Learning and the Evolution of the Brain

00:05 As we launch into our study of the science of learning, we should start with defining learning, and one of the most common definitions is the act of acquiring knowledge, skills, and behaviors.

00:19 These are the attributes which determine a person's ability.

00:24 I would note that ability is often used to simply denote knowledge and skills, but I often remind my students that it is several of the behavioral components of the ability which are just as important to becoming a good medical professional.

00:38 I like to refer to these as the three A’s, availability, accountability, and affability.

00:47 While these are crucial components which affect one’s ultimate ABILITY as a health care provider, one must always start with a good fund of knowledge and so our initial focus of this course will be to examine how knowledge is acquired, stored, and expanded.

01:07 The concept of knowledge being foundational for other learning has been well characterized in the widely familiar Bloom’s Taxonomy and its stages of learning. It's been useful for a number of years, but actually, we know now that a linear progression of learning, as is represented by this taxonomy, is not completely consistent with learning science.

01:31 In fact, all these various stages interact with and reinforce each other.

01:38 And as we understand the neuroscience better, we now know how axons and dendrites, the components of neurons, link more effectively as these stages of learning interact.

01:52 So I'd like to share with you in this lesson some of the fundamental building blocks of what a thought is or learning is, and it all starts with a cell called a neuron.

02:05 The cells which make up all our organs each have specialized functions.

02:11 A muscle cell squeezes, the liver cell helps with metabolism, the kidney cells filter, the skin cells protect- and the brain cell link.

02:24 That's how circuitry is conducted around the brain.

02:29 And that's how thoughts are stored in memory and how they're retrieved by this process of linking and unlinking.

02:37 This linking and unlinking is actually a dynamic process.

02:43 You actually learn very, very few things forever.

02:47 Most of your memories are transient, and we'll find out later in the course that that's actually a very healthy and important thing, how some memories are more durable than others.

02:59 And these connections, whether transient or durable, are made in synapses that are potentiated by neurotransmitters.

03:08 As we get an understanding of these neurotransmitters, we're becoming able to help modify the process and potentiate it or improve it to learn more effectively. In the medical education process, there are a tremendous amount of knowledge to accrue, skills to master, and behaviors to learn before you have the ability to perform in a certain role.

03:32 So, the culmination of all this learning for me after four years of medical school and nine years of surgical training was my role as a cardiothoracic surgeon specializing in open heart surgery.

03:45 And you see me here pictured in my first year of practice, opposite one of my mentors.

03:52 As you might imagine, heart surgery requires using all of the levels of Bloom's taxonomy at once. And this ability represents a culmination of many years of acquiring knowledge, skills, and behavior.

04:07 But acquiring all that knowledge was hard work, and I wish I had known then what I know now – not only about the heart but about the brain and how we learn.

04:18 Just by taking this course, you’re giving yourself a huge advantage in making your learning more efficient and more effective.

04:25 And one way to make your learning more effective is to understand how the brain evolved to learn.

04:33 Let’s take a very brief look at the evolution of the human brain and its early development. In early infancy, migratory neurons develop rich synaptic connections.

04:46 And this peaks at about two years of age in humans, thus in early childhood.

04:52 These synaptic connections are then pruned and remodeled, and different parts of the brain develop at different times.

04:59 So some of the basic functions of the visual cortex and the auditory centers develop sooner. In the prefrontal cortex, what is referred to as the central executive where more advanced thought is located develops much later.

05:14 In fact, the development of this area does not finally mature until late in one’s teenage years or even a bit beyond.

05:23 And that can help explain some of the unusual behaviors that teenagers have been known to exhibit.

05:31 All through life, however, there is a continual remodeling.

05:36 You can think of it as a rewiring of your house to make improvements.

05:40 When you understand how these processes can be improved, you can use that to your own advantage for learning more effectively.

05:49 You can also apply that knowledge for patients who have had a neurologic injury.

05:54 As a medical professional, you’ll always be switching between teaching and learning.

06:00 Understanding how to leverage neural connections in the brain can help you learn, help you teach, and help you access the knowledge you’ve already acquired so that you can perform as a medical professional to the best of your abilities. So how can we better understand these neural connections? The way the human brain changes and learns in early development is not terribly different from the evolutionary process that our species, the Homo sapiens, have gone through for thousands of years.

06:33 Remember that for the majority of our evolutionary process, things that were really important for survival were hearing and sounds, facial recognition, and linguistics.

06:45 These things were important to the evolutionary process, so they are generally easier to learn. For example, learning to speak your first language as a child was easy.

06:56 So what we understand now is that because of this evolutionary process, there are things that are easier to learn biologically and things that are harder to learn.

07:06 As the brain develops into adulthood, it gets harder for us to learn new languages.

07:12 But only relatively recently has Homo sapiens had to master the skills of reading and writing and really recently that we had to understand how to use computers, apply advanced math and understand biochemical principles.

07:29 These things like reading and writing and doing mathematics are called secondary material, and they are harder for your brain to learn.

07:38 So there are different neurological pathways which are utilized when you're doing easy stuff or hard stuff – and we’ll talk about the concept of desirable difficulty a little later.

07:52 Throughout our lives, there's always a recycling, a pruning, a regenerative process of neural pathways, and this is very important to remember as you care for patients with neurological deficits or you accommodate learning differences in neuro-atypical students.

08:09 The goal of education is understanding, leveraging, and reprogramming these dynamic neural circuits in order to help students accrue knowledge, master skills, and learn behaviors that will give them the ability to perform at the highest levels in their fields.

08:30 And we'll find their ways to do that through direct instruction and desirable difficulty and through repetition and active learning and student-based strategies.

08:44 You’re continuing a lifelong journey of learning and the skills you'll develop in this course will help you throughout this journey, no matter what you decide to do in the health care profession. You are giving yourself a great advantage by taking this course. A few tips as you proceed: Just think of the Why, What, and How: Remember why you decided to enter your field of study in the first place.

09:10 It may be helpful to picture yourself in either a white clinical coat, surgical scrubs, or whatever image you see that you're hoping to become.

09:20 And that image may change with time, and that's OK.

09:24 But it'll be very motivating for you to keep your “why” in mind.

09:31 The what refers to the fact that many of the effective strategies we will share with you in this course may feel awkward and difficult, but these are known as desirable difficulties, and in the long run, they will make your learning more efficient and effective, and most importantly, help you become a better health care provider. We’ll talk more about desirable difficulty in a later lesson. The howrefers to just how to use these strategies.

10:02 You'll find it's very important to space out your learning, as this will make it more durable, so try hard not to get behind in your studies.

10:12 It's very important to use the concepts of learning science along your journey so that you retain what you’ve learned.

10:19 Remember the previous video lesson? You used retrieval to access the knowledge about how quickly we can forget what we’ve learned.

10:31 We forget 75% of what we learn - do you remember how quickly? Is it 1 week, 2 weeks, 3 weeks, or 4 weeks? That’s right - In less than a week.

10:48 But now you know that retrieval practice can help you retain information instead of losing it. But always remember what happens at the cellular level, as you learn and bring in new concepts, you need to strengthen the pathways you create - by helping the associated neurons create strong and effective links, so that you can retain that knowledge, and have it readily available for when you need it.

11:17 In order to create those links and then strengthen them, you need to retrieve the information and work with it.

11:26 Effective learning is rarely a passive exercise! In the next section of our course, we're going to go in-depth into this “learn it and link it” process.