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Pediatrics
The Secrets of Successful
Curriculum Design:Putting the Learner at the Center of
Instruction
Teri Turner, MD, MPH, Med
Innovations Consultant for the AAP Committee on CME
Associate Professor of Pediatrics
Vice Chairman for Educational Affairs
Director, Center for Research, Innovation and Scholarship
(CRIS) in Medical Education
Department of Pediatrics
Baylor College of Medicine
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Pediatrics
Teaching and Learning
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Pediatrics
Listening isn’t learning and telling isn’t
teaching
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Pediatrics
Objectives
•Articulate the difference between lecture driven instruction and
student-centered instruction
•Articulate the learning benefits of student-centered instruction
•Identify student-centered teaching strategies and tools and
discriminate between student-centered and lecture-centered
teaching practices
•Construct a lesson, or part of a lesson, using student-centered
design principles
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Pediatrics
Teaching Adults: WIIFM Principle
•Want their learning to be relevant
•Prefer that their knowledge is
acknowledged and valued
•Want to be able to apply what
they learn now
•Want feedback on how they are
doing
• Knowles, M. (1975). Self-Directed Learning. Chicago: Follet.
• Knowles, M. (1984). The Adult Learner: A Neglected Species (3rd Ed.). Houston: Gulf Publishing.
• Knowles, M. (1984). Andragogy in Action. San Francisco: Jossey-Bass.
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Pediatrics
Shift from Teacher to
Learner-Centeredness
“I never teach my pupils; I only
attempt to provide the conditions
in which they can learn.”
Albert Einstein
1. Weimer, M. (2002). Learner-centered teaching. San Francisco: Jossey-Bass.
2. Doyle, T. https://learnercenteredteaching.wordpress.com/learner-centered-teaching-
resources/definition-of-learner-centered-teaching/
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Pediatrics
What are the Benefits to Learner
Centeredness
•Engages students in the hard and messy work of learning
•Strengthens motivation
•Encourages collaboration and peer-teaching
•Permits opportunities to connect learning to real life
•Encourages students to reflect on what they are learning and how
•Provides opportunities for higher order thinking
•Benefits the teacher as well
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Pediatrics
The LEARN Curriculum and SBU School
of Medicine
•L = learning centered
•E = experiential
•A = adaptive
•R = rigorous
•N = novel
2016 Latha Chandran, MD, MPH
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Pediatrics
If You Fail to Plan Then You Plan to Fail
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Pediatrics
Kern 6-step Approach
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Pediatrics
Systematic Process Just Like Research and
Patient Care
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Pediatrics
Mind the Gap
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Pediatrics
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Pediatrics
What do we want our students to learn?
What would make us happy from
all that we taught—(the skills,
content and behaviors) that our
students remembered and could
use one year after they finished
our course?
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Pediatrics
Goals and Objectives
•Goals are like zip codes and objectives are like
street addresses
•They are signposts for learning and teaching
•Provide a framework for evaluation
•Place value or prioritizes content
•Must emphasize performance – What a learner
will DO
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Pediatrics
DRAW THE KREBS
CYCLE
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Krebs Cycle
www.en.wikipedia.org
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Pediatrics
Focus Should Be On Critical Thinking
Bloom, Benjamin Samuel. "Taxonomy of educational objectives: The classification of educational goals ." (1956).
Anderson LW, Krathwohl DR, Bloom BS. A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of
educational objectives. Allyn & Bacon; 2001.
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Pediatrics
It Takes More Than Knowledge
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Pediatrics
ABCD’s of Objectives
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Pediatrics
Activity
•Identify the goal(s) and objectives of your learning session.
•Make sure and identify at least one higher learning objective.
•Consider what skills should be practiced during the session.
•Focus your objectives on what the learner should be able to do.
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Pediatrics
Cognitive Pause
•Think about a time you learned
something that has stuck with
you to this day.
•What methods did your teacher
use to help you learn?
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Pediatrics
If You Only Know How to Use a Hammer…
You Tend to See Every Problem as a Nail
Abraham Maslow
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Pediatrics
Why We Need More Learner Centered
Teaching
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Pediatrics
We Have Information (Morbid) Obesity
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Pediatrics
In 2020, information will double every 72
days
Levit, L., Balogh, E., Nass, S., & Ganz, P. A. (Eds.). (2013). Delivering
High-Quality Cancer Care:: Charting a New Course for a System in
Crisis. National Academies Press.
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Pediatrics
How much do we retain 1 hour after
learning?
A. 10%
B. 20%
C. 30%
D. 40%
E. 50%
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Pediatrics
How much do we retain 1 hour after
learning?
A. 10%
B. 20%
C. 30%
D. 40%
E. 50%
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Pediatrics
We Forget Rapidly
Ebbinghaus H. Memory: A contribution to experimental
psychology. 1913.
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Pediatrics
Refresher Training is Needed to
Maintain Competence
1. Pusic M. et al. Academic Emergency Medicine
Volume 19, Issue 12, pages 1476-1480, 2012.
2. Kerfoot BP. Spaced Education (2007-2016)
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Pediatrics
When does a medical students attention
begin to wane during a lecture?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 40 minutes
E. 50 minutes
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Pediatrics
When does a medical students attention
begin to wane during a lecture?
A. 10 minutes
B. 20 minutes
C. 30 minutes
D. 40 minutes
E. 50 minutes
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Pediatrics
Attention Span
Stuart J and Rutherford RJD. Lancet. 1978
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Pediatrics
Active Learning is Better than Passive Learning1
Prince M. Does active learning work? A review of the research. Journal of
engineering education. 2004 Jul 1;93(3):223-31.
Interactivity is the Secret Sauce of Teaching!
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Pediatrics
Active Learning Engages the Brain
1. Vannest JJ et al. J. Magn Reson Imaging (2009)
2. Friedlander et al. Academic Medicine (2011)
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Pediatrics
Without Interactivity You Lose Learners
Quickly
Cantillon P, BMJ (2003)
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Pediatrics Schunk, Dale H. Learning Theories: Pearson New International
Edition: An Educational Perspective. Pearson Higher Ed, 2013.
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Pediatrics
Penny Memory Test
Which way does Lincoln’s head
face on a penny?
A. Left B. Right
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Pediatrics
Too Much Content Overloads Working
Memory
1. Sweller J Cogn Sci (1988)
2. Leppink J, van den Heuvel A. The evolution of cognitive
load theory and its application to medical education.
Perspectives on medical education. 2015 Jun 1;4(3):119-27.
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Pediatrics
Learning is Messy and Takes Work
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Pediatrics
Methods to Increase Learner Engagement
•Patient cases
•Small group discussion
•Think-pair-share
•Quizzes
•Reflection
•Flipped/Blended classroom
•Projects
•Team based learning
•Role play
•One minute paper/Muddiest point
•Peer teaching
•Debate
•Brainstorming/Brain Drain
•Invented dialogues
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Pediatrics
Armstrong E and Parsa-Parsi R. Academic Medicine 2005
Klein M and Vaughn LM. Medical Teacher 2010
Brooks-Harris and Stock-Ward. Workshops: Designing and facilitating experiential learning.
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Pediatrics
Role of the Teacher when Using Kolb’s
McCarthy B, O'Neill-Blackwell J. Hold on, you lost me!: Use learning styles to
create training that sticks. American Society for Training and Development; 2007.
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Pediatrics
Choosing Instructional Strategies
•Use multiple methods
•Dream big and adapt
•Interactive and fun
•Maintain congruence between
methods and evaluation
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Pediatrics
Activity
•Match instructional strategies to your learning objectives.
•Consider the Kolb experiential learning cycle when identifying
strategies for teaching.
‐How will you engage the learner? (Why is this important?)
‐Share – What information is essential vs. important vs. nice to know?
‐Practice – How will they practice what they have learned?
‐Perform – If they are confronted with this issue, how can they apply what they have
learned and how do I know they can do it? (This is the relevance.)
•Do not use lectures as an instructional strategy for this exercise.
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Pediatrics
The LEARN Curriculum and SBU School
of Medicine
•L = learning centered
•E = experiential
•A = adaptive
•R = rigorous
•N = novel
2016 Latha Chandran, MD, MPH
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Pediatrics
Too Much Teaching and Not Enough
Learning
Objective #2 Identify at least 3 teaching techniques that promote
learning
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Pediatrics
Just Because it was Taught Doesn’t Mean it
was Learned
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Pediatrics
How Do You Know Learning Occurred and it was what you wanted them to learn?
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Pediatrics
The Exit Ticket or One Minute Paper
•What is one thing you learned today?
•What will you do differently based on
what you learned today?
•What is one thing you still do not
understand and are going to go learn
more about? (aka the Muddiest Point)
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Pediatrics
Questioning Techniques
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Pediatrics
The Socratic Method Using Bloom’s
Taxonomy and the 3 Little Pigs
•Of what material did each of the 3 little pigs build his (or her) house?
•If the wolf had asthma, how would this have changed the outcome of
the story?
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Pediatrics
Conducting a Cognitive Autopsy
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Pediatrics
Debriefing Using Advocacy Inquiry
•Advocacy is an assertion, observation or statement
•Inquiry is a question
‐Debriefing with “good judgment”
‐Creates a context for learning and change
‐Seeks understanding through honest inquiry
‐Respects that the trainee is trying to do the right thing.
Rudolph JW, Simon R, Dufresne RL, Raemer DB. There's no
such thing as “nonjudgmental” debriefing: a theory and method
for debriefing with good judgment. Simulation in Healthcare.
2006 Apr 1;1(1):49-55.
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Pediatrics
Example of a Cognitive Autopsy using
Advocacy Inquiry
•“Okay, that seems reasonable. I saw
you looking all around the room for
equipment, though, and that seemed
to prevent you from trying any
alternative approaches to oxygenating
the patient [advocacy]. Can you help
me understand what you were
considering at the time? [inquiry]”
Rudolph JW, Simon R, Dufresne RL, Raemer DB. There's no such thing as
“nonjudgmental” debriefing: a theory and method for debriefing with good
judgment. Simulation in Healthcare. 2006 Apr 1;1(1):49-55.
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Pediatrics
Concept Mapping: It’s Not Just for
Grade School
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Pediatrics
Concept Mapping Facilitates Deeper
and Longer Lasting Learning
Cutrer Castro, Roy and Turner. Medical Teacher. Dec 2011.
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Copyright restrictions may apply.
West, D. C. et al. JAMA 2000;284:1105-1110.
Low-Scoring Concept Map
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Copyright restrictions may apply.
West, D. C. et al. JAMA 2000;284:1105-1110.
High-Scoring Concept Map
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Pediatrics
Role Play: Practice, Observation and
Feedback
You can’t know for certain how good a
musician is by how good they say they
are. (All providers think they are good
communicators – but would their
patients agree?)
We all have blind spots
Ericsson KA. Acquisition and maintenance of medical expertise: A
perspective from the expert-performance approach with deliberate
practice. Academic Medicine. 2015 Nov 1;90(11):1471-86.
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Pediatrics
Promoting Self-reflection and Self-
monitoring
•Self-reflection after clinical
encounters
•Self-monitoring of milestones and
other performance-based
assessments
•Role-modeling and Peer-directed
self-reflection
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Pediatrics
Team Based Learning
(and Assessment)
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Pediatrics
Assessment Drives Student Learning
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Pediatrics
Assessment Bites
•Pro Con Grid
•Summarizations
•Student Generated Test
Questions
•Audience Response or other
type of Quizzes
•Application Cards
•Scoring rubrics (i.e. for a debate)
•Case based discussion
Angelo, T.A. and Cross, K.P. (1993). Classroom Assessment Technologies
(Second Edition). San Francisco: Jossey-Bass Publishers.
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Pediatrics
Activity
•How will you know your students learned?
•What types of assessment “bites” might you include in your learning
session?
•Are there questions you might want to ask the learners during the
session to gain an understanding of their learning– if so write these
down as well.
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Pediatrics
Summary: Effective Teaching Practices to
Improve Learning
•Ask yourself first – Will what I am doing be effective?
•Tell learners why something is important
•Engage learners
•Make it relevant
•Help them apply what they have learned
•Help them problem solve their own learning problems
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Pediatrics
Kern 6-step Approach
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Pediatrics
Why be Systematic in Designing
Learning Experiences?
• Focus time and effort on the right solution
• May help achieve “buy-in”
• Lends credibility
• Ensures work is scholarly
• Leads to further refinement and improvement
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Pediatrics
Armstrong E and Parsa-Parsi R. Academic Medicine 2005
Klein M and Vaughn LM. Medical Teacher 2010
Brooks-Harris and Stock-Ward. Workshops: Designing and facilitating experiential learning.
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Pediatrics
Role of the Teacher when Using Kolb’s
McCarthy B, O'Neill-Blackwell J. Hold on, you lost me!: Use learning styles to
create training that sticks. American Society for Training and Development; 2007.
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It’s not what you EXPECT,
but what you INSPECT
that learners see as important.
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Pediatrics
The LEARN Curriculum and SBU School
of Medicine
•L = learning centered
•E = experiential
•A = adaptive
•R = rigorous
•N = novel
2016 Latha Chandran, MD, MPH
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Pediatrics
Group Exit Ticket
•What did you learn today? What was most helpful to you?
•What was the muddiest point? On what topics would you like more
faculty development?