engaging health professionals and trainees in online learning
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Engaging Health Professionals and Trainees in Online Learning. Graham McMahon MD MMSc [email protected]. The World of Medicine is Changing Fast. Hard to anticipate how this generation of learners will be practicing? . Our learners have changed: Some Characteristics of Millenials. - PowerPoint PPT PresentationTRANSCRIPT
The World of Medicine is Changing Fast Hard to anticipate
how this generation of learners will be practicing?
Our learners have changed: Some Characteristics of Millenials
have never known a life without computers and the Internet generally began using computers between the ages of 5 and 8;
almost all used computers by age 16 are more accustomed to using keyboards rather than pens or
pencils generally prefer to read information from computer screens or
mobile devices rather than from printed texts have more friends in social networking sites than in person have spent more time playing games than reading books
More standardization?
Create new standards
Raise standards
Standardization Conformity
vs.
Engage the heart Goal that is meaningful (task vs. knowledge
orientation) Engage the mind
Interesting achievable task Personalized feedback over time
Engage with others Nurture collaboration
Information is Ubiquitous and Easily Accessible
Challenges
The Challenge Millenials don’t need information; they need
Prioritization Context Understanding Feedback
The Challenge: Engage Learners Variety Style Interactivity
Unique Issues The technological forces that have affected this generation
necessitate digital multitasking and interaction in online communities
Individuals raised with computers deal with information differently compared to previous cohorts: “They develop hypertext minds, they leap around.”
Efficiency is very important
Issues for Learning learn better through discovery and
experiential learning rather than by being told want an immediate response have the ability to shift their attention rapidly
from one task to another and may choose not to pay attention to things that don’t interest them — attentional deployment
believe multitasking is a way of life and are comfortable when engaged in multiple activities simultaneously
respond to visual cues and stimuli
The Decline of Experts Millenials are interactors – creating and consuming
information Old Model:
Reputation Experience Access
New model: Crowd Someone with experience Anyone with an opinion
What are gamers getting good at? Urgent optimism
Ability to engage immediately with a problem where there is a reasonable hope of success
“always worth trying, and trying now” Tight social fabric
Takes a lot of trust to play a game with someone Blissful productivity
Happier working hard gaming than relaxing
Emotion and Learning Students retain what they learn when the
learning is associated with strong positive emotion. Dulay & Burt, 1977; Krashen, 1982
Stress, boredom, confusion, low motivation, and anxiety individually, and more profoundly in combination, interfere with learning Christianson, 1992
Attributes of Engaging Games Clear and consistent rules Clear goal Clear rationale Mission connected to and dependent on your
ability Plenty of support Lots of positive feedback Shared experience
Educational technologies are advantageous in providing: safe, controlled environments that eliminate
risk to patients enhanced, realistic visualization authentic contexts for learning and
assessment documentation of learner behavior and
outcomes instruction tailored to individual or group
needs learner control of the educational experience repetition and deliberate practice uncoupling of instruction from place and time standardization of instruction and assessment perpetual resources and new economies of
scale
Creating Engagement Individualize the
offering Relevant and
important Build on prior learning Personalized
comparative feedback
Develop and maintain a longitudinal relationship Curriculum for
personal growth
Make it rewarding Goal oriented Fun Positive
Engage the social instinct Collaborative models
Learning is facilitated when the learner is engaged in solving a real-world
problem. is engaged at the problem or task
level, not just the operation or action level.
solves a progression of problems. is guided to an explicit comparison
of problems
Learning is facilitated when the learner is directed to recall, relate,
describe, or apply knowledge from relevant past experience that can be used as a foundation for the new knowledge.
is provided relevant experience that can be used as a foundation for the new knowledge.
Learning is facilitated when the learner is shown rather than told. the demonstration is consistent with
the learning goal. the learner is shown multiple
representations. the learner is directed to explicitly
compare alternative representations. the media play a relevant
instructional role.
Learning is facilitated when the learner is required to use his or her new
knowledge to solve problems. the problem solving activity is consistent
with the learning goal. the learner is show how to detect and correct
errors. the learner is guided in his or her problem
solving by appropriate coaching that is gradually withdrawn.
Learning is facilitated when the learner can demonstrate his or her new
knowledge or skill. can reflect-on, discuss, and defend
his or her new knowledge. can create, invent, and explore new
and personal ways to use his or her new knowledge
Rationale: Learning Theory Learning can be optimized if the material
Activates prior knowledge Is
engaging relevant Integrative interactive
Facilitates elaboration
Page 28
Online Simulations
Rationale Learning is greatest when
The materials meet the learner’s needs Relevant Sufficient detail
The learning process is active Problem solving Making choices
Feedback is provided
20 cases across many specialties Flash environment Recreate the physician-patient encounter
History Physical Exam Relevant clinical decisions Real patient cases, actual data & media
Reinforce learning and retention Make decisions and receive feedback “Learn more” links
Simulation to Enhance the Learning Experience
Page 31
Questions with Feedback
Page 36
Learn More
Page 37
Article
More Questions with Feedback
Page 38
Learning Element
Page 39
Learning Element
Page 40
Learning Element
Page 43
Total IMCs Initiated and % Completed
Page 46
The W
riting o
n the W
all
A Bloody Myst
ery
A Crisis i
n Late
Pregnan
cy
Painful P
urple T
oes
Stalki
ng the D
iagnosis
The B
eat Goes
On
A Rash Hyp
othesis
Hard to
Conceive
Bitter Pills
A Crazy C
ause
of Dysp
nea
Lying L
ow
A Sweet
Source
of Ab Pain
A Sleep
ing Gian
t
A Problem
in Gest
ation
A Birds E
ye View
of Fev
er
Breathles
s
A Start
ling D
ecline
Whistling i
n the D
ark
At a Lo
ss
Disconnect
ed0
10,000
20,000
30,000
40,000
50,000
60,000
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Total Exams Initiated% Completed
550,175 initiations
N=10,353 Ratings of 4 & 5 Mean score (of 5)
Overall learning experience 96% 4.70
Ease of use 95% 4.71
Visual design 95% 4.69
Quality of the questions 95% 4.61
Level of detail 94% 4.59
Interactivity 93% 4.62
Rating of Interactive Cases
Amount of Information
Page 48
Less information
2.0%
Sufficient86.0%
More Information
12.0%
N=10,329
N=10,123 All
To test my clinical decision-making 80%
To learn about a topic outside my specialty area 58%
To learn generally about a topic in my specialty area 44%
As a teaching tool 29%
To obtain CME credits 28%
How they will be used?
Physicians Non-Physicians
Physicians involved in clinical practice 91% 72%Residents or trainees 83% 75%Medical students 69% 82%Fellows 60% 50%Physicians involved in research & teaching 48% 49%Physician Assistants 32% 35%Nurses or Nurse Practitioners 20% 28%
Recommend to Whom?
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Once a week Once a month Every 2-3 weeks Less often thanevery 3 months
66% of the US physician respondents said they would participate in the IMC’s on a weekly basis
How Often?
Very valuable,
53.6%
Somewhat valuable,
42.2%
Not at all valuable,
4.2%
96% selected Very or Somewhat valuable
How Valuable is the Comparative Score?
Adaptive Education
Hermann Ebbinghaus (1850-1909)
In 1885, he published "On Memory”
Forgetting curvesLearning curvesSpacing effect
Forgetting Curve for Web-Based Teaching Modules
Weeks0 10 20 30 40 50
Per
cent
age
Sco
res
50
60
70
80
90
100
Web-based Teaching Modules
Module 1
Module 2
Module 3
OC-1
OC-2 OC-3 OC-4
Spaced Education: the basics
Spacing effect spaced repeated repeated at increasing intervals
- Increased efficiency of learning- Reduction in the slope of the forgetting curve ► Improves neuronal longevity in the hippocampus of rats ► Phosphatase mediator identified in Drosophila
Sisti et al, Learn Memory 2007;14(5):368-375.Pagani et al, Cell 2009; 139, 186–198.
Testing Effect
Interactive Spaced Education (ISE) harnesses both the testing effect & the spacing effect.
Roediger & Karpicke. Test-enhanced learning: taking memory tests improves long-term retention.Psychol Sci, 2006; 17: 249.
Karpicke & Roediger. The critical importance of retrieval for learning. Science 2008; 319:966-968.
How to Structure Spaced Education
Answer & Explanation
Question
Curriculum to be Covered
Spaced Education on GU Pathology
Weeks0 10 20 30 40 50
Per
cent
age
Cha
nge
from
Bas
elin
e
-10
0
10
20
30
Spaced EducationWeb-based Modules
77%; 580/583
SEPT: Study Structure
• University of Virginia School of Medicine• University of Pittsburgh School of Medicine• Harvard Medical School• University of Alabama School of Medicine
SEPT: CONSORT Flow Chart
Weeks0 10 20 30 40
Per
cent
age
Sco
re
30
40
50
60
70
80
90
LPTASEPT
p<0.001effect size=0.95
2-weekcycled-review
6-weekcycled-review
Items 1-40initial presentation
Final cycle to assess
learning retention
SEPT: 40-item assessment of retention
Adaptive Spaced Education
• Personalizes the content and spacing of the spaced education course for each physician
• Example – 932 urology residents in US & Canada– Residents receive two spaced education questions every day. – Incorrect → repeated 2 weeks later.– Correct → repeated 6 weeks later. – Correct twice in a row → item is retired & is no longer repeated. – Residents complete the program when all are retired.
• Advantages: – reduces the unnecessary repetition of mastered material.– turns the spaced education course into a game.– measures not only what physicians know, but how well they learn.
38%
Spaced Education Works Increases knowledge & retention
- Medical Education 2007: 41:23-31 --- UGME- Journal of General Internal Medicine 2008; 23(7):973-8 --- UGME - Journal of Urology 2007; 177, 1481-1487 --- GME Journal of Urology 2009; 181, 2671-2673 --- GME Annals of Surgery 2009; 249: 744–749 --- CME
Improves self-assessment of knowledge American Journal of Surgery 2009; 197(1):89-95
Changes behavior American Journal of Surgery 2009: 197(2), 252-257 Academic Medicine 2010
Is well-accepted by learners- Demonstrated in all trials to date
Online Lectures
Traditional vs. Online ClassActivity Traditional Class Online ClassLecture In-class lectures Lecture recorded and stored online
Discussions In person discussion Online blogDiscussion board
Assignments Paper submissions Electronic submission
Tests & Exams Written, person proctored Online, digitally proctored
Group Work In class or in a room together Virtual meetingsCollaborative google documents
Training Follow along to an onscreen demo. Students complete a guided self-completion exercise
Office Hours In-office appointments Online anonymous questions
Grading Grades released on each paper Grades released instantaneously online
Demos Talk about your materials and work Video vignette
Online Tutorials
“Headache & Heartache”
Learning Objectives: Understand the role of pituitary hormones in
growth and development Appreciate the emotional and physical
effects of sex hormones Recognize the challenges in providing care
to financially disadvantaged individuals and minorities
Case: 19yo woman with headache and primary amenorrhea
Problem: Supra-sellar tumor, ultimately leading to pan-hypopituitarism
Student Preference for Learning
Strongly prefer paper5%
Strongly prefer Visual33% Prefer paper
10%
Prefer Visual26%
Not sure26%
n = 658 surveys
Tutor Preference for Teaching
Not sure29%
Strongly prefer video36%
Prefer video35%
Strongly prefer paper 0%Prefer paper 0% n = 62 surveys
Student Data
*p<0.05**p<0.01
4.0
3.8
3.6
3.4
3.2
3.0Stimulation Learning Time Usage
5-p o
i nt L
iker
t Rat
ing
(S
EM
) *****
Video Paper
**p<0.01*p<0.05vs paper
n = 658 surveys1 3 52 4Strongly Disagree
StronglyAgree
NeutralScale Used:
Identification5%
Exploration56%
Applicability4%
Integration3%
Description32%
Video Paper
Identification3%
Exploration57%
Applicability6%
Integration3%
Description31%
Critical Thinking Ratio by Video and Paper Cases
Video Text P
Problem Identification -0.25 -0.35 0.001
Problem Description 0.53 0.61 0.001
Problem Exploration 0.78 0.87 <0.001
Applicability 0.96 0.98 NS
Integration 0.95 0.95 NS
1. Mobile technologies are omnipresent, technology is mobile-first
2. Seamless integration and synchronization across devices and platforms
3. Systems are user-experience driven – more human, less technical, highly user-friendly
4. Smarter adaptive programs with instant feedback
5. Higher-fidelity simulations
6. Collaborative social learning and immersive experiences using seamless communication
Happening Today
“No matter how sophisticated or robust the delivery, the content must fundamentally inspire (people) to learn”
Source: MIT RELATE
Current and future technologies impacting learning
Current and Future Technologies Impacting Learning
Interactive web based
learning
Learning On The Go
Seamless Synchronicity
Predictive Suggestions
Serious Games
Collaborative learning in
social networks
Advanced, Simulations
Visual Data Analysis
Augmented Reality
Improving cognitive
performance
Happening Today Future Horizon
Electronic Books
Mobility
Intelligence
Content
Delivery
Case-based learning
Ubiquity?
Predictive Competence AI Tutor?
Mind reading of commands
Advanced6th Sense Devices
Holographic devices
Direct connection to
the brain
Key Messages from Online Learning Experiments Online learning is
Acceptable Effective Efficient
Online learning is best when it is Relevant Interactive Uses a variety of programs Is spaced Is adaptive Provides feedback
Summary
The principals of gaming apply to learning the complexities of medical practice online
Physicians and medical students welcome the opportunity to learn online, and welcome High-fidelity decision-making simulations Personalized feedback & comparative performance Multimedia interactive learning elements
Page 82
Systemic approaches to creating engaging learning and teaching experiences
LearningTeaching
The Power of Taking Breaks
The Power of Setting High Expectations
The Power of Visualization & Visual
Association
The Power of Deferring Critical
Judgment
The Value of Expert Coaching
The Value of Structured
Sequencing
The Value of Progressive
Add Ons
The Value of Anchored Instruction
The Value of Fusing Content with Process
The Power of Being Observed
The Value of Adaptive Teaching
Styles
The Power of Removing Hierarchical Boundaries
Barriers to Physician Participation Lack of motivation Fatigue Lack of time Competing demands Lack of awareness of
knowledge deficit Personal reluctance
to change Ambivalence Group mentality
The “Dirty Dozen” of Human Factor Errors:• Lack of Communication• Complacency• Lack of Knowledge• Distraction• Lack of Teamwork• Fatigue• Lack of Resources• Pressure• Lack of Assertiveness• Stress• Lack of Awareness• Norms
EXAMPLE:NEJM INTERACTIVE CASES
Focus Group Feedback
Learners want efficiency (permit saves) Learning mindset vs. challenge mindset (range of difficulty) Welcome mobile usage and ‘take home’ summary Dependent Outcomes Model
Next outcome depends on your decisions Learners worry it creates too much opportunity to fail; want earlier
feedback for incorrect paths Probabilistic Outcomes Model
Outcome in case reflects likelihood of that outcome in actual practice
Learners concerned they’ll miss the learning point with rare outcomes; they want to know what’s common
Page 87
Image Challenge
Image Challenge Votes Over 200 images in directory 2006: ~2 million votes 2007: ~3 million votes 2008: ~4 million votes 2009: ~6 million votes Most popular link from e-table of contents
• 30 videos• Popular learning tool
• 4 of top 10 downloads from site in 20109 were videos
• Avg. 20,000 impressions/month)
Videos in Clinical Medicine
• For the savvy, connected physician
Audio Summaries#3 most useful
podcast for professional
purposes -- and the only journal cited
(Manhattan Research ePharma Physician® v8.0)
Thank You!
Utility of NEJM.org Features
% Extremely or Very Useful:
93
WhoProfessional Profile
Where does he/she work? Works in a small practice or community health center/hospital, may have
teaching/research responsibilities May work in a technologically-forward practice or employing institution (i.e. already
utilizing EMR)
What does he/she value in his/her professional and personal life? Cares about patient-centered approaches to medicine and patient education: educates
thepatient through websites, handouts and images
Values structure and advance planning to ensure preparedness when meeting patients Enjoys interacting with co-workers or peers during everyday interactions or at
conferences Values and makes time for family and/or outside interests Values practicality and real-world applications of learned knowledge (e.g.,
acknowledging different approaches to medicine, allowing for medical uncertainty or workflow management teachings)
Busy schedule, may take work home with him when needed
Task-Oriented Clinicians
WhatBehaviors Related to Learning
What are his/her preferences for learning? Prefers information and learning to be convenient and concise Wants to learn through information that is contextual and focused on practical tasks Enjoys listening to experts in his/her field, even if they do not always have the time Does not subscribe to NEJM because it is too scientific or is not relevant to his/her everyday
practice Does not have sufficient time to extensively read journals Occasionally reads journals or specialty relevant information to review articles that
discuss guidelines or practice changing information*
How does he/she choose to complete formal learning requirements? Likes the convenience of online activities and events given by the hospital Attends conferences put on by major industry players, societies and boards Is price-conscious (e.g. goes to conferences that are closer, or does not subscribe to NEJM due to
price) Adheres to CME and MOC requirements as needed, but views them strictly as
requirements* Relies on societies/boards to tell him where to go to complete MOC and CME* Puts off study for CME and then works intensively to acquire sufficient credits before the deadline*
Task-Oriented Clinicians
* Denotes statements articulated by a minority of individuals within the segment
What is the context in which unstructured, informal learning occurs? Researches information at the time it is needed (e.g. for patients, other doctors calling
with questions) Learns while doing - at bedside, while patient is getting dressed, in between patients Looks up diagnostic and treatment information to refresh memory or to confirm beliefs Looks up drug information for specific medications (i.e. dosages, interactions, etc.) Completes further research when faced with unusual situations Completes research when receiving incoming consult calls or patient e-mails With “spare” time will look further into unusual or interesting cases
What is the context in which formal learning occurs? Tries to fit bites of learning when possible in the day (e.g. listens to a CD while
commuting, completes15-20 minute Epocrates sessions)* Due to busy schedule, needs to plan ahead or set commitments to ensure formal
learning gets done*
Task-Oriented Clinicians
When & WhereContext in which Learning Takes Place
* Denotes statements articulated by a minority of individuals within the segment
What types of electronic resources, tools and devices does he/she value? Likes multimedia sources such as video content, CDs or information posted after
presentations* Enjoys ability to do 15-20 minute CME courses on a handheld device* Prefers Epocrates for drug information, and utilizes iPhone app for immediate access* Uses EMR for drug information*
What factors influence his/her choice of electronic resources, tools, devices? Utilizes UpToDate to look up information when under time pressure Relies on familiarity and reputation to ensure sources are trustworthy Uses computer to access PubMed for more in-depth and academic searches Uses computers in patient rooms to look up information with the patient* Uses Google to search for more specific questions regarding patients and cases* Accesses websites and journals through free hospital access or free websites*
Task-Oriented Clinicians
HowMaterials / Media / Technology Usage
* Denotes statements articulated by a minority of individuals within the segment
What are his/her frustrations with unstructured, informal learning? Too busy to devote extra time to establishing a consistent schedule of reading journals Feels that there is an overload of information and would prefer sources to summarize relevant,
practical findings Finds it difficult to take the time to focus on professional growth or to reflect on informal learning
opportunities on a daily basis*
What are his/her frustrations with formal learning? Feels CME activities (e.g. question formats, topic choice, content) and curricula can be poorly
designed Finds it difficult to evaluate the quality of a CME activity or provider without the aid of a medical
association or peers Believes that completing MOC/CME requirements can be expensive Believes that CME and MOC impose requirements on learners that conflict with his/her own or
employers’ goals*
Task-Oriented Clinicians
WhyFrustrations around Learning
* Denotes statements articulated by a minority of individuals within the segment
Where does he/she work? Works in an academic setting, or has additional, non-clinician responsibilities Works within a technologically forward practice, or institution (i.e. utilizes EMR)*
What does he/she value in his/her professional and personal lives? Feels responsible for educating patients through handouts, discussion and citing information in
medical records Creates his/her own informational material, if he/she feels what is available is insufficient (e.g. uses
patient websites, guidelines, diagnosis templates) Distrusts biases and sponsored studies/courses Values communications with peers/co-workers Is overloaded with clinician work and additional responsibilities Ends up bringing work home
Knowledge-Oriented Clinicians
WhoProfessional Profile
* Denotes statements articulated by a minority of individuals within the segment
What are his/her preferences for learning? Likes to listen to, or see information visually (e.g. images, video content, podcasts) Interested in building awareness of broader issues, but prefers materials that are focused on his/her
specialty Refreshes knowledge, or learns something new in preparation for presentations and/or lectures Consults experts/specialists/peers to gain consensus, learn new information, or feel confident with a
course of action Cares about the quality of articles and sources when researching information, takes note of study
methodology and/or looks at article references* Reads or shares articles with practice group and peers*
How does he/she choose to complete formal learning requirements?• When studying for boards and doing CME activities, relies mainly on certifying board/specialty
society/academic institution for review materials Meets some CME/MOC requirements through institutional events or fulfilling institutional
requirements For CME activities, gets credit for current research efforts and/or likes to prep with questions (e.g.
UpToDate, journal articles, pre-tests) Likes learning through case studies or conferences
Knowledge-Oriented Clinicians
WhatBehaviors Related to Learning
* Denotes statements articulated by a minority of individuals within the segment
What is the context in which unstructured, informal learning occurs? Reads journals when he/she can squeeze it in (e.g. during lunch, or at night time) Due to busy schedule, will spend personal time preparing for presentations and on research projects
outside of working hours Shares information with peers/colleagues when it is interesting, or is needed to inform a
diagnosis/treatment (e.g. printing out interesting articles, consulting specialists, recommending a new medication)
Prefers to wait until the patient has left to follow up on relevant issues, or until he/she can sit at a computer*
What is the context in which formal learning occurs? May study for multiple board exams* Likely to begin preparing for MOC and/or boards early*
Knowledge-Oriented Clinicians
When & WhereContext in which Learning Takes Place
* Denotes statements articulated by a minority of individuals within the segment
What types of electronic resources, tools and devices does he/she value? Utilizes many different websites for learning new information and research (e.g. UpToDate, Medline,
Medscape, PubMed and specialty websites or journals) Currently involved, or was involved in forums for sharing experiences and answering questions Looks up drug information on Epocrates smartphone application Receives electronic alerts from journals and other websites to keep up to date
Knowledge-Oriented Clinicians
HowMaterials / Media / Technology Usage
* Denotes statements articulated by a minority of individuals within the segment
What are his/her frustrations with unstructured, informal learning? Feels that he/she cannot always access information quickly enough Frustrated by his/her inability to complete an effective literature search with current online
resources*
What are his/her frustrations with formal learning? Believes that preparing for boards/recertifications is a tedious process or a waste of time* Believes CME activities are not aligned with his/her interests and learning needs*
Knowledge-Oriented Clinicians
WhyFrustrations around Learning
* Denotes statements articulated by a minority of individuals within the segment
1. Current and Future Technologies Impacting Learning
2. Systemic Approaches to Effective Learning and Teaching
3. Teaching & Training Methods in Other Life Critical Professions (Aviation, Military, Firefighting)
Contents
Learning opportunities can be made more effective by setting appropriately high expectations at the outset –
both in terms of learning goals and teaching standards
Individuals with poor expectations internalize their negative label, while those with positive labels succeed accordingly. This is known as the Pygmalion Effect (also, Rosenthal Effect).
Experiments have shown that expectations about the competency level of a teacher, or one’s own ability to learn, and learners’ assessment of how difficult it is to assimilate the material can all positively and negatively influence learners’ test performance.
For this reason, the greater the expectations instilled in learners, the better they perform.
The Power ofSetting High Expectations Upfront
Source : Rosenthal, Robert and Jacobson, Lenore. Pygmalion in the Classroom: Teacher Expectation and Pupils' Intellectual Development. Irvington Publishers: New York, 1992.
Applicable to?
Progressive Learning
Make the Most of My
Time
Make it Rewarding
for Me
Help Me Through the Professional Developmen
t Process
Make it Real
Drawing upon the
Wisdom of Others
Patient-centered Learning
Learning while Doing
Learning it in My Own
Way
Adults have a tendency to self-edit their thoughts. They fear embarrassment and the judgment of their peers. This fear causes them to be conservative in their thinking.
To improve problem-solving, Tim Brown, the CEO and president of design firm IDEO, suggests that we must find ways to lessen self-editing and feel free to experiment, and be more ‘playful.’
Problem solving consists of two very distinctive modes of operation: Divergence, a generative mode where we explore and create many ideas, and Convergence, where we look back for solutions. The Divergence mode is where we most need experimentation ad playfulness.
Freedom to think, without fear of judgment, can improve one’s ability to generate better solutions
The Power ofDeferring Critical Judgment & Self Editing
Source: TED Talks, Tim Brown on Creativity and Play
Applicable to?
Progressive Learning
Make the Most of My
Time
Make it Rewarding
for Me
Help Me Through the Professional Developmen
t Process
Make it Real
Drawing upon the
Wisdom of Others
Patient-centered Learning
Learning while Doing
Learning it in My Own
Way
Visualization enhances our ability to memorize
After surviving a tragic collapse of a banquet hall and being able to remember where each of the guests was sitting, Simonides of Ceos, a fifth century Greek, reasoned that anything could be memorized by imagining a “memory palace,” containing imagery of what needed to be recalled.
The tale of Simonides has been the basis for memorization techniques of the modern professional memorizers. MRI scans of professional memorizers reveal that they rely on regions of the brain known to be involved in spatial memory, in order to remember large quantities of information.
This principle has been applied by Rosetta Stone, the popular language learning program whose learning tools encourage learners to remember by visual association.
The Power ofVisual Association
Source: The New York Times, Secrets Of A Mind-gamer
Applicable to?
Progressive Learning
Make the Most of My
Time
Make it Rewarding
for Me
Help Me Through the Professional Developmen
t Process
Make it Real
Drawing upon the
Wisdom of Others
Patient-centered Learning
Learning while Doing
Learning it in My Own
Way
The Power ofBeing Observed
People improve or modify an aspect of their behavior that is being experimentally measured simply in response to the fact that they are being studied, and not in response to any particular experimental manipulation.
This is known as the Hawthorne effect.
Productivity gains can be the mere result of the motivational effect of the interest being shown in the people observed.
Knowing that one is being observed can increase performance and productivity
Source: Roethlisberger, F. Jules and W.J. Dickson. Management and the Worker. Cambridge, MS: Harvard University Press, 1939.
Applicable to?
Progressive Learning
Make the Most of My
Time
Make it Rewarding
for Me
Help Me Through the Professional Developmen
t Process
Make it Real
Drawing upon the
Wisdom of Others
Patient-centered Learning
Learning while Doing
Learning it in My Own
Way
Removing hierarchical constraints creates more effective sharing of knowledge and ideas
Employees are often reluctant to share knowledge due to their fears of loss of control over the ideas.
Equally, bosses are reluctant to accept those ideas because of the fear of becoming useless, and consequentially loss of position.
Thus, French CPG firm, Danone has recognized that and has developed “Knowledge Marketplaces” – events at which ideas are freely exchanged as products for “sale” at “idea stands,” and participants must dress in such a manner that there is no visible way of distinguishing their hierarchical rank.
The Power ofRemoving Hierarchical Boundaries
Source: Story-telling At Danone : A Latin Approach To Knowledge Management
Applicable to?
Progressive Learning
Make the Most of My
Time
Make it Rewarding
for Me
Help Me Through the Professional Developmen
t Process
Make it Real
Drawing upon the
Wisdom of Others
Patient-centered Learning
Learning while Doing
Learning it in My Own
Way
Companies have embraced the power of time-off: 3M and Google allocate their employees “personal time” – time out from everyday work, which they are free to invest in their own projects. This enlightened approach to employee management has driven many of the innovations that have emerged from these two organizations.
Ferran Adrià, the executive chef of world-renowned El Bulli in Spain would close his restaurant for half the year to experiment and discover new ways of cooking. The result has been three Michelin stars and recognition as the best restaurant in the world by Restaurant magazine.
Every seven years, the two-time Grammy Award winning graphic designer Stefan Sagmeister, closes his New York studio for a yearlong sabbatical to rejuvenate and refresh its creative outlook. The result: “everything that we've done in the seven years following came out of thinking that took place in the sabbatical year.”
Time out and freedom to invest in personal interests can play an important role in raising motivation, and inspiring creative problem-solving.
The Power ofTaking A Break
Sources: The New York Times: The Google Way: Give Engineers Room; Wired Magazine: The 15 Percent Solution; TED Talks, Stefan Sagmeister: The power of time off; The New York Times, Ferran Adrià
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Knowledge coaching allows the wisdom of experts to be transferred to others. Effective coaching comprises:
‘Deeply smart’ people and experts in a particular field have been shown to make intuitive decisions fast, and are able to spot problems and possibilities others miss.
Their wisdom is crucial to any organization’s success and can be an institutional loss when the knowledge is not passed on.
To ensure knowledge transfer and retention, experts should be empowered to act as coaches.
Effective coaching spurs transfer and retention of vital wisdom, yields better solutions and more efficient processes. To maximize the degree to which novices absorb this wisdom, knowledge coaching should comprise a blend of guided practice, observation, debriefing, collective problem solving, and experimentation.
The Value of Teaching ThroughExpert Coaching
Guided Practice
Guided Observation
Guided Problem Solving
Guided Experimentation+ + +
Source: Harvard Business Review, Deep Smarts
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Sequencing – aligned with natural cognitive processes – can create more effective learning
Gagne posited that teaching actions should follow a precise sequence, to ensure alignment with the cognitive processes that allow us to learn new intellectual skills. The sequence of teaching actions is (illustrated with an example sequence of teaching actions for the skill “recognize an equilateral triangle”):
1. Gain attention Show a variety of different triangles2. Identify the objective Pose the question: "What is an equilateral
triangle?“ 3. Recall prior learning Review the definitions of triangles4. Present stimulus Provide the definition of an equilateral triangle 5. Guide learning Show an example of how to create an equilateral triangle 6. Elicit performance Ask students to create five different examples of equilateral
triangles 7. Provide feedback Indicate whether the examples are correct or incorrect 8. Assess performance Provide scores and remediation9. Enhance retention Show students various pictures and ask students to pick out
equilaterals
Source: Gagne, R., Briggs, L. & Wager, W. Principles of Instructional Design (4th Ed.). Fort Worth, TX: HBJ College Publishers, 1992.
The Value of Teaching ThroughStructured Sequencing
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According to elaboration theory, instruction should be organized in increasing order of complexity for optimal learning. A key idea of elaboration theory is that the learner needs to develop a meaningful context into which subsequent ideas and skills can be assimilated.Elaboration theory proposes seven major strategy components:
• Elaborative sequence – by adding successive layers of complexity• Learning prerequisite sequences – via conceptual, procedural, or theoretical structures• Summary – through content reviews presented in rule-example-practice format• Synthesis – via presentation devices, diagrams, procedural flowcharts, or decision tables• Analogies – by relating the content to learners' prior knowledge• Cognitive strategies – by using a variety of cues (pictures, diagrams, mnemonics, etc.) needed for
appropriate processing of material• Learner control – by clear labeling and separation of instructional strategy components
Source: English, R.E. & Reigeluth, C.M. Formative research on sequencing instruction with the elaboration theory. Educational Technology Research & Development, 44(1), 23-42, 1996.
The Value of Teaching withProgressive Add-Ons
For optimal learning, allow learners to develop meaningful understanding before moving on to the next step
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Cognitive styles refer to the preferred way an individual processes information, a person's typical mode of thinking, remembering, or problem solving. There are many contrasting styles organized around context, content, and structure.
Some examples of cognitive styles are:
• Field Independence vs. Field Dependence – Field independent learners tend to approach the problem-solving in an analytical fashion, whiles field dependent learners approach it in a global fashion.
• Serialist vs. Holist – Serialists prefer to learn in a sequential fashion, whereas holists prefer to learn in a hierarchical manner.
• Leveling versus sharpening – in sharpening individuals tend to exaggerate selected characteristics of the original memory and in leveling minimize the same. This affects a person’s account of what actually happened and may not be the same as what actually did occur.
The Value of Teaching ByAdapting to Cognitive Learning Styles
Source: Kearsley, G. (April 19, 2011). The Theory Into Practice Database. Retrieved from http://tip.psychology.org
To achieve greatest effectiveness, teaching approaches need flexibility to adapt to different cognitive learning styles
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Component Display Theory (CDT) classifies learning along two dimensions: content type and performance. It also specifies nine presentation forms that are unique to each material and learner. A complete lesson would consist of objective followed by some combination of rules, examples, recall, practice, feedback, helps and mnemonics appropriate to the subject matter and learning task.
To teach most effectively, consider both content dimensions and applicable forms of presentation/interaction
Source: Merrill, M.D. Instructional Design Theory. Englewood Cliffs, NJ: Educational Technology Publication, 1994.
The Value ofFusing Content with Process
Performa
nce
Find
Use
Remember
Fact Concept Procedure Principle
Types of Content
Rules Examples Recall
Practice Prerequisites Objectives
Helps Mnemonics Feedback
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Anchored instruction theory requires putting the students in the context of a problem-based story.
The students "play" an authentic role while investigating the problem, identifying gaps to their knowledge, researching the information needed to solve the problem, and developing solutions.
Anchored instruction is comprised of five principles:
1. Realistic task or event is presented in which the problem is anchored or focused 2. Students take ownership based on relatedness to problems and goals seen everyday3. Deep development of knowledge structure that is highly transferable to other situations4. Complex content presented in a narrative format5. Generative learning context is created in which students identify with problem and become
actively involved in generating solution
Source: Bransford, J.D. et al. Anchored instruction: Why we need it and how technology can help. In D. Nix & R. Sprio (Eds), Cognition, education and multimedia. Hillsdale, NJ: Erlbaum Associates, 1990.
The Value ofProviding Contextual Anchors
Adding contextual “anchors” in teaching improves learner assimilation and problem-solving
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