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Avoiding The Pitfalls of 'Surface Learning' in Healthcare

April 1, 2021
April 1, 2021

After 25 years of practice as an anesthesiologist, Dr. John Yosaitis has plenty of experience with continuing education in the healthcare arena. He’s seen the good and bad, and now as Medical Director of the MedStar Simulation Training & Education Lab (SiTEL), the education and technology group developing learning solutions for associates at MedStar Health, he is helping develop programs that steer clear of many continuing-education pitfalls.                            

“I’ve been through a lot of school, and the most negative experience I have unfortunately is the most common experience,” says Dr. Yosaitis, who also is an associate professor at the Integrated Learning Center at the Georgetown University School of Medicine. “It’s something we call ‘surface learning,’ and that’s what most of us do in something called ‘school.’ You’re given a lot of information and you cram for the exam because the teacher told you to, and then after the exam you forget most of the material. You’re really just touching the surface of what it’s all about.”

On the flip side, he says a positive (and also painful) experience was his residency, where “you have a real learning community, the other residents. You could see what others were doing and you had mentors who gave you a lot of feedback and you really felt where you were on the continuum from novice to expert. You got a continuous feedback as to where you were on that continuum and you were getting evaluated, but also you were given guidance on where you can be. That was deep learning.”

The Importance of a Learning Community

That kind of team environment is crucial to providing staying power to what’s being taught, Dr. Yosaitis adds.

“If you want to become an expert there absolutely needs to be some sort of learning community that you are a part of, and there needs to be a leader there who’s giving you the feedback to tell you how you are doing in that community,” he says. “You need to figure it out yourself, and you need to be guided as to how to get better.”

Lessons for Continuing Education in Healthcare

That type of setup is driving successful healthcare continuing education, and improving patient outcomes alongside the opportunities for more and better learning.

“Education done incorrectly does nothing but frustrate the practitioner,” he explains. “It takes time away and can give them a feeling that they are competent and stop them on their journey to expert or mastery. A lot of the education now being done gives feedback and assessment, telling the learners that they’re just fine, which can stop them from yearning for more or stop them from continuing on to become an expert.”

As an example, he points to some ways in which medical students are educated that may be less than optimal.

“Many practitioners in academic medical settings feel like they are great teachers. It’s really easy to teach a med student. You give them some information and they’re thirsty. They will come and will learn anything you give them, and they will be ready for that test no matter what it is,” he says. “It’s the same with a junior- or senior-high student: if you give them some information you don’t need much of an explanation—they’ll learn it and they’ll be ready for that test and they’ll be ready for the final exam. That’s what I refer to as surface learning. They’ll probably forget it very quickly and they don’t ask a lot of questions. You give them the material and they know it.”

Adult Learners Are Different

Now, fast forward to adult learners, such as medical students in their residencies.  That’s when physicians go from being pedagogical to anagogical, from kids to adults, Dr. Yosaitis says.

“During residency after the first or second year, that’s when physicians start asking, ‘Why do I need to know this?’ They’re all of a sudden coming to the table with a lot of experience. They already know how to do most of the things that they are expected to do so, if you give them some information they want to know how it’s going to help them.”

It’s at this point that surface learning no longer works and, if these students aren’t exposed to a new and different style, they will be stymied in their educational path forward, Dr. Yosaitis says.

“You can lose them really quickly if you are teaching them something that they don’t think they need to know,” he says. “They will tune out immediately. It’s a big challenge.”

About 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.