Too Smart to Fail: Guide for Struggling Medical Students

Too Smart to Fail:  Guide for Struggling Medical Students

Student Success Orientation Highlights

Mnemonics

Transforming Midterm Evaluations into a Metacognitive Pause

October 31, 2016

Transforming Midterm Evaluations into a Metacognitive Pause   By Gillian Parrish Midterm evaluations often tip toward students’ (unexamined) likes and dislikes. By leveraging the weight of the midterm pause and inviting students to reflect on their development, midterm evaluations can become more learning-centered. Cued by our language, students can become aware of a distinction—that we’re not asking what they like, but what is helping them learn. This opportunity for students to learn about their learning yields valuable insights that not only inform instructors about the effects of our methods, but also ground students in their own learning processes, deepening their confidence in and commitment to their development in the second half of the course. Last semester, I taught a research-based contemporary poetry course with a steep learning curve—due to our rather difficult, graduate-level texts and students’ lack of prior experience. Many students in this evening course were returning learners, and so it felt beneficial to use the natural pause at midterm as an opportunity to grow their confidence by reflecting on the learning process and taking stock of their own development. I therefore tailored my midterm questions with a metacognitive slant that would prompt students to identify and articulate dimensions of and supports for their learning. In promoting students’ awareness and practice of “confronting themselves as learners,” (Weimer, 2013) my questions employed a form of metacognitive awareness defined by Gregory Schraw as “declarative knowledge”—that is “knowledge about oneself as a learner and what factors influence one’s performance” (1998, p. 114). In considering these performance factors, awareness of the “meta-emotional” and “environmental” aspects of their learning process felt crucial for my class of unconfident, novice writers  (Nilson, 2016, p. 227). When a Teaching Center colleague, Michelle Repice, lecturer in American Cultural Studies, saw the midterm questions, she asked to apply them in her history course on racial injustice and home ownership in America. She reported back that this evaluation provided the best feedback on her methods of instruction she had received in her 13 years of teaching. She observed that while the questions yielded detailed feedback on her teaching, they were truly student-centered, noting that the information on her instruction came through students’ articulation of their own learning experiences with the course materials, assignments, and class sessions.  In designing the questions, I opened with components of the course—particular assignments and aspects—which provided the specificity needed for students to direct their thought to details of their learning experiences. This helped students avoid common vague answers (“I liked this” or “It was boring”) in the more open-ended questions that followed. Repice attributed much of the success of this intervention to the wording, such as the introductory sentences, which “gave permission” to students to pause and reflect on their learning. She also noticed students interacting with the words in questions like “What has helped you develop most,” by underlining “most,” and offering thoughtful responses on how certain assignments helped them “develop” skills and understandings. Repice observed that “This set of questions calls attention to the ways you are learning. So students start to see assignments not in a passive way, as requirements, but instead as opportunities to build different skills and on different kinds of thinking.” This maturation from passive to active learners brought surprises for Repice regarding assignments that she was uncertain about. She notes that “The specificity of these midterm questions allowed me see some trends that were helpful for me in refining my course in the last half of the semester.” For instance, students’ body-language had sometimes made her worry how students were receiving her mini-lectures as well as certain key assignments. For one such assignment, she requires students to write summaries of primary sources as a disciplinary training tool. When prompted to reflect, students overwhelmingly noted that this assignment was “hard” but that it is a “helpful” way to build “useful skills.” They also reported that the lectures integrated discussion well and helped them deepen their sense of historical context. In addition to the information from these common trends, individual students made insightful suggestions, such as calling for more group work, explaining that it would be helpful to draw on many perspectives to “pull out” the “many themes and details” in their readings. In their comments, students even requested additional opportunities to write brief papers and asked if they might add discussion questions to the primary source summaries. My own students’ responses, like Repice’s, not only eliminated my concerns and confirmed my plans for the second part of the semester, but gave students a chance to see and describe what they had already learned in this demanding course. This reflection boosted their confidence, which many of them needed in this process of building new skills and self-concepts as students and writers. On this last point, given the difficulty of our course text, I was particularly interested in raising awareness of uncertainty and indeed, “disorientation” as part of the learning process. (See question #4.) Student responses to this question ranged from grappling with the challenging texts and writing assignments, to navigating class discussion on difficult subjects, and included awareness of what was supporting this messy learning process. (For an interesting essay on this topic of “messiness” in learning, please see Lee, 1998-1999.) I also was interested in helping students pause to further connect the course material to their own lives and other coursework, as a sense of relevance can promote learning. (See question #3 and Kember, Ho, Hong, 2008.) Download the questions for midterm reflection   . Feel free to tailor them to your course and students’ needs. Depending on course content and level, you might add questions that cultivate “procedural” and “conditional” metacognitive awareness in your students. (See Schraw, 1998.) Tips for implementation Stimulate student interest by introducing this activity by offering some remarks on the power of metacognition and reflection in learning. It also helps to dedicate time in class to complete and discuss this learning-centered reflection. An unexpected lesson in implementing this midterm reflection is that it can be valuable to pilot your teaching innovations not only in your own course but in courses taught by colleagues in another disciplines. After all, most readers of Faculty Focus are self-confessed teaching geeks who craft effective pedagogical innovations on instinct in the bleary-eyed midnight hours of busy semesters. Hence, conversations with other faculty members are invaluable as we step back to see the nuances of why our pedagogical interventions work and how they can be improved. So don’t be shy in involving colleagues the very first time you implement a new idea. Comparing notes on how it went in each course and across disciplines can evolve your innovation faster. Plus it makes for fun lunches. References Kember, D., Ho, A., & Hong, C. (2008). The importance of establishing relevance in motivating student learning. Active learning in higher education,9(3), 249-263. Lee, Virgina S. “The Uses of Uncertainty in the College Classroom” Toward the Best in    the Academy Volume 10, Number 8, 1998-1999 Reprinted and retrieved from POD Network News, Fall 2016: https://sites.google.com/a/podnetwork.org/wikipodia/pod-network-news-page/pod-essays-on-teaching-excellence   Nilson, Linda B. (2016.) “Helping Students Learn How They Learn” Teaching at Its Best: A Research-Based Resource for College Instructors 4th Edition San Francisco, CA: Jossey Bass. Schraw, G. (1998.)  “Promoting General Metacognitive Awareness” Instructional Science 26: 113. doi:10.1023/A:1003044231033 Weimer, Maryellen. (2013.) “Three Ways to Help Students Become More Metacognitively Aware” Faculty Focus. Retrieved from:http://www.facultyfocus.com/articles/effective-teaching-strategies/three-ways-to-help-students-become-more-metacognitively-aware/   Gillian Parrish teaches poetry and composition at Washington University in St. Louis where she also serves in The Teaching Center.

Revised Bloom's Handout

Revised Bloom's Handout

Study/Learning Skills for Medical Students

https://sites.google.com/site/facultyadvisers/



Study/Learning Skills for Medical Students

Make it Stick

Good News: Your Undergraduate Major Is Irrelevant

your undergraduate major is irrelevant

Cut Text Books
I would take my textbooks to Kinko’s after I had removed the front and back covers. I would have them cut the binding and punch three holes in the sheets so that I could place the pages in a three-ringed binder. I would remove only the pages that pertained to what I was studying for a particular lecture or week and place them in a separate (small binder) that was divided by subject. I would leave the rest of my textbook at home. My small 3-ring binder would have each subject for the day, the pages of text and the appropriate syllabus pages. I would preview each lecture the night before and add what I thought I would need for the day.



Time Your Study

My attention span is about 50 minutes so I would set a kitchen timer for 50 minutes. I would study my notes for that 50 minutes and take a 10-minute break. On my break, I would get a drink, move around, get a breath of fresh air but I would do anything except continue to sit and look at a page of notes. When I returned from my break, my mind would be ready to focus.




Videos 

How To Manage The First Year of Med School

How To Make It Through 1st Year of Med School

Active Studying


Body Building for the Brain


UNC Chapel Hill Learning Center Handouts



Other Sources:




Reinforcement Techniques

These are study skills designed to facilitate learning and to store the learned material in long term memory banks. Frequent repetition is an example of a reinforcement technique. Other examples are using new information to solve problems or to answer questions, and the "see one, do one, teach one" technique used to teach clinical skills. In the basic sciences frequent repetition and using the information to solve problems or to answer questions are the most effective techniques. A sequence of reinforcement might look like this:

· The evening before a class survey the subject material to be covered the next day. Skim the text or syllabus. Major topics, subheadings, and the first sentence of paragraphs might be read. Charts and graphs are quickly scanned and the captions are read. Major topics and concepts are quickly listed in the notebook used for lecture notes. The skimming and major topics list should be done in 30 minutes. The list will form "advance organizers" that will serve as categories or concepts around which other information can be learned and organized. Also take about 15 minutes to look back over the work that you did after the preceding class session.

· Attend to the lecture next day by adding information as subtopics under the list of advance organizers. The structure of each of the major concepts will begin to form as you carry out this task. Do not try to write down everything. Most faculty present a syllabus, handout, or reading assignment that will contain the details needed to understand the topic under discussion. Take 3-4 minutes to read through your notes immediately after the lecture.

· That evening read your notes again and either begin to work out the content of the instructor's learning objectives or write out three or four questions that you will answer during that evenings study period. Again, move quickly, using the objectives or questions to guide your study. Return to step 1 the evening prior to the next scheduled class in each subject.

· The weekend will play an important role in this reinforcement scheme. Study time during the weekend might be used to go back over the weeks work, tie up loose ends, and to organize the weeks work so that it can be easily reviewed prior to an examination.
Taking notes from Lectures

It is very helpful to "skim" the material to be covered before the lecture, and to provide a list of advance organizers so that you can relate what the lecturer says to what you already know. Active listening is an important skill that will help you get maximum learning gain from a lecture. To listen actively, listen for the signals the lecturer uses to stress important information. There are seven common signals used by most lecturers to signal important information:
Introduction of a topic: For example "next, I am going to discuss..."
Words that stress importance: For example "It is important to know that ...", "You should remember that ...", "The next exam will cover ...".
Definitions: "The term adductor means ...", "Atrophy is a process that ...".
Identification of a list or series of steps: "The stages in the process of wound healing are ...", "Damage to the ulnar nerve will cause the following list of problems...".
Writing on the blackboard, speaking slowly and louder, body language.
Showing a graphic or drawing on the blackboard.
Summarizing or restating important points.
Group Study or Peer Teaching

One of the most powerful ways to learn is to teach other students about a subject. One of the most efficient ways of completing the work of the medical curriculum is to organize a committed group of three or four students that will study, teach, and learn together.

http://medicine.utah.edu/learningresources/



Learning objectives

It is important to determine what it is you want to or need to learn. Not everything is of equal importance. Objectives help focus on the more important information. In most cases objectives are provided by teachers. Some textbooks contain learning objectives. Other times learning objectives may not be explicit, and you will need to determine what is important to learn. Some suggestions on how this might be done are:

1. Pay close attention to the instructor's lectures, handouts, and other learning material supplied by the instructor. Frequently instructors structure their lectures and handout materials much like a textbook with heading and subheadings that will tell you what is important.

2. After you identify a topic or concept that is important, ask a series of questions about the topic or concept, that, when fully answered, will provide essential information necessary to understand the topic or concept.

Bloom's Taxonomy and Learning Objectives


Concept mapping

Humans learn new information best by integrating the new information into an existing knowledge base. This is called meaningful learning as contrasted to rote learning. Rote learning doesn't hang around the brain very long. Concept mapping utilizes this knowledge about learning by providing a technique by which interrelationships can be mapped or charted. It taps into a learner's cognitive structure and externalizes what the learner already knows while depicting relevant concepts and relationships the learner is currently learning. A meaningful map will integrate the new knowledge with the previous knowledge.




Highlighting and attaching questions

Many students use highlighting or underlining techniques to emphasize information that they believe to be important. We have seen 900 page textbooks and complete syllabuses colored yellow or pink from cover to cover. In other words, highlighters have difficulty discerning degrees of importance in the text of a book, lecture notes, handouts or a syllabus. A process for increasing the efficacy of highlighting as a study skill/learning tactic is to attach questions to the highlighted text material. When a passage of text is highlighted, ask what question does the highlighted text answer, and write that question in the margin of you notes or textbook.

http://www.kumc.edu/som/medsos/ss.html

How to Study in Medical School

What worked in undergraduate school (did well on the exam but forgot the material quickly) which was OK because you didn't need to use it again: Cram

What you need to do in medical school (do well on the exam AND remember the material for other modules and for Step1): study and re-study!


No pain, No gain (applies to learning too)

Use all the learning styles (even if they are not your preferred style)