After 30 years of innovations in medical education and training and conducting hundreds of live and online programs, I have gained some important insights into effective strategies that make educational programs more successful. I would like to share a few of these with you.
Blended Education Solutions
Medicine requires more complex education and training strategies than other disciplines due to the need to integrate cognitive (knowledge), technical (psychomotor/procedural), and nontechnical (e.g., communication, collaboration, professionalism, and management) skills within limited work hours. All learners, independent of learning styles and background knowledge and experiences must meet or exceed high level standards determined by government, medical societies, and regulatory/credentialing boards.
In my experience this is best accomplished by providing a blended solution education model that promotes interactivity and limits traditional lecturing. The blended solution model builds pre-knowledge through e-learning, so the adult learner comes to live meetings with a higher level of understanding and knowledge. Live meetings are reserved for “flipped classrooms” (facilitated discussions rather than teacher-directed lectures) and the training of technical and non-technical skills.
Providing precise and directed information in the moment the learner needs it to build context around the present learning experience. This technique also ties information to past learnings and experiences to build “scaffolding” or “schema”.
Providing immediate feedback regarding decisions or actions within an education and training program. An emphasis on the avoidance, recognition, and management of errors fosters more efficient and effective implementation of learnings into clinical/surgical practice.
Providing multiple “educational touch points” improves retention and provides opportunities for continued knowledge growth as experience increases.
The process starts with deconstruction of a procedure into its component parts (task deconstruction). The learner can then undergo deliberate practice to perform a single task to a high-level benchmark set by experts. Once a single task is mastered (proficiency), other tasks increasing in difficulty and complexity (progression) are practiced and mastered. These tasks can be conducted in dry labs, wet labs, or simulation settings.
Once all of the component tasks from a particular procedure are mastered, they are reintegrated so the entire procedures can be practiced, mastered, and assessed. Such teaching should focus on the correct execution of the procedure, forward planning, decision making and error detection. This method improves safety and outcomes for full procedures. Procedures should be accomplished in a laboratory setting first (animal, synthetic, cadaver, or simulator models) before attempting them on a live patient. Appropriate mentoring/coaching should be included for the first several live cases to ensure successful procedure completion and patient outcomes before granting privileges for independent practice.
Communication, collaboration, and professionalism are important components of any clinical, procedural, or surgical interaction and should be a critical part of any education and training program.
Incorporate social networking using a peer-to-peer style of education into educational programs to improve learner engagement, retention, personalization, and application of materials.
Trainers should receive standardized training including learning theory, communication skills, and debriefing methodologies before being allowed to serve as a trainer. It is expected that the trainer is an expert in the subject matter, tasks, and procedures being trained. It is optimal to create opportunities for trainers to become ongoing mentors (or develop an additional long-term mentoring system possibly through telementoring) to continue to provide support to the trainee as his or her practice increases in complexity over time.
Metrics and Assessments
Create unambiguous metrics to assess a learner’s knowledge and skills in the most objective and reproducible manner. Binary metrics are preferred over more subject Likert scales.
Ongoing Tracking of Performance and Outcomes
The value of the education and training programs can only be evaluated and improved if data is collected regarding long-term clinical performance and patient outcomes. These measurements are for quality improvement opportunities and training remediation and should not be collected/analyzed for punitive purposes.
Jeffrey Levy, MD