Measuring SelfAssessment: An Innovative Relative Ranking Model

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KIDS THESE DAYS Promoting and Exploiting
Adult Learning in Medical Students
Glenn Regehr, PhD University of Toronto
Faculty of Medicine Centre for Research in
Education At the University Health Network
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Whats in the words?

• ADULT LEARNING
• SELF-DIRECTED LEARNING
• LIFE-LONG LEARNING
• Package of popular educationalese phrases
• Generally considered positive and desirable
• But often vague in details

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What is this stuff?

• Traits?
• (stable characteristics to select for)
• Attitudes?
• (approaches to world to be instilled)
• Behaviors?
• (actions and/or techniques to train and evaluate)

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What exactly does it look like?

• How do these concepts operationalize?
• What is the adult learning behavioral profile?

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When should we expect to see it?

• What conditions encourage/discourage it?
• Under what conditions is it functional?
• Under what conditions is it possible?
• How often are these conditions met in our
  institutional settings?

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Punchline

• Our students are predisposed to function as adult
  / self-directed learners
• Adult learning behaviors only manifest in
  highly specific circumstances and conditions
• Necessary conditions have both cognitive and
  institutional components
• Conditions dont generally exist in medical
  school (especially early part)

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Today

• Give background for my own thinking
• Explore your thoughts on adult learning
• Develop profile of ideal adult learning behavior
• Explore conditions for enacting this behavior
• Explore implications for curriculum and teaching

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Background Anecdotes

• Kids these days conversations
• Clinical faculty as Masters students
• Faculty development workshop

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• AUDIENCE PARTICIPATION TIME!

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What is it?

• What are the quintessential hallmarks of adult /
  self-directed learning?
• What do you think of when you think of adult /
  self-directed learning?

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Whats missing in students?

• What do students do that make us believe they are
  not self directed learners?

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What about us?

• What are some examples in ourselves that
  demonstrate adult / self-directed learning?

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What about us?

• What are some examples in ourselves that
  demonstrate adult / self-directed learning?
• Tried to learn something completely new lately?
• Play guitar
• A new language
• Cognitive/Educational Psychology

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The Adult Learner

• A set of characteristics
• Learning is intrinsically motivated
• Driven by perceived need for information
• Based on a capacity to recognize gaps
• In a pre-existing knowledge/experience base
• When trying to solve immediately relevant problems

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The Adult Learner

• Leading to a set of attitudes toward learning
• An inherent desire to learn more (curiosity?)
• An excitement for the task (a sense of discovery)
• A willingness to take responsibility for own
  learning

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The Adult Learner

• Manifesting as a set of ideal behaviors
• Going the extra step (delving deeper)
• Not being driven by whats on the test
• Not constantly depending on external direction

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• AND NOW FOR THE BAD NEWS

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Limits on expression of AL/SDL Profile

• Individual Cognitive Factors
• Institutional Factors
• Individual/Institutional Interactions

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Limiting Cognitive Factors

• Need for experience in the domain
• Experts have domain-relevant experience on which
  to build and direct learning efforts novices do
  not
• Like trying to get unlost without a map (in a
  place where you dont speak the language)
• Independent learning a luxury of the
  knowledgeable
• In absence of capacity to impose own structure on
  learning, students will look to experts for that
  structure

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Limiting Cognitive Factors

• Need to perceive relevance of information
• Students more motivated to learn if information
  is perceived as directly relevant
• Must have meaningful image of big picture
• Must have reason to seek information (readiness
  to learn)
• Without this, content is meaningless and
  disconnected
• Unlikely to be useful later

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Limiting Institutional Factors

• Curriculum designs
• Part to Whole curriculum model
• Start with elaborate description of parts
• Once understand parts, then build into whole
• Time limited / information rich context
• Self-directed learning for fun requires luxury
  of time
• Test focused achievement criteria
• Whats on test is a survival strategy

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Limiting Institutional Factors

• Institutional misunderstandings of
  AL/SDL(learning as Brownian Motion)
• x Learning should be unstructured and unguided
  (independent of teachers and classes)
• Like arranging a swimming lesson by sinking a
  boat
• x Encourage any learning objectives students pick
  (although there are objectives for the week)
• Self-indulgent rather than self-directed
  curriculum
• Institutional game of guess what I am thinking

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• SO NOW WHAT DO WE DO?
• (just a few suggestions)

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Provide the Big Picture

• Give a curriculum map
• advanced organizers (schemata)
• Situate basic science in the middle
• Whole-Part-Whole educational philosophy
• Build in repetition of content
• Super TA phenomenon

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Build Lectures from Student Questions

• Give readings in advance
• Ask students to express problems with readings
• Generate list
• Arrange list
• Speak to list

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Alternative PBL

• Remember PBL is learning based in problems
• Start with relevant problem (not necessarily
  clinical)
• Actively direct development of learning
  objectives through Socratic questioning
• Show students where their gaps are then give
  resources to fill those gaps

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Change the Tests

• McMaster Progress Test
• Big picture integrative questions
• Where does this fit?
• What was my point?

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• SUMMARY

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Students are adults too

• Our students may be more adult than we infer
  from their learning behavior
• Much of their non-adult activity is likely a
  result of the situation we place them in
• Very new content
• Institutionalized pressures that implicitly
  discourage adult-like learning behavior

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So Promote It and Exploit It

• The planning of teaching activities from the
  level of curriculum to the level of individual
  classes must involve an active effort to provide
  an environment that allows students to engage
  their natural propensity for adult learning
  activities