In medical education, simulation is a rapidly growing methods of providing experiential learning to healthcare practitioners in many disciplines and at many levels.Cognitive learning theory in the classroom much of this increase in popularity is due to the “wow” factor involved in technologies such as human patient simulators, but it is also due to the increasing literature that reveals improved outcomes over traditional approaches (mcgaghie, issenberg, petrusa, & scalese, 2010; mcgaghie, issenberg, cohen, barsuk, & wayne, 2011).Cognitive learning theory in the classroom I have (in a past life) been involved in the design, implementation, and evaluation of simulation-based training for medical students, residents, nurses, and paramedics, and I too was focused on ensuring that the outcomes (as designed in our programs) were better than traditional methods.Cognitive learning theory in the classroom as I approach my future research interests, I have the opportunity to continue in this vein, along with a growing number of physician-researchers identifying and confirming improved learning, but would then be left with a with a question that has progressively crept into my psyche (and I can’t get it out)… and that is, “why?”

cognitive learning theory in the classroom

This question might sound silly or obvious, but, to my knowledge, it is not a question that has been well addressed in this field. It is great to see that innovative methods have been identified that lead to improved clinical performances, but it’s becoming more important to understand why that difference in learning has occurred, how learning in such activities occurs, and, diving deeper, what aspects of learning in this environment can lead to better learning yet.Cognitive learning theory in the classroom

So there is an area within the discipline that will help outcomes-based researchers shed light on understanding how there results have been achieved and, subsequently, how to improve on their design.Cognitive learning theory in the classroom one group that has broached this area includes dr. Parchoma’s group (parchoma, zenios, & shahoumian, (2012); shahoumian, saunders, zenios, parchoma, & hanson, 2014) who have explored learning in this environment from a number of different theoretical frameworks with the understanding that a theoretical foundation will assist in the comprehensive integration of this important learning method into the overall medical curriculum.Cognitive learning theory in the classroom

McGaghie, W. C., issenberg, S. B., cohen, M. E. R., barsuk, J. H., & wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education?Cognitive learning theory in the classroom A meta-analytic comparative review of the evidence. Academic medicine: journal of the association of american medical colleges, 86(6), 706.

Cognitive learning theory in the classroom

Parchoma, G., zenios, M. & shahoumian, A. (2012). Theorizing blended simulation based medical education (SBME): A networked learning theory-informed perspective.Cognitive learning theory in the classroom in T. Bastiaens & G. Marks (eds.), proceedings of world conference on E-learning in corporate, government, healthcare, and higher education 2012 (pp. 1881-1886).Cognitive learning theory in the classroom chesapeake, VA: AAC.

I had a very unusual and disheartening reaction to a comment yesterday… now that I (might) have your attention, let me explain.Cognitive learning theory in the classroom I had reflected upon a book I had read during my residency (mid-90’s) and how the innovative ideas and research that were contained in it had really left an impression upon me.Cognitive learning theory in the classroom I was not alone; the author was a rhode scholar and had been selected as the most admired person in education (in the US). One of my colleagues searched the book and found that the author had committed suicide a few years back in the midst of a class action sexual abuse case.Cognitive learning theory in the classroom she asked, “how do we react to something like this? Do we discount the work or research?”

The visceral reaction I had, immediately, was intense.Cognitive learning theory in the classroom the positive perspective I had of the author dissipated, despite my belief in the concept of innocent until proven guilty. But what to do with the research findings?Cognitive learning theory in the classroom how to refer to the material, and/or the author? These questions stem not just from what do I think others will think if I use these references, but (hopefully) more importantly, what do I think?Cognitive learning theory in the classroom what is consistent with my principles? And for all of these questions, I have no answer. Guilt or innocence will never be proven, but even if it were, how might that change my perspective?Cognitive learning theory in the classroom

I found it interesting yesterday when we began taking about placebos and it made me realize that just as we have difficulty wrapping our heads around how learning occurs (pun intended), we are equally flummoxed in trying to understand the placebo effect.Cognitive learning theory in the classroom let me first define what I understand the placebo effect to be as it is commonly misunderstood phenomenon. Steven novella (2014) describe it as “a measurable response to an inert treatment.” in other words, it is not simply feeling like some treatment or intervention (in fact, the placebo) is improving whatever condition it was intended for (although patient feelings and satisfaction are certainly measurable), but that there is often an objectively measurable change in the patient’s condition.Cognitive learning theory in the classroom levels of infection may be reduced, tumor size may decrease, demise may dissipate. We simply don’t know why, (although there are no shortage of people who will offer their opinion… BEWARE!).Cognitive learning theory in the classroom how much does our expectation, hope, and intention play in cause physiologic changes in the body, and how much is simply happenstance where the medical condition reverses course.Cognitive learning theory in the classroom here’s my opinion (for what it’s worth): it’s probably a bit of both … I know … profound!

Throughout our courses so far this summer we have often referred to “adult” learners and in many instances associated this with age or level of education.Cognitive learning theory in the classroom along these lines, I have long been concerned with the necessary transition medical students must make from the relative teacher-dependence many have coming out of their undergraduate degrees to the independent learning characteristics that they will need to possess in order to succeed in their clinical training years and beyond.Cognitive learning theory in the classroom in my masters program, I explored this transition in a paper entitled, “an orderly progression to self-directed learning”. My research revealed that many adults in post-graduate studies did not possess (or practice) what are generally described as “adult learning” characteristic and that the considerable increase in courses and programs based on these principles (and our assumptions that our learners possessed them) may be doing a disservice to these students.Cognitive learning theory in the classroom not surprisingly, learners learn best when teaching styles match their learning styles. To make this somewhat more convoluted, “self-directedness,” the extent to which a learner practiced adult learning characteristics (garrison, 1997), can be situational, depending on the subject matters and the learners past experience and skill set (grow, 1991).Cognitive learning theory in the classroom

The good news is that researchers in this area have reported that self-directedness can be taught (and learned) (brockett & hiemstra, 1991).Cognitive learning theory in the classroom other positive news is that curricula can be designed to incorporate this progression of self-directedness as students advance in the course or program.Cognitive learning theory in the classroom A self-directed learning readiness scale (SDLRS) has been validated in a number of disciplines (guglielmino & associates, as cited in hiemstra, 2003) and can be used to assess the levels of self-directedness possessed by a class of learners to ensure that the approach to teaching (i.E.Cognitive learning theory in the classroom level of dependency) matches the learning styles and abilities of the students. If the level of self directedness is less than desired for a course or program, grow (1991) developed a staged self-directed learning model (SSDLM) that can be used as a curricular platform to help students advance to higher levels of independence while engaged in the course materials.Cognitive learning theory in the classroom

I have known about this curve for some time (and have certainly experienced folks with all of these characteristics over the years) but have never formally read about it.Cognitive learning theory in the classroom enacting change is a fascinating challenge (the bigger the bigger). As I thought about where I fit on this curve (somewhere on the left), I thought about my lunch yesterday.Cognitive learning theory in the classroom I had the opportunity to sit with two young ladies in the masters, child psych program. One had graduated from university and gone off to tanzania to work.Cognitive learning theory in the classroom since that time she had traveled to many locales and done many different things. The other was born and raised in calgary, had gone to undergrad at mount royal and was now at UC for grad school.Cognitive learning theory in the classroom I asked her what her future plans were and they involved working in the calgary school system. Two very different approaches, neither ‘better’, but I wonder where they would sit on this curve.Cognitive learning theory in the classroom is change in our personal lives and circumstances approached by us in the same manner we approach change in organization. It happens to be in my case, but…

cognitive learning theory in the classroom

The fascinating part was that there were many different concepts and ideas that I had heard or learned of previously that seemed to get connected up in a rather unusual thread as the discussions went on.Cognitive learning theory in the classroom for example, sharon spoke of complex adaptive systems, an area I had done some work in long ago, exploring the chaos that we affectionately called the emergency room (my home away from home at the time).Cognitive learning theory in the classroom from my experience, much of this work stems on the realization that not all areas in an organization function in the same manner, regardless of their similarities on paper.Cognitive learning theory in the classroom personalities, goals, challenges, circumstance, etc. All may be different to varying degrees and a top down approach will meet with varying success.Cognitive learning theory in the classroom the best solutions are often those that are developed locally and can then be shared and appropriately adapted in other areas of the organization.Cognitive learning theory in the classroom

That idea morphed in with sharon’s talk of leverage points … the idea that getting things done in an organization (education related or otherwise) is often predicated on the participation of certain individuals (and/or sectors).Cognitive learning theory in the classroom this reminded me of gladwell’s tipping point characters, the descriptions of which instantly brought to mind people in my organization as I read it.Cognitive learning theory in the classroom we all know the connectors, mavens and sale smen in or organizations and their importance in institutional evolution. This whole idea of how to get things done; how to move things forward was looked at from a programmatic (rather than personal) perspective when sharaz brought up john kotter’s work (“the heart of change”) and his 8 steps to organizational change.Cognitive learning theory in the classroom I immediately thought of one of kotter’s lesser know works, “my iceberg is melting”, a story of penguins that analogizes his 8 steps. In this story, sharaz’s primary point is made clear: in order to get people to move to something new (new curriculum, new methods, etc.), kotter suggests the first thing to do is to get them to realize that they can’t stay where they are; inertia is not an option.Cognitive learning theory in the classroom in the penguin story, movement to a new iceberg is not simply desirable, it is necessary (as, you may have guessed from the title, their current one is melting).Cognitive learning theory in the classroom

This whole idea of how do we get methods that we all know are better ways of doing things to replace our current methods made me think of something I had heard of many years ago regarding the excitement that often comes from attending conferences, think tanks, etc.Cognitive learning theory in the classroom the wet dog phenomenon. We gain great enthusiasm and excitement at the possibilities and we can’t wait to get back to our home institutions to tell everyone how wonderful things can be.Cognitive learning theory in the classroom the problem is, those we return home to have not had this wonderful kumbaya experience … in fact they were stuck at home covering for you. They stand back and let you shake out all your ideas and fascinations, just like a wet dog, knowing that in a few days, the drudgery of the circumstance in which you are all intertwined will return you to your senses.Cognitive learning theory in the classroom