Learning Styles “Myth”-busting

Since the work by Jung (1964) on personalities, research and publications on learning styles and cognitive styles have grown in prominence (Coffield, 2004; Pashler, 2008). While the number of learning style models has grown exponentially and with great commercial success, practical use has remained limited (Coffield, 2004; Cook, 2012; Pashler, 2008). Multiple literature reviews continue to demonstrate similar findings and recommendations – insufficient evidence to recommend classroom use (Cook, 2012; Pashler, 2008). While some models, like Allinson and Hayes’ Cognitive Styles Index (CSI), demonstrate some promise, the supporting empirical evidence for pedagogical application is lacking (Coffield, 2004). So why do these theories remain so prominent? What can we take away for health professional education (HPE)?

Despite the lack of empirical evidence for the benefit of these learning styles, we all could likely think of personal experiences that support the idea.  For example, my brother (J) who is an electrical engineer always seemed to learn math better than me or my other siblings. He clearly has an aptitude for mathematics and has excelled in this field. Given a combination of intrinsic and extrinsic reinforcements, he made choices that led him to a self-reinforcing career in a math-based field. As many mathematical concepts avail themselves to certain instructional best practices and styles, it would be very easy for my brother to assume he has a learning style and falsely presume instructional matching as the cause of his success. Many scholars note this powerful confirmation bias as one possible reason for the persistence of the learning styles “myth” (Marshik, 2015). From a larger cultural perspective, I suspect learning styles remain ingrained as they resonate with a pervasive individuality more prominently dominating Western philosophy and culture for the latter half of the 20th century. Also, these models provide a much desired explanation for why people fail to learn. Educators desperately desire a way to diagnose “pathology” and come up with “cures.” It is empowering to think that I can give a tailor-made prescription of style-matched instruction to help a struggling learner. As “an ounce of prevention is worth a pound of cure,” it would be even better to tailor instruction to everyone and never have a student struggle.  This premise sounds too good to be true. As discussed above, many contemporary scholars believe just that; however, the belief still persists (Britt, 2009; Marshik, 2015; Willingham, 2008).

So how can we, in HPE, address the dubious yet pervasive belief of learning styles? While Marshik, Willingham, and company fight the uphill battle to crush belief in learning styles, I believe HPE may do well to stay out of the fray and continue to innovate while employing best practices. I believe we can best help learners in HPE by providing context, layering instruction through multiple methods using multiple sensory modalities, and by employ contrasting and comparator cases. See my previous post “crisscrossing the landscape” for more on this.

Works Cited

Britt, Michael. “Learning Styles: A Grand Myth – An Interview with Daniel Willingham.” The Psych Files. The Psych Files, 28 Mar. 2009. Web. 15 Aug. 2015. http://www.thepsychfiles.com/2009/03/episode-90-the-learning-styles-myth-an-interview-with-daniel-willingham/

Coffield, Frank, David Moseley, Elaine Hall, and Kathryn Ecclestone. Learning Styles and Pedagogy in Post -16 Learning. N.p.: Learning and Skills Research Centre, 2004. LEARNINGAND SKILLS RESEARCH CENTRE. Web. 18 Aug. 2015.

Cook, David A. “Revisiting Cognitive and Learning Styles in Computer-Assisted Instruction.” Academic Medicine 87.6 (2012): 778-84. Web.

Glenn, David. “Matching Teaching Style to Learning Style May Not Help Students.” The Chronicle of Higher Education. The Chronicle of Higher Education, 15 Dec. 2009. Web. 15 Aug. 2015. http://chronicle.com/article/Matching-Teaching-Style-to/49497/

Marshik, Tesia. “Learning Styles & the Importance of Critical Self-reflection – TEDxUWLaCrosse.” YouTube. YouTube, 02 Apr. 2015. Web. 15 Aug. 2015. https://www.youtube.com/watch?v=855Now8h5Rs

Pashler, Harold, Mark Mcdaniel, Doug Rohrer, and Robert Bjork. “Learning Styles: Concepts and Evidence.” Psychological Science in the Public Interest 9.3 (2009): 105-19. Web.

Willingham, Daniel. “Learning Styles Don’t Exist.” YouTube. YouTube, 21 Aug. 2008. Web. 15 Aug. 2015. https://www.youtube.com/watch?v=sIv9rz2NTUk

“Crisscrossing the Landscape”

Constructivist learning theory is based on an epistemology in which knowledge constructs are individual and experiential. Constructivists maintain that knowledge building is an internal cognitive process. As knowledge is internally filtered through our experiences, values, and perceptions of the world, any external reality can never be fully known or understood. Similar to the Gestalt movement’s “Law of Closure,” constructivist learning theories maintain that we often “fill in” missing information to build a construct of a complex phenomenon (Ormrod, 2012). Early constructs are typically oversimplified, reducing the complexity to the most basic and useful form – as in the Gestalt movement’s “Law of Pragnanz” (Ormrod, 2012). Such constructs are only restructured when necessary. Piaget notes a driving force for such adaptation, describing it as “disequilibrium.” Understood as the discomfort of a construct not matching a new experience, disequilibrium can either be ignored or resolved through the cognitive process of assimilation or accommodation. By experiencing multiple aspects of a situation through multiple modes of learning, adaptive disequilibrium can be fostered and drive us to reconstruct knowledge with more nuanced understanding and more flexible applications. In experiencing “multiple juxtapositions of instructional content,” Spiro claims that we are effectively “crisscrossing the [cognitive] landscape” to build a richness and depth that is more readily adaptable to new experiences (Nix & Spiro, 1990).

This concept of “crisscrossing the landscape” is helpful in health professions education where the complexity of many topics promotes pragmatic oversimplification. However, “crisscrossing the landscape” can be practically challenging. Our learners are apt to complain or lose focus when we present yet another case of dyspnea. They may fail to adapt to the disequilibrium. As teachers, we can develop strategies to combat this common trap. With the spiral approach to education teachers strive to expose a learner to a topic on multiple occasions with increasing levels of nuance and sophistication as they developmentally progress through training. Using temporal proximity to juxtapose the distinguishing features of case studies in varied settings and through multiple media can help promote more sophisticated understanding of a topic. Advanced organizers can serve as blueprints to building knowledge. Using different instructional styles, simulation, or live patients can help maintain attention and provide scaffolding of contextual relevance for the learners while simultaneously providing a juxtaposition of various sensory experiences and multiple modes of learning. Health Professions Education (HPE) leaders have an opportunity to model this strategy directly in teaching. We can also promote such a strategy through faculty development programs. HPE leaders must ensure programs have the necessary time, financial support, and technical infrastructure to deliver such robust learning opportunities. With enough effort and attention, we can crisscross the landscape with good educational practices that will ultimately promote better learning.

Works Cited
Nix, D., & Spiro, R. J. (1990). Cognition, Education, and Multimedia: Exploring Ideas in High Technology: L. Erlbaum.
Ormrod, J. E. (2012). Human Learning (6th ed.). Upper Saddle River, NJ: Pearson.

Meaningful Learning in Clinical Health Professions Education

Ausubel’s 3 conditions for “meaningful learning” can be remembered with the mnemonic “ASK (Attention, Structure, Knowledge).” This approach to meaningful learning, while incomplete in expressing how newly stored knowledge might be used or applied by the learner, can be extremely helpful in health professions education (HPE) where learners are often overwhelmed by the volume and complexity of information. This approach highlights the learner as the focus of Ausubel’s conditions. Using an instructor’s viewpoint, this post takes a functional approach to Ausubel’s Meaningful Learning Theory with some ties to Cognitive Load Theory (CLT). In doing so, we explore one application of this theory to clinical teaching.

Ausubel insisted that meaningful learning first required the learner’s attention to meaningful learning. This commonly accepted premise for Cognitive Theorists is explored further in information processing theory (IPT) and CLT. IPT conceptualizes a dual-store model for memory where only information that is consciously manipulated by the learner (i.e., working memory) can enter into retrievable long-term memory storage. CLT uses the concept of working memory and research by Sweller, among others, to explain the limitations to the amount of data and duration that working memory can “hold.” Unless information is processed to fit into schemata or anchored and organized, learners are left to rely on rote memorization and the limits of working memory. Therefore, Ausubel maintains that engaging learners to a process of meaningful learning is the first step. CLT suggests that cognitive resources should be managed to optimize learning. In order to minimize extraneous cognitive load and to help learners process information (i.e., germane cognitive load), learners also benefit from instruction that is structured. Ausubel’s strategy of an advance organizer, helps lay an initial organizational framework for new information to fill while providing context. This meaningful structure will help the learner make interconnections with and build upon their already existing relatable knowledge.

Clinical bedside teaching rounds is a strategy in which the team members present findings, evaluate the patient, and discuss care at the patient’s bedside. Challenged by work compression of modern medical education, bedside rounds are rarely practiced. By implementing bedside teaching rounds, the instructor can engage the learner in a mindset for meaningful learning further brought about by the presence of the learner’s patient. However, we must also consider the potential for adding extraneous cognitive load that may occur if the learner is particularly uncomfortable with this style of teaching. Teaching at the patient bedside also maintains a very real context and structure in which instruction can be framed for the learner. Using the patient as an initial organizational framework and the learner’s presentation as a demonstration of baseline knowledge, the instructor can help build up knowledge, fill in schemata, and challenge the learner to pull together interconnecting ideas.