4Some assertions about learning Learning and remembering results from assimilation of new knowledge into existing knowledge, and meaning is critical to learningTransfer (applying old knowledge to new situations) doesn’t happen easilyStructured, planned, practice with multiple examples is key to transferGeneral skills don’t exist – it’s all imbedded in knowledge
5Learning and Understanding Learning is strongly influenced by the meaning .If we can understand what we are learning in terms of pre-existing knowledge, better learning and retention resultsMeaning is a consequence of the interaction between learner and ‘to be learned’
6Tomorrow, and tomorrow, and tomorrow, Creeps in this petty pace from day to day,To the last syllable of recorded time.And all our yesterdays have lighted foolsThe way to dusty death. Out, out brief candle!Life’s but a walking shadow, a poor playerThat struts and frets his hour upon the stage,And then is heard no more. It is a taleTold by an idiot: Full of sound and furySignifying nothingW. Shakespeare, Macbeth, V, v
7DAMES DONATE DUBLINS CITS SPEEDPILLS VELOCITOUS AEROLITHS BELIEF SOPHIST WALLOPS HAUGHTY HELENSQUARE ON PROBOSCIS. SPARTANS GNASH MOLARS. ITHACANS VOWPEN IS CHAMPJ. Joyce. Ulysses. P.148
8Sound is walking, stage struts and a tale is heard Sound is walking, stage struts and a tale is heard. No more a poor candle, frets life. A brief idiot, fury and shadow, is in a dusty fool.
10Meaning is imposed by the learner and involves an interaction between existing knowledge and new information
11The procedure is quite simple The procedure is quite simple. First you arrange things into different groups. Of course, one pile may be sufficient. If you have to go somewhere else due to lack of facilities, this is the next step. It is better to do too few things at once than too many. At first it seems complicated, but soon it just becomes a fact of life. After it’s over, you arrange the materials in groups again, then put them in the right place.
12Washing ClothesThe procedure is quite simple. First you arrange things into different groups. Of course, one pile may be sufficient. If you have to go somewhere else due to lack of facilities, this is the next step. It is better to do too few things at once than too many. At first it seems complicated, but soon it just becomes a fact of life. After it’s over, you arrange the materials in groups again, then put them in the right place.
18Recall after 5 sec. exposure The way they do it is by matching…
19It’s not just Visual Patterns Lab data, nephrology problems5 research associates6 students5 experts
20Recall of Nephrology Data So with coherent meaningful data, expertise shows
21Basic science and meaning Why do students need basic science?Some docs use it a lot?Nephrologists, anesthesiologists, intensivistsMany docs use it a little?With difficult problemsIt may provide meaning and coherence for students…….
22Basic Science and Meaning (Woods, Brooks, Norman, 2003) 4 neurology / muscular diseases36 medical studentsBasic Science or Symptom/Disease probability
23Measurement Diagnostic Test Administered at 0, 7 days 15 cases, 4-6 featuresAdministered at 0, 7 days
27Woods et al., Exp 2 4 conditions; 6 features / condition 3/6 features have a causal (A>B>C) story3/6 features no causal story38 undergraduate studentsTest with 15 cases4-6 features mixed diagnosesTest at 0, 7 days
29Basic science is used to construct and reconstruct coherent relations between symptom and disease
30SummaryRemembering for meaningful material is enhanced because there are more links or pathways to the memory trace
31Implications for Teachers How can we, as teachers, help students impose meaning on what they’re learning?
32Implications for Curriculum What are we doing now?“Traditional”PBLDoes PBL enhance learning”MACRO -- no or maybeMICRO:Active LearningImbedding problemEveryday analogy
33Effect of active, problem-oriented processing (Needham & Begg, 1991)Intro psychology students, 5 classic problems“Try to solve these difficult problems”( 27% successful)vs.“Remember the problem and solution so you can solve some additional problems”(21% successful)
34Effect of Active Problem-solving Needham & Begg, 1991
36Imbedding Principle in Problem (Ross & Kilbane, 1997)Practice and Test problems with:SEQUENTIALPrinciple explanation, then problem exampleIMBEDDEDPrinciple imbedded in problem, explanation as part of problem“Reversal” = using original principle incorrectly
47Implications for Teaching/ Curriculum Arrange learning to integrate with prior knowledgeActive learningProblem – based learningImbed principle in problemEveryday analogySequencing of concepts
48Transferusing old knowledge to solve new problems
49As teachers, we act as if all the knowledge we impart to students will be available to them to solve problems in the future
50As teachers, we act as if all the knowledge we impart to students will be available to them to solve problems in the futureUnfortunately….. it won’t
51Views of Transfer General Transfer (1900-1915….) Subjects like Latin, algebra teach general “habits of mind”(disproved by Thorndike, 1913)Specific transfer (Behaviorism,1910--> Now)Learned concepts can only be transferred if new behavior = old behavior(disproved by Judd, 1908, Wertheimer, 1959, Pressley 1990)Intermediate / hybrid transferLearned concepts can be applied (with difficulty) to new, dissimilar problem situations
52A general wishes to capture a fortress located in the centre of a country. There are many roads radiating from the fortress. All have been mined so that, while small groups of men can pass over the roads safely, a large force will detonate the mines. A full-scale direct attack is therefore impossible. The general’s solution is to divide the army into small groups, send each down a different road, and have the groups converge simultaneously on the fortress.
53You are a doctor faced with a patient who has a malignant tumour in his stomach. It is impossible to operate on the tumour. X-rays can be used to destroy the tumour. If sufficient rays reach the tumour all at once, the cancer cells will be killed, but surrounding tissue will be damaged as well. How can you arrange the procedure to destroy the tumour cells without severely damaging the surrounding tissue.Gick & Holyoak, 1980
54Transfer and Context Specificity The initial solution (multiple simultaneous paths) was learned in, and stored with the problem context (fortress and army).To solve the new problem, must recognize that the old problem was analogous to the new, despite different contextsTo recognize analogy, we must recognize similarity in deep structurethis rarely happens…..
55Example case + Principle: e.g. Pr(D|S) = Pr(S|D)/Pr(D)Test Cases:(+/+) same situation, consistent solution(+/-) same situation, inconsistent sol’n(+/0)same situation, unrelated sol’n(0/0) diff situation, diff solution
56Why not just teach them the principle? Teach the principle, then give them an example of the principle
57Use of examples w. principle (Ross, 1987)Are examples used to:Cue the principleProvide analogy for solution
58Example case + Principle: e.g. Pr(D|S) = Pr(S|D)/Pr(D)Test Cases:(+/+) same situation, consistent solution(+/-) same situation, inconsistent sol’n(+/0)same situation, unrelated sol’n(0/0) diff situation, diff solution
60“…during early learning, the principle is only understood in terms of the earlier example… the principle and example are bound together. Even if learners are given the principle or formula, they would use the details of the earlier problem in figuring out how to apply that principle to the current problem”Brian Ross
61Effective Use of Practice Examples Multiple examples vs. “Principle + Example”Active Compare and Contrast vs. Separate (Gentner, 2003, Holyoak,1989)
62Multiple Examples vs. Principle + Example MBA Students , negotiation problemFactor 1Two cases, implicit principle vs.Principle + CaseFactor 2Read case and principle (on successive pages) vs. Compare Case and PrincipleLoewenstein& Gentner, 2003
63Effect of Examples and Comparisons Gentner, 2003
64Effect of examples (Catrambone & Holyoak, 1989) Undergraduate psychology students,Two related examples vs. one example and control“Summarize the two stories”vs.“Describe the ways the two situations are similar”
65Effect of Examples, Comparisons Catrambone & Holyoak, 1989
66Problems in moving to the “Real World” Near/far transfer is not so black/whiteSurface and deep structure not orthogonalPrinciples are “to be learned”“aha” insights are the exceptionProcess of learning / application is more complex“problem”(+/-) --> principle -->example (-/+)--> practice, ---> test
67Implications for Teaching Transfer can be facilitated by use of examples during initial learningmultiple examples > principle + examplecompare and contrastActive search for deep structure
68Transfer, examples and practice Critical to learning, transfer is the opportunity to see the concept arise in multiple contextsThis can only arise with multiple practical exercisesWhat can we do to enhance the value of practice?
69Strategies to Optimize Practice Mixed vs. Blocked Practice (Hatala, 2002)Distributed vs. Blocked Practice(Schmidt &Bjork,1992)
70What do you need to do stats? An Observation:With the availability of sophisticated statistical software, the central issue facing the statistics student is “ What test do I use?”To learn this, students have to see data sets, think of possible strategies, and get feedback
71What do you get in stats courses? Instructional time occupied by equation proving, formula rememberingPractice at end of chapter of the form:“Do a t test on these data”
72So when do you do a t test?At the end of the t test chapter
74Mixed vs. Blocked Practice In the face of ambiguous features (which are subject to reinterpretation), and multiple categories, students must learn the features which discriminate one category from another, not those which support a particular category
75Mixed vs. Blocked Practice Hatala, 2000 ECG Diagnosis -- 3 categories6 examples / categoryBlockedReview, then 6 examples/categoryMixedReview, 2/category, 12 (4 x 3) practiceTEST 6 new ECGs
79Timing and Sequence of Learning Would you rather learn to skate (type, play violin, speak Spanish):1 hour/day, biweekly, for 60 weeks = 301 hour / day for 3 days/wk for 10 wks = 303 hours/day, 1 day/week, 10 weeks = 306 hours/day, 5 days, 1 week = 30
80Massed vs. Distributed Practice All learning takes place at one timeDistributedLearning takes place over multiple occasions
81Massed vs. Distributed (Raman, McLaughlin, 2010) 20 GI residents Nutrition course- 4 hr, one 1/2 day vs. 1 hr. 4 1/2 dayMultiple choice test, 0, + 1 wk., + 3 mo.
84Implications for Teaching Practice is critical for learning and transferto impose meaning on conceptsto overcome “context specificity”to enhance transferSome practice works better than othersMixed >> blockedDistributed >> Blocked
85Exercises, Experience and Expertise The critical role of deliberate practice in acquisition of expertiseIs practice just a matter of learning to apply the rules?remember the chess master!!!!
93Age and Diagnostic Accuracy Hobus & Schmidt, 1993
94Schuwirth et al., 2004 Total score on the CCT test EXPOSURE 140000 12000010000080000600004000020000Total score on the CCT test70686664626058Schuwirth et al., 2004
95How many years after you finished specialty training before you felt yoou were competent?
96Who do you choose?Dr. JS. finished residency last year and was in top 5 on cardiology RCPS exam?Dr. KT finished residency 10 years ago and was in top 1/3 on cardiology RCPS exam?
97What does the clinician gain from years of experience? Years of experiences
98Is Expertise Just a Matter of Applying the Right Rules? Experienced clinicians are poorer than recent graduates on formal tests (of the rules)But no one picks a recent graduate for their docExperience provides a storehouse of prior examples
99What are all these things? A DIAGNOSTIC TASKWhat are all these things?each member is unique. lots of perceptual variation, but all treated as identicle category members. CLEAR LINK TO FUNDAMENTALS OF PSYCHOLOGY
113Similarity and recognition of everyday objects When we recognize everyday objects, the process is effortless, seemingly unconscious.We are not aware that we are eliciting or weighting individual featuresThe process appears to occur all at once (Gestalt)
114Rapid, effortless, accurate recognition Familiar CategoriesRapid, effortless, accurate recognition- despite massive within – category variation- despite no overt understanding of rulesUnfamiliar CategoriesSlow, effortful, inaccurate recognitionDespite NO within – category variationDespite an explicit and simple additive rule
115Exemplar Theory - Medin, Brooks Categories consist of a collection of prior instancesidentification of category membership based on availability of similar instancesSimilarity is “non-analytic” (not conscious), hence can result from objectively irrelevant featuresRatings of typicality, identification of features, etc. done “on the fly” at retrieval
116Effect of Similarity (Allen, Brooks, Norman, 1992) 24 medical students, 6 conditionsLearn RulesPractice rulesTrain Set A Train Set B(6 x 4) x (6 x 4) x 5Test (9 / 30)
125CONCLUSIONS - The Role of Examples Categories and concepts are based on our specific experience with the world as well as application of rules
126Implications What are we doing now? How should we do it differently? “Traditional”PBLHow should we do it differently?
127Implications for Teaching Practice with examples is critical in ambiguous domainsPractice results in a collection of exemplars as a problem-solving resource
128What happened to Skills? Any measure of “problem-solving”, “reasoning”, “critical thinking”, “clinical judgment”, etc. correlates across problems at aboutProcess measures of the above show no gradient with expertise
129But what about technical (motor) skills? Do surgeons (e.g.) have innate talent?Are surgical skills generalizable (high transfer)?Are there predictors of technical skills (e.g. motor ability, spatial ability?
130Do surgeons (e.g.) have innate talent? No Are there predictors of technical skills (e.g. motor ability, spatial ability? NoAge, gender, grades, manual dexerity don’t correlate with surgical skill.Visual-spatial may, but swamped by practice
131Are surgical skills generalizable (high transfer)? NO! Transfer across similar procedures low(Wanzel, 2002)Strong gradient of mortality with no.of operation (within procedure)Colorectal Cancer Recurrence rate 1.4 x for <21 resections/yearAbdominal aneurism Operative failure rate decreases up to 55/yearPancreatic cancer resectionMortality rate:< 5 cases, 19%5-50 cases 7%>50 cases 1%
132Recurring Themes Learning Human learning and remembering is critically sensitive to the meaning the learner imposes on the “to be learned”
133Recurring ThemesTransfer of concepts to new, dissimilar problem situations does not occur effortlessly or frequentlyEnhanced by active learning, search for principles, multiple practice examplesImpeded by learning for memory, passive learning, single example
134Recurring ThemesFormal conceptual knowledge is insufficient for expertiseExperience provides an array of prior examples to draw from and reduce memory load
135Recurring Themes Kinds of Knowledge Expertise is more a matter of having the right knowledge (both formal and experiential) and being able to mobilize it, than of any general skills
136Thinking depends on specific, context-bound skills and units of knowledge that have little application to other domains….. The case for generalizable, context-independent skills that can be trained in one context and transferred to other domains has proven to be more a case of wishful thinking than hard, empirical evidence.Perkins & Salomon, 1989
137Conclusion“The problem-solving difficulties of novices can be attributed largely to the inadequacies of their knowledge base and not to limitations in their problem-solving capabilities”R. Glaser, 1984We have discussed a number of strategies to improve the knowledge base
139To use analogy, the user must: Encode the problem in a way thatRetrieves the encoded analogySelect the correct analogue rather than others brought to mind during retrieval thenAdapt the solution principle to the needs of the target problem
140Context, Learning and Remembering Recall of knowledge is strongly related to the match or mismatch between context of learning and context of recall
143Implications for Teaching Everything is learned in a context. You can’t teach a principle out of context.sooo…..
144Implications for Teaching Everything is learned in a context. You can’t teach a principle out of context.sooo…..Expose students to the same principle in multiple contexts (multiple retrieval pathways)(practice, practice,practice)