Thread by @alvarezzzy

Dr. @sherbino is the Medical Education Keynote Address: Efficiencies in Education: How to Hack Educational Training to Get From 10,000 Hours to 100 Hours.

#SAEM20 #MedED

When we get into more complex problems in emergency medicine, we construct knowledge instead of just transferred. The use of algorithms doesn't work in a complex rapidly changing tasks.

#SAEM20

Deliberate practice and mastery learning allow learners to wrestle with the fundamental piece before they get to the complex task. This is the magic of #simulation.

The jump becomes manageable instead of impossible.

#masterylearning #deliberatepractice #EMSim #MedED

Our inability to access material is a function of time. While we don't forget, the challenge is the retrieval of information from long term memory. Networks and synapses allow for this. Spacing over time allow for easy retrieval.

#MedED

consider spiraling the information: Start broad, then adding more complexity as you revisit the concept.

At first pass, minimize overwhelming with information. The subsequent pass allows for adding complexity.

#MedED

To sustain learning, you need multiple re-inoculation of information.

Reading a single lecture or going to a single lecture does NOT establish a robust recall of information.

#MedED #spacedrepetition #spiralcurriculum

If you have a practice of learning involving a highlighter? Throw it out! Elegantly colored books don't work. Reading and re-reading are inefficient.

Here's what works:
Use elaboration. Create your own schemata. Build a representation that makes sense to you.

#MedED

On flashcards:
It works!

The process of recall is even more powerful than in the process of elaboration.

Elaboration expands the resources.

EFFORTFUL, MIXED RECALL is best.

Learning/information needs to have a desirable difficulty.

In sum:
We do not upload. We construct it.
We require progressive sequence feedback.
We need a process of re-inoculation vs. 1x exposure.
We need a mixed process of elaboration and recall.

#MedED

Also important is to socialize learning. We learn by observation, modeling, imitation, and shared values.

Most of what students learn from us is through modeling.

#MedED

FALSE: Learning styles are an important consideration.

Truth: Learning styles are not a phenomenon. Align the instructional method with the goals of learning. A textbook chapter on thoracotomy is less efficient than demonstrating it.

#MedED

FALSE: Mastery allows us to multitask.

Truth: We are interrupted every 8 minutes with a critical task. We do rapid task switching. There is a degradation of information from Task 1 to Task 2. Both tasks get less optimal care and attention.

#MedED

FALSE: We are great at assessing ourselves.

Truth: We can't see what we don't know. It's hard to see you're own lacune. As we try to maintain competence in our training, we need others (peer consult) to get supporting and refuting data to assess our work.

#MedED

Our own self-assessment is impaired. We need formal, psychologically-safe ways of getting #feedback.

#MedED

What's the role of digital learning in the future?
Online platforms speak to scale. Reach and access a larger population.
Allow for re-access and review.
Flattens the hierarchy on who is the expert teacher.

--Dr. @sherbino

Caveats to digital learning:
We need to consider the topics above in order to be efficient.
If you don't have a principled design for curriculum, the internet is just a platform, and everything will fail.
--Dr. @sherbino

#MedED #SAEM20

Should didactics virtually be year-specific?
Team-based learning literature: sequence senior, intermediate, and junior learners. This allows for Spiral curriculum. You do not need to pull people apart to learn. You can target each cohort within the didactic.
--@sherbino

#MedED

The calendar is not the best way to measure levels of expertise.

Keep it simple. Focus on spiral curriculum.
--@sherbino

#MedED

We can be very effective in providing #MedED remotely. Here's the list of resources.

--@sherbino #SAEM20

What is the future of CME given the above talk?
The next big challenge for us in #MedED is to socialize learning. Individualized education 2/2 data on individual practice. #PrecisionMedED

requires feedback and social accountability

--@sherbino #SAEM20

How do we address the degradation of clinical expertise over time?
Expertise if unaccessed will show decay. Must be balanced with implementation of new science and approach (non-acquisition of new information)
Focus on attention. (awareness)
Don't go from 0 to 100 or 100 to 0.

Authenticity in our clinical practice (teaching and actually still being in practice is key)
Simulation of acquisition of new skills
Coaching model. Ex: videotaping a procedure then have a peer coach providing feedback.

--@sherbino #MedED #SAEM20

Anything you would have changed in the learning revision methods you used? Top tip for #MedStudentTwitter
You need to be systematic. If you just jump in the excitement and enthusiasm of life-long learning, the volume and scope/scale will catch up.
--@sherbino #MedED #SAEM20

#Impostersyndrome will catch up. Instead, be systematic. With a plan, you can find moments of finding redundancy and maximizing efficiency. In the absence of systematic processes, we continue doing the highlighters way of learning.

--@sherbino #MedED #SAEM20

We construct knowledge.
We require specific, staged, progressive feedback.
We need multiple re-inoculation.
We need to incorporate effortful, mixed recall of knowledge/
We learn by observation, by watching others, especially those we look up to.

--Dr. @sherbino #MedED #SAEM20

@threadreaderapp, unroll, please! 🌲

#MedED #SAEM20