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General Assessment Criteria
General Assessment Criteria
Appraise literature to inform selection/development of educational approaches, methods, educational research/scholarship, assessment, curriculum evaluation or leadership
Apply education theory, with appropriate justification, to build upon educational practice, scholarship and research
How to use these resources
How to use these resources
As a complex and complicated domain, educational scholarship and practice are built on theories. Theory helps define problems and phenomena by highlighting things that are important, ignoring things that are not, proposing relationships and explaining how things work. There is never just one theory for the issue you may be concerned with, but often many. This means that competence in educational theory is demonstrated by selecting an appropriate theory, applying it to your problem and explaining why your selection is better than alternatives.
Applying theory means mapping the key concepts and relationships of theory onto your situation, considering where it fits well and where it fits poorly. A good theory will not only explain but also predict, so this prediction and examination of the validity of the predictions is also part of the competency in Educational Theory.
Subject Matter Expert
Subject Matter Expert
Karri Grob (kgrob@med.umich.edu)
Karri Grob (kgrob@med.umich.edu)
provide the following information when reaching out to Karri:
your topic,
whether your upcoming EPA includes the Educational Theory competency,
your draft EPA (if available) so Karri can review in advance
Education Theory Resources
Education Theory Resources
Each volume explores 10 educational theories and how they would apply practically to an educational situation. Each explanation begins with a vignette and each theory is well-referenced. The books are free to download
Education Theory Made Practical, Volume 1
Chan TM, Gottlieb M et al (eds). Academic life in Emergency Medicine ISBN: 978-0-9992825-0-2- Chapter 1: Modal Model of Memory
- Chapter 2: Naturalistic Decision Making
- Chapter 3: Communities of Practice
- Chapter 4: Emotional Intelligence
- Chapter 5: Social Constructivism
- Chapter 6: Reflective Practice
- Chapter 7: Self-Directed Learning
- Chapter 8: Bloom’s Taxonomy
- Chapter 9: Dual-Process Reasoning
- Chapter 10: Gaming and Gamification
Education Theory Made Practical, Volume 2
Gottlieb M, Chan TM, Krzyzaniak S, Grossman C, Robinson D, Papanagnou D (Eds). (2018) Education Theory Made Practical: Volume 2 (1st Edition). Academic Life in Emergency Medicine. ISBN: 978-0-9992825-3-3.- Chapter 1: Action Learning
- Chapter 2: Digital Natives
- Chapter 3: Dreyfus Model of Skill Acquisition
- Chapter 4: Organizational Learning
- Chapter 5: Self-Determination Theory
- Chapter 6: Spaced Repetition Theory
- Chapter 7: Zone Proximal Development
- Chapter 8: Transformative Learning Theory
- Chapter 9: Deliberate Practice Theory
- Chapter 10: Constructive Developmental Framework
Education Theory Made Practical, Volume 3
Robinson D, Chan TM, Krzyzaniak S, Gottlieb M, Schnapp B, Spector J, Papanagnou D (eds). Education Theory Made Practical: Volume 3. 1st ed. Academic Life in Emergency Medicine; 2020. ISBN: 978-0-9992825-7-1- Chapter 1: Kern's Model of Curriculum Development
- Chapter 2: The Kirkpatrick Model: Four Levels for Evaluating Learning
- Chapter 3: Realist Evaluation
- Chapter 4: Mastery Learning
- Chapter 5: Cognitive Theory of Multimedia Learning
- Chapter 6: Validity
- Chapter 7: Programmatic Assessment
- Chapter 8: Self-Assessment Seeking
- Chapter 9: Bolman & Deal Four-Frame Model
- Chapter 10: Kotter’s Stages of Change
Using Educational Theory
Using Educational Theory
Anne Messman, MD, MHPE (amessman@med.wayne.edu)
Anne Messman, MD, MHPE (amessman@med.wayne.edu)
Associate Dean of Graduate Medical Education
Wayne State University
MHPE Summer Retreat 2021 Session Notes
MHPE Summer Retreat 2021 Session Notes
4 broad categories of learning theories
Socrates and his method (c. 900BC)
Behaviorism - Skinner and his rats, Pavlov and his dogs
Cognitive information processing (70s and 80s) - Piaget, Vygotsky
Constructivism (1990 to present)
Cook DA, Beckman TJ, Bordages G. Quality of reporting of experimental studies in medical education: a systematic review. Med Educ. 2007;41:737-745. - classified conceptual frameworks in review of experimental papers on medical education. The results were not pretty - many papers written without a clear conceptual framework for learning theory. Odds of publication rise with the presence of a conceptual framework.
Research in Medical Education: Asking the right questions. Prideaux D, et al.
Four learning theories for application
Self-determination theory - benchmarks of expected performance, relying on intrinsic motivation to attain these benchmarks. Also comparing self to peers as social motivation. Outcomes and feedback as another form/source of motivation. Hit all three autonomy, competence, relationships,
Scaffolding/Zone of proximal development (Vygotsky) - using simulation as a way to identify one’s zone of proximal development and then defining the performance target just beyond their competence.
Deliberate practice - reflection and efficiency as part of a simulation based program, senior resident as coach and time to reflect on performance. Book: PEAK by Ericsson
Spaced repetition - observe faculty first and then attempt central line, repeat attempt 24 hrs later to determine prograss. Need skills lab as a setting for practice and probably feedback from a skilled individual. Learning the skill and adding it to more complex scenarios/skills - building on basic/foundational skills. Feedback important as part of the practice - self generated or from someone else.
Applying Theory to Practice
Applying Theory to Practice
Using Theory [recording].
Five Principles for using educational theory: Strategies for advancing health professions education research. Samuel A, et al. Acad Med 2020;95(4):518-522.
Learning Theory, Ch 1. Bowen JL, Smith CS. In: Theory and practice of teaching medicine, ACP teaching medicine series. Ende J (ed). pp. 1-30
Twelve tips for incorporating educational theory into teaching practices. Dennick R. Med Teach 2012;34:618-24.
ABC of learning and teaching in medicine: Applying educational theory to practice. Kaufman DM. BMJ 2003;326:213-216
Applying theory to educational practice, Chapter 2. Smith CS, Bowen JL. In: Theory and practice of teaching medicine, ACP teaching medicine series. Ende J (ed). pp 31-54
Have Motivation Theories Guided the Development and Reform of Medical Education Curricula? A Review of the Literature. Kusurkar RA, Croiset G, et al. Acad Med; 87(6):735-43.
Monthly Webinar Discussion
Monthly Webinar Discussion
Facilitator: Patricia Mullan
Facilitator: Patricia Mullan
Date: January 6, 2021
Competency: Education Theory
Description: A discussion on how to use educational theory to guide research using two theories (Self-determination theory (SDT) and Mastery Learning Theory)
Top 10 Education Theories
Top 10 Education Theories
Cognitive Load
Cognitive Load
Relevant Domain: Cognitive processes like problem solving and reasoning
People have limited working memory (7±2) but unlimited long-term memory.
Retrieval from long-term memory is effortless and unlimited but relying on working memory imposes limits on capacity and speed.
Novel and complex situations require extensive use of working memory. Familiar situations and activities can be stored in long-term memory.
Problem-solving can be based on generate-and-test procedures or by obtaining information from other people or resources (more efficient)
Intrinsic cognitive load refers to information and activities relevant to the task. Extrinsic cognitive load refers to extraneous noise and suboptimal information presentation.
Dual Processing
Dual Processing
Relevant Domain: Cognitive processes like problem solving and reasoning; expertise development
Cognition has two ‘Systems’. System 1 is automatic, largely unconscious, fast, and highly specialized. System 2 is effortful, slow, analytic, and general.
System 1 takes priority until it doesn’t work, then system 2 becomes necessary.
System 1 can be biased, system 2 can be overloaded.
Expertise develops, in part, by shifting cognition from system 2 to system 1.
Reference
Thinking, fast and slow. 1st ed. Kahneman D. 2011 New York : Farrar, Straus and Giroux, ISBN 9780374275631; 0374275637
The causes of errors in clinical reasoning: Cognitive biases, knowledge deficits, and dual process thinking. Norman GR, Monteiro SD, et al Acad Med 2017;92:23-30.
Check out the newly published article by Doug McHugh and his student on this topic:
This is useful when thinking about about implicit/explicit bias recognition/mitigation
The Four Stages of Competence
The Four Stages of Competence
Bloom's Taxonomy
Bloom's Taxonomy
Relevant Domain: Curriculum design and educational outcomes
Provides a hierarchical framework for considering educational goals and outcomes.
The lowest level of the taxonomy is focused on knowledge whereas the top level focuses on evaluation. Each level up from the bottom is more complex and builds on the levels below it.
An alternative version of the taxonomy frames the distinctions in terms of activities, going from remembering at the bottom to creating at the top.
References
Bloom's Taxonomy. Armstrong P. Vanderbilt University Center for Teaching
Bloom's Taxonomy of Learning Domains by Donald Clark (1999)
Cognitive (knowledge)
Affective (attitude or self)
Psychomotor (skills)
Per Larry - a useful “heuristic” but don’t assume it is generalizable
"A Vocabulary exercise...it improves your use of adjectives (e.g. for use in teaching portfolios, CV, creating goals and objectives)"
Constructivism
Constructivism
Relevant Domain: Cognitive processes like problem solving and reasoning and understanding
A meta-theory
Meaning and understanding is constructed out of one’s current understanding of the world. Knowledge is not ‘objective’ but subjective and unique (to varying degrees) to each person, depending on their history and prior learning and experience.
Social interaction and communication requires co-construction between individuals to reach a common understanding.
Teaching is not telling but the effort to foster the learners own, individual understanding of a phenomenon or skill. Learning is necessarily active f=to form this understanding.
A paradigm that describes learning as an active, constructive process. The learner is an information constructor. People actively construct or create their own subjective representations of objective reality. New information is linked to to prior knowledge, thus mental representations are subjective
Originates with Jean Piaget but has grown into many more specific theories and frameworks. Many forms of constructivism: radical, relational, social, communal, etc.
References
Constructivism: The view of knowledge that ended philosophy or a theory of learning and instruction? Colliver JA. Teach Learn Med 2002;14(1):49-51.
Constructivist perspective
Not claiming that everyone views things the same way
Constructivist approach in qualitative research
As the researcher you are not trying to create meaning, you are trying to figure out how participants create meaning and not come in with your own assumptions
Situated Learning/Communities of Practice
Situated Learning/Communities of Practice
Relevant Domain: Social structures and influences on learning
Learning is situated (takes place in a specific social and spatial context) and meaning is co-constructed within a group.
Learning takes place in social practice, which depends on the community of practice. Learners enter the community gradually, taking on more responsibility and learning more through progressively more central zones of peripheral participation.
Content: In situated learning, no importance is given to the retention of the content. Rather, situated learning stresses reflective and higher order thinking where the results are used in solving problems faced in daily life. Situated learning is thus more application-based.
Context: Context provides a framework for the usage of the product or the result at the right time, place and situation in the social, psychological and material environment. Context creates a platform to examine the learning experiences.
Community: Community helps the learner to create, interpret, reflect and form meanings. It provides opportunities to share experiences among learners and also to interact.
Participation: It is where interchange of ideas, problem solving and engaging of the learners take place. This takes place in a social setting which includes reflecting, interpreting and negotiating among the participants of the community.
References
Jean Lave and Etienne Wenger (1991) Situated Learning. Legitimate peripheral participation, Cambridge: University of Cambridge Press
Social Cognition
Social Cognition
Relevant Domain: Social structures and influences on learning
A meta-theory
How do people understand, remember, and respond to other people in social interactions and how do cognitive processes support this social understanding.
Focuses on the processes involved in the perception, judgment, and memory of social events and stimuli.
Deals with such phenomena as stereotypes, cultural differences, social forms and expectations, etc.
Howard Bandura is the grandfather but there are many, many specific versions of this meta-theory to look up
Reflective Practice
Reflective Practice
Relevant Domain: Expertise and reflection on practice
Distinguishes between learning in formal educational settings and learning in professional practice.
Reflecting on one’s practice is a key component of professional development.
Coaches and teachers can help guide this reflection in junior members of the profession.
Reflection ON practice takes place after an activity. Reflecting IN practice is concurrent with the activity. Reflecting IN practice is more difficult than reflecting ON practice and signifies a higher level of professional expertise and personal insight.
Reference
Deliberate Practice
Deliberate Practice
Relevant Domain: Expertise Development
Developing expertise takes many, many hours of deliberate practice (“10,000 hours to make an expert”)
Deliberate practice is not just practice but practice that analyses and focuses on elements or components of the skill, e.g., a musician practicing a few bars over and over again.
Experience does not automatically transform into expertise and even better performance.
Experts are made and not born.
Theory was developed in context of ‘well-defined’ domains like games, sports, music. The extension to medicine depends greatly on how you define ‘deliberate practice”
References
Professional Identity Formation
Professional Identity Formation
Relevant Domain: Professional development
Kegan R. Cambridge,MA: Harvard University Press; 1982.
Kegan focuses on adult meaning-making as four lenses. Individuals have a trajectory over time through these lenses but not everyone reaches the full trajectory.
The four lenses are:
instrumental (see things from their own desires/needs);
socialized (see things through expectations of important groups);
self-authoring (see things from a personally defined value system); and
self-transforming (see things from multiple and possibly conflicting systems.
The lenses vary in what motivates people and how they make sense of their professional identities.
Transitions from one lens to the next are intensely disruptive to the individual and require considerable psychological and emotional work.
References
Mindset
Mindset
Relevant Domain: Self theory, orientation towards learning
There are two mindsets that people have towards their own knowledge and intelligence
A ‘fixed’ mindset views intelligence as set at birth and cannot be altered by learning - it is immutable. Such individuals focus on manageable tasks they can perform.
A “growth” mindset views intelligence as changeable and can be increased by learning. Such individuals focus on a “mastery-oriented” approach to learning. They look for opportunities to challenge themselves and thrive in challenging educational environments.
Educational methods, feedback, and environments are thought to support or encourage one or the other mindset.
[it's not entirely clear whether these are stable or changeable characteristics]
Fundamental Attribution Error
Fundamental Attribution Error
Social Judgement, Causal Attribution
Ross, L. (1977). "The intuitive psychologist and his shortcomings: Distortions in the attribution process". In Berkowitz, L. (ed.). Advances in experimental social psychology. 10. New York: Academic Press. pp. 173–220. ISBN 978-0-12-015210-0. DOI: 10.1016/S0065-2601(08)60357-3
People are biased to attribute actions to inherent traits of the individual rather than to transient situation and context. E.g., cutting someone off in traffic is not because you are a jerk but because you didn’t see the other car, you were preoccupied with some other thoughts, or the blinker on your car doesn’t work.
refers to an individual's tendency to attribute another's actions to their character or personality, while attributing their behavior to external situational factors outside of their control. In other words, you tend to cut yourself a break while holding others 100 percent accountable for their actions
This is particularly true for first impressions and stereotypes.
Most behavior is heavily guided by the situation and not stable personal characteristics.
This error applies equally to desirable and undesirable behaviors.
We do NOT make this error when we consider our own behavior, especially poor behavior – then we blame the circumstances.
Other Theories to Consider (alphabetical)
Other Theories to Consider (alphabetical)
Adaptive Expertise
Problem-solvers demonstrate adaptive expertise when they are able to efficiently solve previously encountered tasks and generate new procedures for new tasksAdaptive Expertise
Online Discussion - Adaptive expertise. Facilitator: Larry Gruppen
How student models of expertise and innovation impact the development of adaptive expertise in medicine. Mylopoulos M, Regehr G. Med Educ 2009;43:127-32.
Adult Learning (Andragogy)
Adult Learning (Andragogy)
TEAL Center Fact Sheet No. 11: Adult Learning Theories. 2011
Learning in Adulthood: A Comprehensive Guide, 4th edition (Book) Merriam, S., Caffarella, R., & Baumgartner, L. (2007).
Clinical Reasoning
The process by which clinicians collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process. Clinical Reasoning
Online Discussion - Clinical Reasoning and Diagnostic Error [ Slides] [Article]
Online Discussion - Clinical Reasoning. Facilitator: Larry Gruppen
Scripts and medical diagnostic knowledge: Theory and applications for clinical reasoning instruction and research. Charlin B, Tardif J, Boshuizen HPA. Acad Med 2000;75:182-90.
Article summary (Gruppen) - presented at MHPE retreat
Diagnostic reasoning of high-and low-domain-knowledge clinicians: a reanalysis. Elstein AS, Kleinmuntz B, et al. Med Decision Making: 13(1);21-29
Article summary (Chris Merritt) - presented at MHPE retreat.
Non-analytical models of clinical reasoning: the role of experience. Norman G, Young M, Brooks L. Med Educ 2007:41;1140-45.
Article summary (Renato Samala) - presented at MHPE retreat
Cognitivism
A paradigm that argues that the “black box" of the mind should be opened and understood. The learner is viewed as an information processor (like a computer).Cognitivism
Cognitivism slide presentation (David Wald) - presented at MHPE retreat
Diffusion of Innovation
Explains how, over time, an idea or product gains momentum and diffuses (or spreads) through a specific population or social system. The end result of this diffusion is that people, as part of a social system, adopt a new idea, behavior, or product. Diffusion of Innovation
Online Discussion. Facilitator: Larry Gruppen
Disseminating innovations in healthcare. Berwick DM. JAMA 2003;289:1969-75.
Evolution of Diffusion and Dissemination theory. Dearing JW. J Public Health Management Practice 2008;14(2):99-108
Experiential Learning (Kolb)
A four-stage cyclical theory of learning that combines experience, perception, cognition, and behavior.Experiential Learning (Kolb)
Experiential learning theory. Powerpoint Presentation by Louito Edje from MHPE retreat
Expertise
Expertise theory specifies how talent develops across specified fields or domains, focusing on cognitive task analysis (to map the domain), instruction and practice, and clearly specified learning outcomes against which one can objectively measure the development of expertise.Expertise
Expertise Online Discussion. Facilitator: Larry Gruppen
Mark Twain excerpt for online discussion
The five stage model of adult skill acquisition. Dreyfus SE. Bulletin of science, technology and society 2004;24(3):177-81.
Acquisition and maintenance of medical expertise - a perspective from the expert-performance approach with deliberate practice. Ericsson KA. Acad Med 2015;90(11):1-16.
Having our cake and eating it too: seeking the best of both worlds in expertise research. Myopoulos M, Woods NN. Med Educ 2009;43:406-413.
Grit Theory
Grit is a quality that learners have that enables them to persevere while facing struggles and obstacles. This can help the learners attain success because they don’t give up until they reach their goals.Grit Theory
Grit: Perseverance and passion for long-term goals. Duckworth AL, Peterson C, et al. J of Personality and Social Psychol 2007
Grounded Theory
Grounded Theory
Constructivist Grounded Theory Webinar
Facilitator:
Justin Triemstra, MD, MHPE
Associate Designated Institutional Official for Spectrum Health
Associate Program Director of the Pediatrics Residency Program at Spectrum Health/Helen DeVos Children’s Hospital
Assistant Professor of Pediatrics and Human Development at Michigan State University College of Human Medicine
Articles Discussed
Articles Discussed
How Trainees come to trust supervisors in workplace-based assessment: A grounded theory study. Castanelli D et al. Academic Medicine. DOI: 10.1097/ACM.0000000000004501
Dressing the part: Gender differences in residents' experiences of feedback in internal medicine. Billick M, et al. Academic Medicine. DOI: 10.1097/ACM.0000000000004487
Discussion Points
Discussion Points
Provide a brief review of the article
Discuss how the authors utilize grounded theory to arrive at their conclusions
Discuss the limitations of the article
Discuss how to apply this theory to daily practice
Hierarchy of Needs (Maslow)
A motivational theory in psychology that argues that while people aim to meet basic needs, they seek to meet successively higher needs in the form of a pyramid.Hierarchy of Needs (Maslow)
Beyond Burnout: A physician wellness hierarchy designed to prioritize interventions at the systems level. Shapiro DE, et al. Am J Med 2019;132:556-63.
Master Adaptive Learner (MAL)
Master Adaptive Learner (MAL)
Facilitator: Lou Edje
Fostering the development of master adaptive learners: A conceptual model to guide skill acquisition in medical education. Cutrer WB, Miller B, et al. Acad Med 2017;92(1):70-75
Facilitator: Lauren Maggio, USUHS
Curiosity and Medical Education. Dyche L, Epstein RM. Med Educ 2011;45:663-68.
Varieties of uncertainty in health care: A conceptual taxonomy. Han PK, Klein WMP et al. Medical Decision Making 2011;31:828-38.
How do we develop the Master Adaptive Learner? transcript from DrEd online chat 9/6/2018 containing resources about MAL
Fostering the development of master adaptive learners: A conceptual model to guide skill acquisition in medical education. Cutrer WB, Miller B, et al. Acad Med 2017;92:70-75
Mastery Learning Theory
Mastery Learning Theory
Making July Safer: Simulation-Based Mastery Learning During Intern Boot Camp. Cohen ER, Barsuk JA, et al. Acad Med 2013, 88;233-239
Considered by John B. Carroll in 1963 as a new way of thinking, formally proposed by B. Bloom in 1968. “Given enough time, students will achieve a high level of understanding in a particular domain and become more confident in their learning abilities.”
Key elements:
Specify learning objectives and evaluation
Allow learning at own pace
Assess progress (formative assessment), provide feedback and remediate as needed
Test achievement of mastery (i.e. ≥ 90% on a knowledge test) https://www.instructionaldesign.org/concepts/mastery/
Self-Determination Theory (SDT)
Self-Determination Theory (SDT)
States that human motivation stems from three psychological needs: autonomy (self-control, free will), competence (successful and effective action) and connection with others (sense of belonging) all of which must be fulfilled for the ultimate goal of becoming independent practitioners. Human behavior may be characterized by lack of motivation on one extreme to complete internal motivation on the other extreme (Fig. 1). Extrinsic motivation (EM) incorporates conformation to rules, acceptance and understanding of those rules and linking them to one’s own beliefs. Intrinsic motivation (IM) indicates complete self-regulation relying on inherent satisfaction rather than driven by external forces. Higher IM has been associated with improved learning, better performance and wellness.
Self-determination theory. Deci and Ryan
A Theory-informed, process-oriented resident scholarship program. Thammasitboom S, Darby JB, et al. Med Educ Online 2016.
How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide #59. ten Cate OTJ, Kusarkar RA, Williams GC. Med Teach 2011;33:961-73.
Self-Directed Learning/Self-Regulated Learning
Self-regulated learning is a mega-theory of learning that encompasses many subordinate theories (i.e., theories of feedback, or motivation, or practice, etc.)Self-Directed Learning/Self-Regulated Learning
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