The Science of Learning: How it Can Help Improve Nephrology Education

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Leveraging the Science of Learning to Elevate Your Teaching” was the topic of an inaugural faculty development workshop for medical educators at Kidney Week 2019. The workshop showcased high-yield strategies to optimize participants’ teaching, enhance the experience of learners, and translate teaching innovations into education scholarship for dissemination and academic credit. Advancing education in nephrology has long been a focus of ASN Past President Mark E. Rosenberg, MD, FASN.

Suzanne Norby, MD, FASN, chair of the ASN Continuous Professional Development Committee, and Melanie Hoenig, MD, developed and moderated the session, which featured a cast of education rock stars and provided an opportunity for participants to brainstorm together and network. Norby is affiliated with the Mayo Clinic College of Medicine and Science Division of Nephrology & Hypertension in Rochester, MN, and Hoenig is affiliated with Beth Israel Deaconess Medical Center in Boston.

Keynote speaker Peter Brown, author of Make It Stick: The Science of Successful Learning, shared big ideas, including the role of retrieval in learning. He explained that long-term memory develops from encoding, consolidation, and then retrieval—in other words, “get it out to get it in.” He stressed the effectiveness of low-stakes spaced quizzes and of mixed practice: the process of alternating different topics and skills during the same study session. Although these strategies may take some learners out of their comfort zones, this can be desirable to promote growth, Brown said.

Exploring approaches to unpack the core concepts in teaching kidney physiology was the focus of Joel Michael, PhD, an educator and physiologist from Rush University, who has worked with the National Science Foundation and the American Physiological Society to improve learning in physiology. He noted that different aspects of physiology and pathophysiology are too often taught in silos, making it difficult for learners to absorb material. When different symbols and terminology are used to reflect the same concept, the parallels can be unrecognizable for students, he said. For example, Fick’s law, Poiseuille’s law, and airflow in airways are all examples of flow-down gradients, but this key concept can be missed by students. Communication among educators is the key to limiting this confusion and facilitating students’ ability to make these connections.

Kris Gorman, an education program specialist from the University of Minnesota’s Center for Educational Innovation, helped the group contemplate metacognition. Metagcognition means “thinking about thinking” and is used to consider how to assess cognitive processes and promote higher-order thinking skills. Gorman demonstrated how these strategies may be used both in the classroom and in the clinical arena to encourage learning.

To address the challenge of engaging digital natives and meet their learning needs, David Roberts, MD, dean of external education at Harvard Medical School, spoke about harnessing technology in medical education. He emphasized that good teaching is still about the content: technology is only a tool. When electronic content is created, however, it should be accessible on all platforms, especially by cell phones. He acknowledged that because modern learners are so accustomed to finding instant answers on the internet, they have had fewer opportunities to experience the “productive frustration” that can lead to learning, reinforcing Brown’s point about thoughtfully leading learners out of their comfort zones.

Because the impact of the learning environment should always be considered in the complex system of medical education, Thomas Viggiano, MD, former associate dean of faculty affairs at Mayo Clinic Alix School of Medicine, highlighted the challenges learners face in clinical settings and how these challenges may affect the decision to pursue nephrology. He also offered solutions to common learning environment problems, including creating a positive and supportive climate when teachers work with learners of all levels.

Grace Huang, editor-in-chief of MedEdPortal, noted the importance of educators’ disseminating their teaching successes and promoting scholarship, including publication in the medical education literature. She said there are a surprising number of journals and sites interested in publishing medical education content.

To conclude the session, Hoenig and Gorman facilitated small-group discussions to stimulate formulation of tangible ways participants can apply concepts from the workshop in their own teaching practices. Participants who shared their ideas will receive an e-mail from Norby and Hoenig asking how they implemented their strategies.