Wednesday, February 3, 2016

Designing learner-centered presentations

As I discussed recently, too many educational sessions in medicine are ineffective. Most of the educational sessions I've seen aren't true presentations, at least not according to my definition:

A "presentation" is a deliberately planned educational activity that incorporates ample opportunity for learners to immediately apply and reinforce new knowledge.

In contrast, a "talk" is nothing more than a speaker or teacher droning on, typically zooming through far more material than any learner could hope to remember afterwards.

Even if delivered by an engaging speaker, talks don't result in any meaningful information gains for learners. Think back to the last talk you attended; even if it was just last week, I bet you can't recall more than 1-2 facts from it (and if you've got 1-2, you're doing better than most).* Adult learners simply aren't wired to memorize reams of facts without context and/or without the opportunity to apply those facts to concrete examples. Even the most motivated of adult learners will struggle to take away something meaningful from observing a talk.

The solution is to incorporate learning activities into educational presentations. Here's one relatively fool-proof presentation formula (warning: this formula will not work if your presentation objectives are weak):
  • Introductions; review presentation objectives
  • Teach content re: objective 1
  • Learning activity re: objective 1
  • Teach content re: objective 2
  • Learning activity re: objective 2
  • Teach content re: objective 3
  • Learning activity re: objective 3
  • Wrap-up; questions; evaluations

The learning activity should directly correlate to its learning objective. So, if one objective is to "List the four types of allergic rhinitis," the learning activity might be to identify which of the four types applies to various patient scenarios, thereby reinforcing what the four types are along with their definitions. If a second objective is to "Describe the classes of medications available to treat allergic rhinitis," then the learning activity might be to match various allergic rhinitis medications with their mechanism of action. 

Each learning activity should fit with the objective's place on the Bloom's taxonomy pyramid. Here are some suggested learning activities for each step of the taxonomy, from top to bottom:

Creating: create a new process or workflow, brainstorm solutions, write/paint/reflect on a recent patient/peer encounter
Evaluating: rate the quality of a group of clinical trials, assess the pros/cons of an office/hospital workflow
Analyzing: categorize disease types by severity, compare and contrast different treatment approaches
Applying: calculate sensitivity/PPV/NNT/etc, diagram the pathophysiology of a disease/condition
Understanding: interpret diagnostic test findings, explain a medication's mechanism of action
Remembering: recall the typical patient history of a disease/condition, list common physical exam findings for a disease/condition

As you can see, it's often appropriate for your objective to precisely reflect the corresponding learning activity.

Most of the time, when we are teaching medical content, we're working within the bottom 3 tiers of Bloom's. But I challenge you to consider how your presentations might incorporate some of the top 3 tiers; especially in curricula on practice management, quality improvement, medical humanities, and evidence-based medicine, where infinite opportunity exists for our learners to analyze, evaluate, and even create.

The exceptions to this fact are those rare individuals with a photographic or eidetic memory