​By Dr Ruban Poopalalingam
Program Director, Anaesthesiology
SingHealth Residency

We may have taught our residents – but this does not necessarily translate to them learning what has been taught.   Perhaps, their learning and remembering can be improved by modifying the way we teach.   Are there any teaching principles that we can use?

If a resident can’t learn the way we teach, maybe we should teach the way they learn.   Many of us teach the way our most effective teachers did because that was how we learnt best.   This creates an inherent bias towards our own learning style.

The Kolb Learning Cycle shows that despite our learning preferences, the best teaching strategy takes the learner through all four quadrants of the Kolb cycle : Why (knowing why one is learning), What (understanding what is the new knowledge that one is acquiring), If (practical application of the new knowledge and its relevance to practice) and How (trying out the new knowledge).

Developmental teaching principles say that the amount of new knowledge a learner acquires is directly dependent on how much prior knowledge the learner has. T  his means that as educators, we need to adjust our lessons’ contents to complement our residents’ prior understanding.   The residents’ prior knowledge should be activated so they can process new information more easily and residents should be taught in the context where they will likely use the new knowledge.

Ideally, learning is best done within the zone of proximal development as described by Vygotsky – learners gain the most when the educational content is just outside of their reach but can be bridged with guidance from the educator.

As adult learners, residents remember best through active learning.   They must be actively involved in constructing personal understanding of the new knowledge and linking it to their prior knowledge. This results in a qualitative change rather than a quantitative change to their knowledge.

In addition, residents need time to reflect on what they have learned.   This allows them to cognitively manipulate the new knowledge to increase the number and strength of links to the novel information as they internalise it.   The more interconnected their clusters of knowledge in an organised construct, the more likely learners will be able to apply this knowledge to new situations and solve problems.

Adult learners are internally motivated.   They need to see the relevance of the information and therefore, our strategy as their educators should be to share with them the learning objectives and their value. Furthermore, adult learners appreciate autonomy.   Educators should initially provide support and direction in learning with the intention of phasing these out to residents to take greater control and responsibility.

Educators can help residents identify their learning needs and direct their own learning plan.   All these need to be in a climate of trust, respect and support.   With adult learners, feedback may be more important than tests. The feedback should be targeted, constructive, actionable and timely.

Many of our residents are Generation Y.   They were born into a technological era that makes them digital natives – techno-savvy, highly connected and multitasking individuals who engage with formats that are interactive, accessible and graphic.   Engaging the Generation Y adult learner should include the appropriate integration of technology into teaching and the provision of reliable and comprehensive multimedia-rich interactive content that is accessible to them at their own convenience.   By harnessing the benefits of both online and face-to-face teaching, we can create a form of blended learning: a ‘flip classroom’ where educational content can be accessed online at home, while the workplace becomes an environment that provides the context for active learning, application and problem solving.

"This means that today’s educators should function more as facilitators rather than transmitters of information."