Louisville Medicine Volume 65, Issue 12 | Page 18

FEATURE (continued from page 15) "IF A LEARNING METHOD IS CLUNKY AND SLOW, SWITCH TO ANOTHER METHOD. AS AN EDUCATOR, MENTOR OR PARENT, YOU SHOULD PRAISE KIDS FOR BEING INTELLIGENT." Learning for maximum retention is hard. Martin tells his kids it’s good if homework “hurts your brain.” The brain is like a muscle. Researchers have found that a slower apparent rate of accumulation [leads to] greater accumulation of skill and learning over time. Grit predicts success in education. This is why we should praise children for working hard, not for being smart. This lays the foun- dation for a “growth mindset.” Perhaps we should tell our medical students: “you aren’t that smart, but you have a top one percent work ethic!” "JUST PUT IN THE TIME AND THE MATERIAL WILL STICK. INTENSIVE WEEKLONG BOARD REVIEW IS THE BEST WAY TO LEARN THE MATERIAL." As noted above, one must work smarter, not harder. The 10,000 hour rule does not equate to mindless massed practice. Purposeful practice involves goals, intense focus, feedback and leaving the comfort zone. Deliberate practice takes this up one level by adding a coach. You have to put in more than just time. Weeklong board review right before an exam may add a few points on a test, but very little of this information will be retained long- term. This is the reason for the term “continuing medical education.” Unfortunately many doctors take a recertification test once every 10 years and cram their annual CME credits in at the last minute. "SOME PEOPLE JUST HAVE STRONGER MEMORY RETENTION." We intended to create a hyperbolic example of learning to jam all of these principles into one exercise. But medical training already invented such a practice in roughly 1628 C.E. Say what you will about pimping, this [Socratic?] method of instruction utilizes just about every aspect of effective learning. Retrieval is the cornerstone, it uses testing to learn, one must generate the answer, one must elaborate and potentially apply a rule to different examples, lessons learned are by association with patients, interleaving and varied practice are inherent, you might be interrupted (correct or not) and certainly will have distractions, the group is standing and often walking, providing both brain perfusion and different environmental cues. And let us not forget about the feedback from your “coach” as she employs desirable difficulties to euthanize your fluency illusions. References: Boster. U. (2017). Learn Better: Mastering the Skills for Success in Life, Business, and School, or, How to Become an Expert in Just about Anything. Rodale, Inc.: New York, NY. Brancati, F. (1989). The Art of Pimping. JAMA, 262, 89-90. Memory is highly trainable, its drastic improvement being truly straightforward. Though a strong memory has fallen out of favor in our era of information overload, ancient cultures assumed everyone could form his own memory palace. Memory, like learning, is a skill to be cultivated. Brown, P.C., Roediger III, H.L., & McDaniel, M.A. (2014). Make it Stick: The Science of Successful Learning. Harvard University Press: Cambridge, MA. "WE ALL HAVE OUR OWN LEARNING STYLES. " Duckworth, A. (2016). Grit: The Power of Passion and Perseverance. Scribner: New York, NY. Contrary to popular belief, very little data support the existence of learning styles. Howard Gardner proposed intelligence types in his book, Frames of Mind, largely without evidence. Sternberg proposed the following learning styles: analytical, creative, practical; still with minimal evidence. Data seem to show that people learn best with the method that matches the subject matter, NOT individual learning styles. We learn music by listening, art by looking, and math by doing. There is some evidence to suggest the idea of learn- ing preferences (e.g., I like flipping through PowerPoints) but not ingrained, biological ideas of learning styles. Importantly, a strong belief in learning styles may divert some students from unfamiliar methods of learning. 16 With full-time educators finally seeing these myths busted, it is time for physicians to incorporate more efficient learning, aka transference of knowledge for future application. We have the responsibility to continue teaching ourselves, and to impart both knowledge and wisdom onto the next generation. We should all attempt to adopt more deliberate practice at work. Atul Gawande gave a TED talk on hiring a coach to help him improve as a surgeon. He is serious about the practice of medicine. When do practicing physicians get feedback? How much deliberate practice do even res- idents receive? Ten thousand hours represents a desirable quantity, but quality is necessary for learning complex skills or information. We challenge you to abandon these learning myths and actively improve your knowledge and skills. LOUISVILLE MEDICINE Carey, B. (2015). How We Learn: The Surprising Truth about When, Where, and Why it Happens. Random House: New York, NY. Dweck, C. S. (2006). Mindset: The New Psychology of Success. Ballantine Books: New York, NY. Willingham, D. T., Hughes, E.M., & Dobolyi, D.G. (2015). The Scientific status of learning style theories. Teaching of Psychology, 42, 266-271. Dr. Huecker is a practicing UofL Emergency Medicine Physician and Faculty Member. Dr. Horn is an Education Learning Specialist for the UofL School of Medicine Office of Medical Student Affairs.