion What was a good technique for a specific learning type?
What was not a good technique for a specific learning type?

16. Types of learners
Teaching techniques to fit them
Active
Activated demonstration
Reflective
Reflection, Think aloud
Sensing
Activated demonstration, Arrow in the Quiver
Intuitive
SNAPPS (Summarize, Narrow, Analyze, Probe, Plan, Select), One minute preceptor
Visual
Verbal
Think aloud, Arrow in the Quiver
Sequential
One minute preceptor, Variances
Global
Reflection

17. Questions?

18. Thanks
Gary Smith, Ph.D., Assistant Dean of Faculty Development in Education, Office for Medical Educator Development
Darra D. Kingsley, M.D., RAE Course Director
Residents as Educators Conference

19. References
1: Pashler H, McDaniel M, Rohrer D, Bjork R. Learning Styles: Concepts and Evidence. Psychol Sci Public Interest Dec;9(3): doi: /j x. PubMed PMID:
2. Hosford CC, Siders WA. Felder-Soloman's Index of Learning Styles: internal consistency, temporal stability, and factor structure. Teach Learn Med Oct;22(4): doi: / PubMed PMID: