TRANSACTIONS OF THE AMERICAN CLINICAL AND CLIMATOLOGICAL ASSOCIATION, VOL. 127, 2016
EDUCATE TO TRANSFORM: THE ART OF DEVELOPING CURIOUS MINDS DEBRA A. SCHWINN, MD IOWA CITY, IOWA
ABSTRACT With rapid changes in health care and academic medicine, deans and medical educators need to carefully optimize medical education in order to best prepare our students for the future. Fundamentally, it is critical that future medical practitioners develop curious minds that look beyond the obvious to ask questions not yet asked and glean reality. This paper summarizes optimal adult learning, including (for example) concepts such as deliberate practice, active and interactive learning, and the flipped classroom.
INTRODUCTION Today is a time of change and challenge in medicine. We live in an era of rapidly changing health care dynamics and new challenges in education. Within this context, we need to prepare our medical students and residents for the future. However, we must do this in deeply thoughtful ways. It is up to us, as academic medical center leaders and faculty members, to find those better ways and investigate the art of developing curious minds. Such a process is the only way to truly optimize lifelong, conscious, and reflective learning.
THE LEARNING PROCESS Expert performance requires thousands of hours of thoughtful training and practice. Whether perfecting a pirouette, improving writing skills, or understanding how to administer a physical examination, practicing the right way can mean the difference between being good and being great. When it comes to understanding expertise and expert performance, psychologist K. Anders Ericsson is perhaps the world’s Correspondence and reprint requests: Debra A. Schwinn, MD, Room 108, College of Medicine Administration Building, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa 52242, Tel: 319-335-8435, E-mail: [email protected]. Potential Conflicts of Interest: None disclosed.
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leading expert. His research is the basis for the 10,000-hour rule that suggests at least 10,000 hours of deliberate practice is required to achieve an expert level of performance in any given domain—and in the case of musicians, this number often translates into 15 to 25 years to attain an elite international level (1). Deliberate or mindful practice is a systematic and highly structured activity that is, for lack of a better word, more scientific. Instead of mindless repetitions, it is an active and thoughtful process of hypothesis testing where we relentlessly seek solutions to clearly defined problems. It might involve monitoring one’s performance, e.g., with a practice notebook, where one keeps track of practice goals and what one discovers in practice sessions, and perhaps even jots down insights and discoveries (2). It might also involve the teacher as a significant influence. In addition, specific pedagogical methods have been shown to result in specific outcomes that influence the quality of education, performance of students, and success in instilling a desire for lifelong learning. A literature review identifies a few opportunities where teaching method is a strong influence: engaged versus didactic learning, interactive learning, active problem solving, and the flipped classroom or flipped learning (a pedagogical approach that calls for a dynamic learning environment where the educator guides students as they apply concepts and engage creatively in the subject matter). The results of such thoughtful and effective adult learning strategies can be dramatic and visible. For example, ballerinas are extreme athletes who, for artistic and aesthetic reasons, are expected to remain lean with strength in order to be graceful athletes. Here, practice method makes the critical difference. If ballerinas use their quadriceps femoris to lift from the top, they promote muscle hypertrophy, or bulk, leading to muscular, athletic shapes, more often seen in modern dance. If they instead use their biceps femoris to support their leg from below, strength can be achieved while promoting willowy limbs (3).
ENGAGED VERSUS DIDACTIC LEARNING Returning to medical education, the literature on engaged versus didactic learning suggests that incorporating more engaging learning sessions improves both qualitative experiences and performance levels of professional students. Miller et al found that the use of engaging lectures (also referred to as broken or interactive lectures, whereby, typically, students are given short periods of lecture followed by breaks that can consist of 1-minute papers, problem-solving exercises,
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brainstorming sessions, or open discussion) led to a statistically significant higher average on unit exams compared with traditional didactic lectures (8.6% higher, P
EDUCATE TO TRANSFORM: THE ART OF DEVELOPING CURIOUS MINDS DEBRA A. SCHWINN, MD IOWA CITY, IOWA
ABSTRACT With rapid changes in health care and academic medicine, deans and medical educators need to carefully optimize medical education in order to best prepare our students for the future. Fundamentally, it is critical that future medical practitioners develop curious minds that look beyond the obvious to ask questions not yet asked and glean reality. This paper summarizes optimal adult learning, including (for example) concepts such as deliberate practice, active and interactive learning, and the flipped classroom.
INTRODUCTION Today is a time of change and challenge in medicine. We live in an era of rapidly changing health care dynamics and new challenges in education. Within this context, we need to prepare our medical students and residents for the future. However, we must do this in deeply thoughtful ways. It is up to us, as academic medical center leaders and faculty members, to find those better ways and investigate the art of developing curious minds. Such a process is the only way to truly optimize lifelong, conscious, and reflective learning.
THE LEARNING PROCESS Expert performance requires thousands of hours of thoughtful training and practice. Whether perfecting a pirouette, improving writing skills, or understanding how to administer a physical examination, practicing the right way can mean the difference between being good and being great. When it comes to understanding expertise and expert performance, psychologist K. Anders Ericsson is perhaps the world’s Correspondence and reprint requests: Debra A. Schwinn, MD, Room 108, College of Medicine Administration Building, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa 52242, Tel: 319-335-8435, E-mail: [email protected]. Potential Conflicts of Interest: None disclosed.
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DEBRA A. SCHWINN
leading expert. His research is the basis for the 10,000-hour rule that suggests at least 10,000 hours of deliberate practice is required to achieve an expert level of performance in any given domain—and in the case of musicians, this number often translates into 15 to 25 years to attain an elite international level (1). Deliberate or mindful practice is a systematic and highly structured activity that is, for lack of a better word, more scientific. Instead of mindless repetitions, it is an active and thoughtful process of hypothesis testing where we relentlessly seek solutions to clearly defined problems. It might involve monitoring one’s performance, e.g., with a practice notebook, where one keeps track of practice goals and what one discovers in practice sessions, and perhaps even jots down insights and discoveries (2). It might also involve the teacher as a significant influence. In addition, specific pedagogical methods have been shown to result in specific outcomes that influence the quality of education, performance of students, and success in instilling a desire for lifelong learning. A literature review identifies a few opportunities where teaching method is a strong influence: engaged versus didactic learning, interactive learning, active problem solving, and the flipped classroom or flipped learning (a pedagogical approach that calls for a dynamic learning environment where the educator guides students as they apply concepts and engage creatively in the subject matter). The results of such thoughtful and effective adult learning strategies can be dramatic and visible. For example, ballerinas are extreme athletes who, for artistic and aesthetic reasons, are expected to remain lean with strength in order to be graceful athletes. Here, practice method makes the critical difference. If ballerinas use their quadriceps femoris to lift from the top, they promote muscle hypertrophy, or bulk, leading to muscular, athletic shapes, more often seen in modern dance. If they instead use their biceps femoris to support their leg from below, strength can be achieved while promoting willowy limbs (3).
ENGAGED VERSUS DIDACTIC LEARNING Returning to medical education, the literature on engaged versus didactic learning suggests that incorporating more engaging learning sessions improves both qualitative experiences and performance levels of professional students. Miller et al found that the use of engaging lectures (also referred to as broken or interactive lectures, whereby, typically, students are given short periods of lecture followed by breaks that can consist of 1-minute papers, problem-solving exercises,
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brainstorming sessions, or open discussion) led to a statistically significant higher average on unit exams compared with traditional didactic lectures (8.6% higher, P
