When I read about learning theories I was struck by how compartmentalized they are. They are presented as if you have to subscribe to one of them. They each have merits and short comings. I am not any one thing. What theory I follow depends on what I teach and to whom.
When I was asked to develop an online course for second year medical students three years ago I had no formal knowledge of online learning or course development. I was mentored by an educator who told me I needed to develop the course based on constructivist principles. I began learning about constructivism and designed the course including elements consistent with these principles. For example, each module is shaped around solving an authentic clinical problem using anchored instruction. Students have a choice in the media they use to learn background material. I included group activities that would lead to richer group understanding as each student developed their own meaning of the material. Task complexity grew throughout the module. The course was somewhat of a failure because the students weren’t metacognitively mature enough to guide their own learning and develop their own meaning. I didn’t include any metacognitive scaffolding.
When I was learning about constructivism three years ago I hadn’t considered any other learning theories. It wasn’t until I took EDTECH 503 last semester that even realized other learning theories existed (Larson & Lockee, 2014, p. 82). In academic medicine it’s assumed you can teach and few are formally trained in education. Prior to this week I hadn’t reflectively inventoried what I teach and how I teach it. After doing so I realized I use strategies that would fall under multiple learning theories. The table below lists much of what I teach, the major techniques I use, and the learning theories that best explain them.
|Instructional Content||Strategies||Learning Theory|
|Procedures||Apprenticeship, simulation, video||Situated
|EBM online course||Anchored instruction, group activities, scaffolding, video material is chunked||Constructivism
|Traditional lectures in large groups||Advanced organizers, ARS questions, cognitive theory of multimedia learning principles to develop slides, occasionally team-based learning||Cognitivism
|Journal club||Case-based, flipped learning (video or articles), group discussion, advanced organizers||Constructivism
|Perioperative medicine conference||Blended, case-based, group discussion of answers to cases||Constructivism|
|Clinical rounds||Cognitive apprenticeship, team-based learning||Situated
In my experience using behaviorist techniques works better with novices or on objectives that are in the lower tiers of Bloom’s taxonomy. Constructivist techniques work better with more advanced learners. Cognitivism is very prominent in medicine as we teach students and residents to use prior knowledge to identify similarities and differences between patients. Cognitivist principles are very useful for organizing all of the disease-based information we must keep in our memory. Doctors make diagnoses by matching patients’ symptoms and findings to illness scripts (defining features of a disease). These require very structured cognitive coding, storage, and organization so that they can be retrieved at the right moment.
I think what is important is that the educational strategy be aligned with the learning objectives and the assessment. I don’t feel an educator has to be locked in to any one learning theory and should use elements of each to best meet the students’ needs.
Ertmer, P. A., & Newby, T. J. (1993). Behaviorism, cognitivism, constructivism: Comparing critical features from an instructional design perspective. Performance Improvement Quarterly, 6(3), 50-72.
Larson, M. B., & Lockee, B. B. (2014). Streamlined ID: A practical guide to instructional design. New York: Routledge.