Study and Learning

Application of Knowledge

An important educational goal for health science students is acquisition of knowledge that can be applied to make decisions in novel, real-world situations. Can you make the diagnosis, construct a treatment plan, and implement the plan? This requires knowledge transfer in complex domains. How can that process be facilitated?

Elements of Application

• Start with a solid knowledge foundation. Define the objectives. What vocabulary, definitions, and scientific data must be committed to memory?

• Organize the facts via schema so that there is an understanding of the concepts that relate the informational elements. These concepts need to be handled as abstractions that are applicable for multiple problems.

• Practice application of the schema in multiple contexts to develop and reinforce working memory that can be applied across multiple situations. Prior knowledge and experiences affect current performance.

• Apply metacognition to self-assess progress and abilities so that ongoing adjustments to the learning process can occur.

• Employ valid assessments in order to determine the level of progress and ability.

For example, the foundation of knowledge can include factual information about white blood cells and about neutrophils as first responders. Additional factual knowledge can include a time frame for acute illnesses developing over hours to days. The student can memorize findings of inflammation with redness, swelling, tenderness, and pain. The factual knowledge of infectious agents can include bacteria that challenge innate immune responses. The student can then organize these facts into the concept of acute inflammation and apply that across organ systems: acute meningitis, acute appendicitis, septic arthritis, etc.

Reference:

Patel VL, Yoskowitz NA, Arocha JF, Shortliffe EH. Cognitive and learning sciences in biomedical and health instructional design: A review with lessons for biomedical informatics education. J Biomed Inform. 2009;42(1):176-97.

Virtual Patients

Virtual patient cases promote knowledge application for future medical practice. Authenticity of the cases helps develop skills transferable to the real clinical setting. These cases promote the following:

• Clinical reasoning: the cases require problem solving in a clinical context. The context can range from simple to complex.

• Transferable skills: the knowledge gained can be used in clinical settings, but also for examinations.

• Retention enhancement: knowledge gained in context is more likely to be retained.

• Learning from mistakes: mistakes can be made in the safety of virtual cases, with learning and correction, to avoid making them in clinical settings.

Reference:

Botezatu M, Hult H, Fors UG. Virtual Patient Simulation: what do students make of it? A focus group study. BMC Med Educ. 2010;4;10(1):91.

Retrieval Practice

The process of taking a test after study aids the learning process. Retrieving knowledge from memory to answer questions about material that has been studied will help to reshape and enhance memory. Retrieval of knowledge through testing is more effective than restudying material. Questions provide a way to enhance diagnostic cues for use of knowledge in context.

Reference:

Karpicke JD, Blunt JR. Retrieval practice produces more learning than elaborative studying with concept mapping. Sciencexpress. http://www.sciencemag.org/content/early/2011/01/19/science.1199327.full.pdf (accessed Feburary 3, 2011).