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Perspectives on Learning: Implications for Instruction (Part 3)
Presented by: Barry G. Sheckley, Ph.D., Neag Professor of Adult Learning, Neag School of Education, University of Connecticut
Mary Martin Lowe, M.A., Ph.D. candidate, Neag School of Education, University of Connecticut
Goals: This was the third in a series of seminars designed to focus on instructor development when conducting small class-size instruction.
- To understand the intersections of classroom-based and clinic-based instruction
- To define the goals of a clerkship directed curriculum in terms of: learning factual knowledge versus developing clinical reasoning skills, and acquisition of introductory knowledge versus advanced knowledge
- To learn research-based practical techniques in improving instruction
It is worthwhile to emphasize that learning involves dynamic interactions between:
A learning process, in which experience is transformed into knowledge, the setting(s) in which the process occurs, and the characteristics of the individuals engaged in the process.
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Learning is dependent upon simultaneous and often subconscious brain activity. This brain activity is dependent upon several interrelated anatomic brain regions designed to accommodate specific functions of the learning process. This process can be conceptualized as a learning loop:
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There are important caveats to remember when instructing a group or individual which can be inferred from this learning loop diagram:
- Whenever learners have no prior experience; explicit instruction can serve to focus their attention on key patterns in a situation.
- Whenever instructing about a “single-ruled” simple structure; explicit instruction is most effective.
- Whenever instructing about a “complex-ruled” multi-faceted structure; implicit instruction is most effective.
- In many instances explicit instruction can lead to decreased performance. This is especially true when learners have prior experience and / or situations are complex.
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The process of clinical reasoning can be broken down into four components. These are the steps typically taken with each clinical problem-solving encounter. The instructional process should endeavor to emphasize these steps.
- Procedural: the general mechanics to approaching the problem, a strategy.
- Relational: the recognition of similarly encountered problems and their solutions to use as a potential template for a solution.
- Contextual: the awareness that the same clinical problem will have a different solution dependent upon changes in context (e.g.) abdominal pain in a man versus a woman, diarrhea in a person in the USA versus Mexico
- Self-monitoring: the recognition of the expected standards of professional practice as applied to the clinical circumstance.
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Practical approaches for instruction to clinical problem solving could emphasize the following points:
- Describe with clarity the differences between the Normal and Abnormal circumstance.
- Emphasize the gestalt of “pattern recognition” of facts and findings, which fit together.
- Expand the clinical heterogeneity and variations of normal.
- Express the mental process of eliminating or de-emphasizing less relevant and irrelevant data.
- Integrate the preceding steps within the “current context” of the patient at hand.
Summarized by F DiMario
References:
Edelman, GM,. Tononi, G.A. Universe of consciousness: How matter becomes imagination. New York: Basic Books, 2000.
Gick, M.L, Holyoak, K.J. Schema induction and analogical transfer. Cognitive Psychology. 1983; 15; 1-38.
Ericsson, K.A., Krampe, R., Tesch-Romer, C. The role of deliberate practice in the acquisition of expert performance. Psychological Review. 1993; 100(3); 363-406.
Raufaste, E., Eyolle, H., Marine C. Pertinence generation in radiological diagnosis: Spreading activation and the nature of expertise. Cognitive Science, 1998; 22(4); 517-546.
Travers, N, Sheckley, BG, Bell, A. Enhancing self-regulated learning A comparison of instructional techniques. Journal of Continuing Higher Education, 2003; 51(3); 2-17.
Knauff, M., Jola, C., Mulack, T., Kassubek, J., Salih, H.R, Greenlee, M.W. Spatial Imagery in deductive reasoning: a functional MRI study. Cognitive Brain Res. 2002; 13(2); 203-212.
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