What really drives learning?
Lessons from the famously self-taught.
Holidays are a great time to catch up on reading. My own preferences are history and biographies. This past couple of weeks, I’ve found it rather humbling to learn that some of the most influential thinkers and shapers of our society were essentially self-taught. In fact, they seemed in some cases to thrive despite the benefits of traditional education or academic success.
Benjamin Franklin (1706-1790) led a peripatetic life, meandering through a variety of career interests, excelling in all. He’s perhaps best remembered as, arguably, the most important and essential influence on the Continental Congress that would draft and ratify the American Declaration of Independence. Along the way, he was a writer/journalist/publisher/politician/diplomat and, in his spare time, a scientist of considerable renown, receiving honorary degrees from both Harvard and Yale, and becoming the first person living outside Britain to receive the prestigious Copley Medal from London’s Royal Society. Remarkably, all this was accomplished without the benefit of college or university level education. In his excellent biography of Franklin, author Walter Isaacson describes three key educational components: the formative influence of his father who encouraged conversation and debate in the home, Franklin’s insatiable curiosity that spanned a huge variety of topics, and his access to books. “Indeed”, Isaacson writes, “books were the most formative influence in his life, and he was fortunate to grow up in Boston, where libraries had been carefully nurtured”. Despite this abundance, Franklin was required to actively seek out these books, generally housed in private libraries. His apprenticeship in his brother’s print shop provided him opportunities to “sneak books from the apprentices who worked for the booksellers, as long as he returned the volumes clean”.
The facts regarding the education of Abraham Lincoln (1809-1865) are almost lost in the mythology that’s developed regarding his early life. In Team of Rivals, author Doris Kearns Goodwin describes the challenges faced by the impoverished Lincoln as a “Herculean feat of self-creation”. “Books”, she writes, “became his academy, his college. The printed word united his mind with the great minds of generations past”. He also treasured conversation and stories he shared with interesting, informed people, and would analyze and reconstruct arguments afterward. He also undertook “solitary researches” in the study of geometry, astronomy, political economy, and philosophy. “Life was to him a school, and he was always studying and mastering every subject which came upon him.”
Although Albert Einstein (1879-1955) did have the benefit of formal education, attending the Swiss Federal Polytechnic School, he was a mediocre, somewhat embittered student and was unable to secure a teaching position after graduation. It seems he found formal curriculum far too rigid and stifling. He eventually undertook relatively menial work at a patent office, which allowed him time alone to read and think. It was during those years that he developed many of the theories that would revolutionize the field of physics and define his life’s work. He also developed a social consciousness that, although less publicized than his scientific work, is in many ways equally intriguing.
So should these notable examples, drawn from three separate centuries, diminish our commitment to formal education? Obviously not. However, it would also be a disservice to simply dismiss them as prodigious intellects who managed to excel despite more primitive educational systems. Simply put, it took more than brainpower for them to rise above their circumstances and become pre-eminent learners and, as a result, leaders of their times. They also shared three essential qualities:
- Relentless curiosity and desire to understand. Although the focus of that drive may have differed, the intensity and commitment were consistent. They simply could not be deterred from learning.
- Willingness to apply themselves to their goal. We tend to believe that people as gifted as Franklin, Lincoln and Einstein came by their success effortlessly, but this is far from the case. Franklin was known by his contemporaries to habitually arrive at work earlier than anyone else and to work long into the night. Lincoln often read or worked through the night, and photographs from the time document dramatically the physical toll.
- Commitment to betterment of their communities. All three were motivated by a desire to improve their societies. In fact, the energy and commitment that was so evident in their work appears to arise from this altruism rather than any personal self-interest.
It would seem that when these three qualities triangulate in an individual, great things are possible. However, those possibilities are only realized if their environment provides a few necessary things, including access to information and people with whom they can converse, share and test ideas.
How does all this relate to our work as medical educators? I think two important lessons emerge. Firstly, it would seem that any admissions process would benefit by concentrating on means to identify within applicants the three essential attributes listed above. Any student with these attributes is essentially programmed to succeed and will do so within, or in spite of, any educational system we choose to impose. Put simply, the appropriately motivated, reasonably capable learner is essentially unstoppable. Conversely, the absence of these attributes virtually dooms the process from the start, despite our best efforts. Secondly, these examples would suggest that the learning environment we develop is at least as important as the methods we employ to deliver and assess knowledge. Providing our learners with direction and opportunities to explore concepts and develop their personal learning skills is critical and, from the perspective of their ongoing career, much more durable than simply requiring them to reproduce pre-determined dollops of factual information.
All this should reassure us that the changes we’ve undertaken over the past few years with our admissions processes, curriculum, information technology, physical space, mentoring programs and educational methodologies are all positive developments, clearly moving in the right direction. We should also be encouraged to creatively and boldly go further.
Reminder: Course Directors’ Retreat Jan. 18, 8:00-2:30, University Club
The Course Directors’ Retreat will take place on Jan. 18 from 8:00-2:30 at the University Club. Course Directors have been asked to bring a designate who will be able to bring back additional information to the course team.
Credit for the workshops will be given.
Here is the agenda: Course Directors Retreat January 18 2013 Agenda
Please RSVP to Elaine Carroll at firstname.lastname@example.org
Many thanks for tremendous work: Farewell but not goodbye
Dr. Stephanie Baxter, has moved from her position as Co-Course Director for Neurology and Ophthalmology in Undergraduate Medical Education to serve as the new Residency Program Director for the Department of Ophthalmology. She has also therefore left her position on the UGME Teaching and Learning Committee of which she was an inaugural member.
It’s difficult to express all that Stephanie has quietly accomplished in undergraduate medicine–from piloting the extremely successful Ophthalmology Skills Fair to complete course revision as she acted as one of the first exemplars of creating balanced teaching methods. Stephanie has served the Teaching and Learning Committee well for 5 years, representing clinical teaching and supporting initiatives through her own teaching practice.
Perhaps most telling, however, is Stephanie’s contribution to student learning. She is the recipient of the 2011 Aesculapian Society’s Lectureship Award, and has already made an impact with her work in teaching residents, winning the Garth Taylor Resident Teaching Award of 2012, both attesting to the way Stephanie is able to interact with students to help them learn.
We wish Stephanie well in her work in Post Graduate Medical Education, and hope that our undergraduate students will still have the benefit of her teaching. Many thanks Stephanie, for all your tremendous work!
Curriculum Matters: Giving Feedback
“Learning without feedback is like learning archery in a darkened room.” (Cross)
The terms feedback and formative assessment have been used frequently in our UG curriculum both in clerkship and pre-clerkship. It’s important that we all recognize a consistent definition of feedback, as well as consider some effective tips and strategies from the educational literature. Sue Fostaty-Young weighs in with some helpful ideas.
Feedback is information regarding students’ performance that is offered with the express purpose of improving their learning and future performance. It is considered one of the most powerful influences on learning and achievement (Hattie & Timperley, 2007).
Tips for Giving Effective Feedback:
- Prepare students to receive the feedback you’re about to give
- Unfortunately, students do not always recognize feedback as such, especially oral feedback during rounds, or in clinic, etc. Consider starting your end of the conversation by saying “I have some feedback for you”.
- Alert students at the beginning of a rotation or any workplace teaching to the fact that feedback may be oral, and part of ongoing bedside teaching.
- Ask a student how he/she thinks they’re doing
- In asking a student to comment on their own performance you initiate the process of self-reflection and emphasize the learner’s active role in the feedback process.
- You may ask them to prepare some notes prior to the feedback session or create a structure for this dialogue.
- Be specific and objective about what you observed
- Begin by identifying what students are doing correctly in their performance.
- Provide examples of what you observed, not what you inferred. For example, rather than saying “You’re shy” (an inference), you might say “I noticed you made very little eye contact with the patient and you spoke very quietly, making it difficult for her to hear your questions” (an observation).
- Give feedback in a timely fashion and in time for students to improve
- Feedback offered almost immediately after an activity has more meaning because the event and the students’ behaviours during it are fresh in their minds.
- Timely feedback allows for students to alter their performance, to practice, and improve. Set a time to review improvement if possible.
- Outline specific targets or goals; articulate expectation
- Feedback has the most impact when learning-specific information is offered.
- Offer specific feedback that is within the student’s ability to improve and a rationale for your suggestions. For example, rather than say, “Stop being so shy,” you might offer specific suggestions such as “Try to make eye contact more regularly so patients know you’re engaged and to gauge their reactions. Speak louder so your instructions can be heard.” You may want to suggest that they practice with a peer or videotape their own practice.
- Invite the student to respond to the feedback you’ve just given
- Initiating this dialogue can help establish whether the student has interpreted the feedback as it was intended, and will be able to use the feedback in a meaningful way.
- Help the student develop an action plan with timelines for improvement to help them use the feedback in a constructive way.
Hattie, J., & Timperley, H. (2007). The power of feedback. Review of Educational Research, 77(1), 81-112.