The Science of Learning Applied to Physical Therapy: Part 1: Dispelling Myths About Effective Learning

Most physical therapists would agree about the importance of delivering “Evidence-Based” treatments for patients in physical therapy settings. However, many fewer are aware of the need (or desirability) of leveraging “Evidence-Based” learning strategies to improve their own skill development or that of students or young clinicians they are mentoring.

Whether your goal is retention of information from continuing education courses, reading for professional growth, or improving clinical decision making, having a better understanding of the cognitive principles underlying effective learning can take your learning game to the next level! Also, if you are serving as a mentor or teacher within the spectrum of Doctorate of Physical Therapy (DPT) education, having a grasp of these concepts is CRUCIAL to most effectively craft learning environments and practice conditions for your students. Let me ask you this…

What if your teaching strategies are NOT as EFFECTIVE as they are intended to be?

What if some of our basic assumptions about teaching and learning are NOT ACTUALLY TRUE?

…And, how can we pursue a more ‘EVIDENCE-BASED’ approach to crafting effective learning environments?

In this series of posts, I would like to investigate each of these questions and do my best to provide answers that may lead to better outcomes in terms of teaching and learning within physical therapy settings.  

THE PROBLEM: “ILLUSIONS OF KNOWING”

As human beings, there are certain cognitive errors that we consistently make that may lead to false judgments on how much we “know”. Also, just like many areas of study, there are common misconceptions and myths perpetuated in our popular culture that contradict what research tells us about how learning actually works best! These misconceptions can unfortunately lead us astray as teachers or learners (even with the best intentions).

The myths that I would like to dispel are these:

  1. People are good at identifying what they know and what they don’t know
  2. It is important to re-read textbook chapters and articles to aid learning
  3. Students learn best if instruction is matched to their “learning style”

Myth 1: People are good at identifying what they know & what they don’t know

As learners, adopting certain study strategies such as re-reading text, looking over notes, or other forms of study that fail to force active recall of information can lead to “illusions of competence”. We all make “judgments of learning”, as we are attempting to take in new information, and certain context clues that are present during knowledge acquisition (but are NOT present when we are expected to remember or use this information) can lead to the feeling that we “know” more than we actually do! (Brown et al., 2014; Koriat & Bjork, 2006). Re-reading or looking over notes may lead to a sense of fluency or familiarity that tricks us into thinking that the information has been learned—more on this below (Little et al. 2015; Wiley et al., 2005).

It is also important to be objective in our assessments of our own knowledge as we gain experience or knowledge within a field such as physical therapy. Just because you have practiced as a physical therapist for a while or have advanced certifications does not make you immune to these “illusions of competence”. For more experienced clinicians, experience can create an inflated sense of “expertise” and can impair objective judgment in the face of novel information or patient presentations. This has been described as the “Curse of Knowledge”(Berner, 2008; Fisher, 2016).

Myth 2: It is important to re-read textbook chapters and articles to aid learning

Another often expressed idea in didactic education and other learning settings is that in order to learn something you must re-read information numerous times. As mentioned above, re-reading of information may not be the most effective study strategy, yet many students adopt this strategy.

In one study, 84% of students reread notes or textbook and 55% rate rereading as their number one study activity! (Karpicke et al., 2009). But, is this study strategy doing anything to improve learning?! The memory and cognition research answers a resounding NO! Multiple experiments demonstrated that re-reading textbook chapters or scientific articles did NOT improve performance on subsequent tests of knowledge versus reading the text just once (Callender & McDaniel, 2009).

Myth 3: Students learn best if instruction is matched to their “learning style”

Some educators talk about the idea that students have preferred “learning styles” and these must be taken into account or catered to in order maximize learning. For example, The VARK® Questionnaire aims to characterize how much different learners align with the styles of “Visual” “Aural” “Read/Write” and “Kinesthetic” after a participant answers 16 questions related to their preferences on how information is presented and how they learn best. Just like in any area of life, preferences are indeed present. There are a variety of preferred hairstyles, musical genres, colors, food items, etc. But, the problem with those that make the “learning styles” argument is not that students have preferences—I believe that they do. The issue is that there is no clear data to suggest that matching teaching styles to a student’s preferred learning style actually improves learning (See: Pashler et al., 2008 for a review on learning styles research).

THE SOLUTION: EVIDENCE-BASED LEARNING STRATEGIES

So, now that we have explored some of the short comings in learning and practice conditions, how can we improve? What does the evidence tell us are EFFECTIVE ways to study and learn?

Check out this Post that I wrote for “The LEVEL UP INITIATIVE”: ENHANCING MEMORY BY MAKING GAINS for tips to OPTIMIZE learning.

References:

  • Berner ES, Graber ML. Overconfidence as a Cause of Diagnostic Error in Medicine. The American Journal of Medicine. 2008;121(5):S2-S23.
  • Brown, PC, Roediger, HL, McDaniel, MA. Make It Stick: The Science of Successful Learning. Cambridge, Massachusetts: The Belknap Press of Harvard University Press, 2014.
  • Callender, A. A., & McDaniel, M. A. (2009). The limited benefits of rereading educational texts. Contemporary Educational Psychology, 34(1), 30-41.
  • Fisher M, Keil FC. The Curse of Expertise: When More Knowledge Leads to Miscalibrated Explanatory Insight. Cogn Sci. 2016;40(5):1251-1269.
  • Karpicke JD, Butler AC, Roediger III HL. Metacognitive strategies in student learning: Do students practice retrieval when they study on their own? Memory. 2009;17(4):471-479.
  • Koriat A, Bjork RA. Mending metacognitive illusions: A comparison of mnemonic-based and theory-based procedures. Journal of Experimental Psychology: Learning, Memory, and Cognition. 2006;32(5):1133-1145.
  • Koriat A, Bjork RA. Illusions of competence during study can be remedied by manipulations that enhance learners’ sensitivity to retrieval conditions at test. Memory & Cognition. 2006;34(5):959-972.
  • Little JL, McDaniel MA. Metamemory monitoring and control following retrieval practice for text. Mem Cogn. 2015;43(1):85-98.
  • Pashler H, McDaniel M, Rohrer D, Bjork R. Learning Styles: Concepts and Evidence. Psychol Sci Public Interest. 2008;9(3):105-119.
  • Wiley J, Griffin TD., & Thiede KW. Putting the comprehension in metacomprehension. The Journal of General Psychology. 2005;132, 408–428.

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