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Durable Learning Introduction

by Peter Horneffer, MD

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    00:05 From the moment we are born we start learning and like it or not, we continue having to learn new things for the rest of our lives.

    00:14 In fact, it is this capacity to learn that makes us so unique among living species on Earth. Yet relatively little time is spent learning how best to learn as we progress through the educational process.

    00:29 Have you ever taken a course specifically focused on learning how to learn? And while there are efforts to improve how teaching is done, many of these efforts are not based on scientifically demonstrated evidence.

    00:44 This course is designed to help students and teachers understand just how our brains learn and then how to apply what we know about learning to make the acquisition of knowledge as effectively as possible.

    00:58 We are confident that using the highly effective evidence-based learning strategies described in this course will help make your life-long pursuit of learning more effective and fruitful.

    01:13 In the early years of our education, the flow of information comes at a gentle rate. We learn to read, to write, to add and subtract- interspersed with breaks for juice and cookies.

    01:27 The flow of information is manageable.

    01:31 As we get older, the flow of information increases.

    01:35 We are being taught more information at a faster rate.

    01:39 For me, it was as a teenager that studying got significantly more challenging.

    01:45 Not only was there more material to learn but more distractions to keep me from learning as well! I didn’t know anything about learning science at that time, so I used whatever tools I had to process and store the information that I was being taught, and it worked well enough.

    02:03 Or so I thought.

    02:06 In professional school, which for me was medical school, the flow of information becomes a flood.

    02:13 My initial excitement at having the opportunity to learn all about the human body soon turned into a struggle to stay afloat in a sea of information.

    02:24 There was so much information being taught to me at an incredibly rapid rate.

    02:30 The tools I had used for learning in the past didn’t seem like enough anymore.

    02:36 And this flow of information is only increasing and getting harder to manage.

    02:42 In fact, there's an explosion of new medical knowledge as measured by what's appearing in the scientific literature.

    02:50 If you go back over the most recent centuries, medical knowledge had historically doubled roughly every 100 years until about 1950 when that doubling time dropped to 50 years.

    03:05 And then by the year 2000, the doubling time was down to every few years, and in 2020 that doubling rate was only 73 days! It is therefore likely that going forward medical knowledge will double in weeks, days, maybe even minutes! This means that not only will medical professionals need to learn as much as they can in school, but we will also need to continue to learn as effectively as we can for the rest of our lives if we want to have any hope of keeping up and staying current with medical knowledge.

    03:41 And to make the problem worse, most of us forget what we initially learn.

    03:47 In fact, about 75 percent of what you learn is gone in 6 days, or a little less than a week.

    03:56 But fortunately, there are strategies to help retain information and knowledge - and one that's very effective is that if you keep retrieving a concept, over time, this forgetting curve flattens, and you remember things more effectively.

    04:15 This is called retrieval practice.

    04:18 For example, what if I ask you to retrieve the information you just learned? In the year 2020, approximately how fast was medical knowledge doubling? Every 50, 70, 90, 110 days? About every 70 days.

    04:43 Here’s another chance for retrieval practice.

    04:45 What percentage of the information we learn have most of us forgotten about a week after we’ve initially learned it? Is it 50%, 66%, 75%, 85%? 75 percent.

    05:07 That retrieval practice we just did is based on learning science.

    05:12 Whether you got the answers right or wrong, simply trying to retrieve them made them easier to remember in the long term.

    05:21 And we even know why this happens at the neurologic level- but more about that later. So where did learning science come from? Like medical science, learning science has evolved over centuries.

    05:35 It comprises theories that people set forth to try and help other people learn better.

    05:40 Those theories were rarely tested objectively until the late nineteen hundreds when there was an effort to really evaluate what worked and what didn't.

    05:50 And this culminated in the nineteen-nineties with the advent of evidence-based medical education.

    05:58 And this should sound familiar to most of us in the medical arena because this is very much how we've learned to treat patients based on evidence.

    06:07 So for an evidence-based approach in the clinical setting, you would question your patient and get a chief complaint and do an examination. You then order tests and evaluate the results of these tests, and all that would lead to a diagnosis and then a recommended treatment based on the evidence which exists to support that mode of treatment And most importantly, you then evaluate the outcomes not just in that one patient, but in groups of patients and populations to improve your methodology and your body of evidence. That’s the same process that is now being used in cognitive science or learning science where most of the learning strategies we will be discussing have been scientifically validated.

    06:56 So if the medical treatments you receive or prescribe are expected to be evidence-based, shouldn't the way one learns and teaches be evidence-based as well? In addition to the evidence-based strategies which have come from cognitive science, we now have a neuro-biological understanding of how our brains learn! This understanding is still very rudimentary but is evolving rapidly to help us understand how memories are formed and retained, how cognitive processes work, and how thoughts exist inside of us.

    07:32 As we understand the role of neurotransmitters, we are starting to develop therapies and understand ways to potentially manipulate these pathways and these neurotransmitters and make learning more effective.

    07:45 So when you put the two together, the strategies built on cognitive science that have been studied methodically, together with a neuroscientific understanding, one can define evidence-based strategies for both learning and teaching.

    07:59 And these evidence-based strategies make for more effective and durable learning.

    08:05 It’s easy to hear information or read about it.

    08:08 But really, what you need to do is retain that knowledge.

    08:13 At the beginning of this video, we talked about one of the tools for retaining knowledge. Do you remember what it was called? Was it retirement, retrieval, returning, or reviving? Retrieval. Did you know that every time you retrieve a piece of information the connections between the nerve cells in your brain which store knowledge grow stronger? We will tell you a lot more about that later in this course.

    08:47 But before we move on I would note that if you learn one thing only in this whole course it would be this concept of learning by retrieval. It is primarily by virtue of recalling information which you have already received, that true durable learning occurs.

    09:10 Let’s try our retrieval practice again, with a slightly different question.

    09:14 Do you remember roughly how many days it takes, as of 2020, for medical knowledge to double? About how many weeks is that? Is it 5 weeks, 10 weeks, 15 weeks, 20 weeks? About 10 weeks.

    09:34 And you know that because in childhood you learned to add and multiply. You can use that knowledge easily to solve problems like this one.

    09:48 Knowledge always builds on prior knowledge which is something else which can help you learn more efficiently.

    09:54 And this is also why it is so important that you develop a good built-in fund of knowledge and why you should not rely on being able to “just look it up” Do you remember how long it takes to forget 3/4 of what you’ve learned if you haven’t used the tools to help you retain it? Is it 1 week, 2 weeks, 3 weeks, 4 weeks? About 1 week.

    10:27 Even if you could somehow learn all of the new medical knowledge that is created in the next ten weeks, you would be forgetting it at a much faster rate than you could learn it. Without better tools for learning, it’s impossible to keep up. This course will provide the solutions you need to not only keep up but even get ahead. It’s designed using evidence-based tools to help you learn the information in not only this course, but in all of your other courses, and retain it weeks, months, and years later.

    11:02 The course is organized much like the curricular structure which is common to most medical schools. You start with your basic sciences, and in this course, that means the examination of the neuroscientific basis and the cognitive scientific basis of learning. We will then apply the strategies that come from cognitive science and the understanding of neuroscience and help share practical applications of these scientific principles.

    11:29 That practical application is much like the clerkships in a medical school or the practicum in other health care professions, where you start applying everything you’ve learned.

    11:43 And lastly, we'll have a section on practical tips because there are an increasing number of tools and applications which can make your learning even more effective.

    11:57 So let’s recap, do you remember from the beginning of the video how quickly medical knowledge is doubling? That’s right - about every 70 days or about every ten weeks.

    12:10 Do you also remember the rate that we tend to forget what we’ve learned? We forget about 3/4 of what we’ve learned in less than a week.

    12:22 It’s easier for you to remember these data points now because you’ve already practiced retrieving them from your memory.

    12:30 That retrieval practice is just one of the many evidence-based strategies you will learn and apply in this course which will help you learn more effectively in every course you take from now on. The net result is at the end of understanding these strategies and these principles, you're going to be able to handle this ever-increasing amount of knowledge effectively and durably so that you retain it and become the best health care provider you can be.


    About the Lecture

    The lecture Durable Learning Introduction by Peter Horneffer, MD is from the course Introduction to Durable Learning.


    Included Quiz Questions

    1. Recalling information at intervals
    2. Taking a quiz each week of the semester
    3. Using flash cards to test yourself after every class
    4. Revisiting the questions you missed on a quiz and testing yourself on them before the next quiz
    5. Reading over your notes before each class
    1. Just as a medical practitioner will recommend treatment based on studies that support that treatment, education should use learning strategies supported by research.
    2. Just as medical school has clerkships, learning experiences should always contain a practical mentorship element.
    3. Just as a medical practitioner will listen carefully to patients in order to define their complaints, instructors should survey students about their learning styles.
    4. Just as a medical practitioner will teach a patient about their disease state, instructors should teach students about the neuroscientific support for each assignment.
    1. The last two decades have seen increases in medical knowledge at unprecedented exponential rates.
    2. Using these strategies makes learning more efficient and effective.
    3. Students like to accommodate their preferred learning styles.
    4. Acquiring knowledge is less important than it used to be.

    Author of lecture Durable Learning Introduction

     Peter Horneffer, MD

    Peter Horneffer, MD


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    Good quality material easily explained
    By Eugene P. on 15. November 2022 for Durable Learning Introduction

    Good quality material easily explained. I really liked how dr.Horneffer smiles after giving the right answer. This small gesture makes me feel involved in the conversation. To make lectures even better add links to the sources. Since we are learning evidence-based medical education techniques that may make a good impression.