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How Identifying The ‘Why’ Improves Medical Education & Training

When it comes to adult learners, especially those in healthcare who are engaged in continuing education around their jobs or the workplace, getting to the “why” of it is key. That’s especially true if the training is revolving around a specific issue or problem, says Dr. John Yosaitis, Medical Director of the MedStar Simulation Training & Education Lab (SiTEL), the education and technology group developing learning solutions for associates at MedStar Health, and an associate professor at the Integrated Learning Center at the Georgetown University School of Medicine.

“The biggest mistake we’ve made in the past is not fully recognizing the problem before we come up with the solution, or we came up with the solution for a problem that may not have existed or wasn’t clearly defined,” Dr. Yosaitis explains. “We take a lot of time doing that now. Take electronic fetal monitoring, for example: There was a very common problem in that the ways people taught electronic fetal monitoring didn’t connect the different variations. You could look at 25 different strips and they are all unique — that’s very much the way a novice looks at something.”

That meant a resident might see every patient as completely unique due to their lack of experience. Dr. Yosaitis, on the other hand, might speak to another experienced practitioner and relay the type of patient based on shared knowledge between the two clinicians. That insight led to dividing the types of patients by their different monitoring strips in order to provide education that was more digestible.

“We would show multiple strips and then categorize them and help the learner group them, help the learner become an expert,” he says. “Help them have those scripts in their mind. If you don’t have that, you look at 25 strips and the next strip is the 26th and it’s completely unique — there is nothing different about it. But, if you look at the 25 strips and you put them into three categories, the 26th strip is just one of three possibilities and it’s much more calming for the practitioner. He or she thinks, ‘These are the things I have to know. These are the categories, and this is the way to treat it.’ So, it was really interesting here at MedStar to watch people go through a relatively short education and help them along that journey from novice to expert.”

Assessment Looms Behind Many Learning Initiatives

That type of data breakdown also comes into play when a set of learning criteria are not connected to a problem that needs to be solved, Dr. Yosaitis notes, pointing out issues in current and traditional approaches to training and development and how they tie into training that’s going to factor into assessments.

“One of the methods we use in teaching is picking out the important things repeating them,” he says. “Assessment is very often treated as something different than learning, and the two need to be connected. Assessment drives learning. It’s painful for educators to admit that sometimes, but assessment drives learning because people know they are going to be assessed. Sometimes in adult education we expect the learner to go out and learn for the sake of learning, but our learners are busy, and our learners are already very much on the path to being experts. Assessment needs to be brought into it, needs to be formative. I think that is going to be the most exciting thing coming in education: Bringing assessment in to the forefront, blueprinting it to the goals, to the ‘why,’ to the problem, and having the assessment go all the way through with the learner from novice to mastery.”

If that doesn’t happen, he adds, “You could really hold the learner back. If it’s just the checklist, just the multiple-choice tests, just searching for competency, they are going to say, ‘OK, I checked that box. I am not going forward anymore. I don’t need to. I’ve been told I’m fine.’ That’s not how we’re going to create experts. That’s how we are going create minimally competent practitioners.”

About Dr. John Yosaitis:

Dr. John Yosaitis is Medical Director of the MedStar Simulation Training & Education Lab (SiTEL), the education and technology group developing learning solutions for associates at MedStar Health, as well as the Integrated Learning Center at the Georgetown University School of Medicine, where he also is an Associate Professor. A former biomedical engineer, Dr. Yosaitis began his medical career at the National Institutes of Health as a clinical anesthesiologist and researcher. Since 2000, Dr. Yosaitis has served MedStar Georgetown University Hospital and Georgetown School of Medicine as both a pediatric and adult transplant anesthesiologist and an educator.  Dr. Yosaitis received his medical degree from Rutgers University. He completed his residency in anesthesiology at George Washington University and his fellowship in transplant anesthesia at MedStar Georgetown University Hospital. He is certified by the American Board of Anesthesiology and is a member of several distinguished professional associations, including the American Medical Association and the American Society of Anesthesiologists.

This blog post is taken from a HealthStream Second Opinions Podcast that was recorded recently. To hear Dr. Yosaitis’ full discussion, click here.

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