Lifelong Learning and
Information Technology
Nancy Clark, M.Ed.
Dir. Medical Informatics Ed.
FSU College of Medicine
Class 1
All resources from today’s workshop can be found at:
www.med.fsu.edu/informatics/LLL.asp
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Objectives
Students will
 Establish a method of ongoing selfassessment of learning needs which includes
constantly and accurately assessing the state
of his or her knowledge and experience base
 Identify and utilize his or her best learning
style
 Developing a written plan for addressing
learning needs that is realistic
 Recognize types of references and sources of
information for lifelong learning
 Identify good information habits to remain
current
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Office of Medical Education
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COM Objectives
See
http://www.med.fsu.edu/education/
COMcompetency.asp
Under Life Long Learning
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What is Medical Informatics?
What does it have to do with
Lifelong Learning?
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Health (Medical) Informatics
 Medical Informatics is the branch of
science concerned with the use of
computers and communication
technology to acquire, store, analyze,
communicate, and display medical
information and knowledge to facilitate
understanding and improve the accuracy,
timeliness, and reliability of decisionmaking.
Warner, Sorenson and Bouhaddou, Knowledge
Engineering in Health Informatics, 1997
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Knowledge
Quote over the entrance to
Dodd Hall, FSU
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Textbooks don’t smell as their contents rot,
so readers will need to develop alternative
crap detectors to avoid poisoning their
minds and robbing their patients of current
best care.
David Sackett
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Goals of Informatics
Curriculum
Create independent, lifelong learners
 Who keep up to date
 Excellent problem solvers
 Who integrate evidence into clinical
decision making
 Who practice information mastery
 Value instant access to latest information
 Who are comfortable with new technology
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Longitudinal Theme of Integrated
Informatics Curriculum
Information management and
computer skills to support
– Lifelong Learning
– Education
– Research
– Communications
– Patient Care
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Year 1 Curriculum
Computer basic skills
Presentation Skills
Effective use of Information
Resources for
– Education (small group)
– Lifelong learning
– Patient care
Using a PDA
Class 1
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Year 2 Curriculum
Evidence Based Medicine
Information Resources for Decision
Support, Patient Education
Research
– Statistical/epidemiological concepts
– Writing a research paper
– Using Medline and other databases
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Year 3
Information Management in patient
care
– Documentation of clinical encounters
(Electronic medical/health records)
– Accessing patient information
– Other practice data management issues
Evidence Based Medicine
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Computer Skills
Survey Result
Mavis Bacon Typing Tutor is
available
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Learning Styles and Approaches
How are these a predictor of your
success in medical school and
long term as a physician?
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Learning Styles and Approaches
Learning Styles Inventories
– http://www.med.fsu.edu/informatics/
– Lifelong Learning
– Additional files on intranet:
What are some learner
characteristics?
What are your characteristics?
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Physicians Reactions to LS
Think non-judgmentally
Appreciate differences
Patient Care and education
Practice management &
administration
Medical Education
Thompson, H. & Bing-you, R. (1998) Physicians’ reactions to learning style
and personality type inventories. Medical Teacher
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Goals of Understanding LS
 Short Term
– Self aware
– Succeed in med
school
– Form cohesive,
productive study
groups
– Adapt to new
learning situations
– Maintain Sanity
 Long Term
– Life long learning
– Select right
specialty
– Work well with
healthcare team
– Teach students
– Educate patients
– Clinical competence
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Development -- Piaget
Toddler
Adult
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Adult Learning Theory
 Learning Theory
– http://tip.psychology.org/index.h
tml
 Learning takes place
–
–
–
–
in context of patient care
when questions are answered
the issues are applicable to work
when it doesn’t take too much
time
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Inventory of Learning Styles
Felder-Silverman Model
Active
Sensing
Visual
Sequential
Decision
Perception
Sensory
Reception
Organization
Reflective
Intuitive
Verbal
Global
Strong ModerateFSUWeak
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Decision Models-- Kolb
Impulsive
Active
Participant
Reflective
Decision
Reflective
Observer
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Active
vs
 Tend to retain and
understand information
best by doing
something with it—
discussing, applying or
explaining it to others.
 "Let's try it out and see
how it works"
 Like to work in group
 Sitting through lectures
hard
 Usually Extroverts
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Reflective
 Prefer to think about
it quietly first
 "Let's think it through
first" is reflective
learner's response.
 Reflective learners
prefer studying alone
 Are quiet in group
learning situations
 Usually Introverts
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Active
vs
Reflective
 The majority of undergraduate students
are Active
 83% of college student leaders were
active
 65% of Phi Beta Kappas were reflective
 Around 62% med students are Active
 Majority of university professors are
Reflective
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Personality Types -- Jung
Meyers-Briggs
Orientation
Extrovert
Sensing
Perception
Judgment
Introvert
INtuitive
Thinking
Feeling
Judging
Perceiving
Do: What is your Myers Briggs Type?
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Sensing
vs
Intuitive
 like learning facts
 like solving problems by well-established
methods (logical)
 dislike complications and surprises
 want step-by-step instructions (linear)
 patient with details (detailed)
 Like memorizing facts and doing handson (procedures) work
 more practical and careful than intuitors
 don't like courses with no apparent
connection to real world (concrete)
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Sensing
vs
Intuitive
prefer discovering possibilities and relationships
like innovation and dislike repetition
may be better at grasping new concepts
often more comfortable than sensors with
abstractions (abstract)
 tend to work faster and to be more innovative
than sensors
 don't like "plug-and-chug" courses that involve
memorization and routine calculations




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Sensing
vs
Intuitive
 The majority of undergraduates are
Sensing
 56% -72% college freshmen Sensing
 83% of national merit scholarship finalists
were Intuitive
 92% of Rhodes Scholars were Intuitive
 75% of first year medical students are
Sensing*
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Organization-- Wertheimer
Gestalt Theory
Step 1
Step 2
Step 3
Step 4
…
Sequential
Organization
Global
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Sequential
vs
Global
 gain understanding in  learn in large jumps,
absorbing material
linear steps, with
almost randomly
each step following
without seeing
logically from the
connections, and then
previous one
suddenly "getting it."
 follow logical stepwise  to solve complex
paths in finding
problems quickly or in
solutions
novel ways, but have
difficulty explaining how
 Majority of M1s are
they did it.
sequential
 Want to see Big picture
 Detailed
first. FSU
Do Cnot
likeOFdetails.
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Sensory Reception Preferences
Auditory
Visual
Kinesthetic
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Do: Visual, Auditory, KinestheticFSU
Styles
Inventory
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Visual
 Visual learners
remember best
what they see-pictures,
diagrams, flow
charts, time lines,
films, and
demonstrations
 70%+ students
are visual
Class 1
vs
Verbal
 Verbal learners get
more out of
words--written and
spoken
explanations
 30%- are verbal
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Tablet PC as Visual Learning Aide
Case Solver for
Windows Journal
On Informatics
Intranet site
under Teaching
Files > TabletPC
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Hemispheric Dominance
Herrmann
Left Brain
Right Brain
Do: Hemispheric Dominance Test (Left brain/right brain)
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Intelligences -- Gardner
HIGH
Verbal
Logical Mathematical
Bodily/Kinesthetic
Visual/Spacial
Musical
Interpersonal
Intrapersonal
LOW
Naturalist
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Special Needs
Physical
Mental
Emotional
Socio/economic
Logistical
Gender
Ethnic/Cultural
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Approach to Learning
More predictive of success in
medical school than learning styles
Three approaches to learning
– Surface
– Deep
– Strategic
Newble, DI & Entwistle, NJ. (1986) Learning styles and approaches:
implications for medical education. Medical Education. (20);162-171.
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Surface Approach
 Predominate Motivation
– Passing the course
– Fear of failure
 Intention
– Fulfill course
requirements by
reproduction
– Gorge and regurgitate
 Learning Process
– Rote Learning: focus on
tasks and pieces of
information in isolation
– Uses routine
procedures and
repetition to memorize
facts and ideas
 Outcome
– Superficial level of
understanding
– Substantial knowledge
of factual information
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Deep Approach
 Predominate Motivation
– Interest in subject
matter
– Career relevance
 Intention
– Reach personal
understanding
 Learning Process
– Relates evidence to
ideas; details to big
picture
– Building frameworks to
add new information
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 Outcomes
– Deep level of
understanding
– Integrated principles
with facts
– Uses evidence to
develop arguments
– Excellent problem
solving skills
– Success in medical
school
– Excellent physician
with honed lifelong
learning skills
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Strategic Approach
 Predominate
Motivation
– Making high grades
– Competing with others
 Intention
– To be successful by any
means
 Learning Process
– Whatever it takes to
make good grades
 Outcome
– Variable level of
understanding
– Shallow, course specific
knowledge
– Depth of learning
dependent on
assessment strategies
of courses and course
requirements
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Transfer of Learner Control
Low
Student
Control of Learning
High
Faculty
Time
Class 1
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Lifelong Learning and
Addressing Learning Needs
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Life Long Learning
 Half-life medical information = 5 years
– Volume doubles
 Average physician practices 30 years
 > 25,000 clinical trial articles published in
2005 (663,524 total new medical journal articles
[MEDLINE citations] in 2005)
 200 new prescription drugs per year
 Medical errors increasing
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Lifelong Learning
Old method: read a few journal
articles per week
Reality: Primary care docs would
need over 17 hrs/day just to review
reasonable pertinent material
Even in one narrow specialty would need
6+ hrs/wk
Practicing docs (all specialties) average 11.5 hrs/wk
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Learning Needs
How do we recognize a
learning need?
What steps do you take to
fill the gap?
What resources do you use
to gain knowledge?
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Adult Learning Theory
Learning takes place
– in context of patient care
– when questions are answered
– the issues are applicable to practice
– when it doesn’t take too much time
Apply this to medical practice…
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Addressing Needs
Passively (ineffective or biased)
– Go to conference
– Read this weeks journal
– What the drug rep wants to tell you…
Actively (very effective)
– Look it up when question occurs
Use reliable, current resources
Apply what you learn immediately
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Information at the Point of Care
A physician seeing patients in an
office setting will generate 15
questions per day
– 33% related to treatment
– 25% to diagnosis
– 15% to pharmacotherapeutics
70% unanswered
Barrie AR, Ward AM. Questioning behaviour in general practice: a
pragmatic study. BMJ. 1997 Dec 6;315(7121):1512-5.
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Sources of Information
Traditional
– Colleagues
– Textbooks
– PDR
– Journals
– CME
– Pharmaceutical
Reps
Web Based
Computer Based
PDA Based
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Good Information Habits
 Using multiple information sources for
problem solving
 Know where to go to get question
answered
 Maintaining a healthy skepticism about
the quality and validity of all information
 Making decisions based on evidence,
when such is available, rather than
opinion
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Compare References and Sources
Answering Family Physicians’
Clinical Questions Using
Electronic Medical Databases
Brian S. Alper, MD; James J. Stevermer, MD,
MSPH; David S. White, MD; and Bernard G.
Ewigman, MD, MSPH Columbia, Missouri
http://www.jfponline.com/content/2001/11/jfp_11
01_09600.asp
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Compare References and Sources
Answering Family Physicians’
Bottom line – there is no one
Clinical Questions Using
resource
that
will
answer
all
Electronic Medical Databases
clinical
questions
Brian your
S. Alper,
MD; James
J. Stevermer, MD,
MSPH; David S. White, MD; and Bernard G.
Ewigman, MD, MSPH Columbia, Missouri
Learn to use many
http://www.jfponline.com/content/2001/11/jfp_11
01_09600.asp
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Assignment
 Create a thought paper on your learning
styles and needs which outlines an
individual plan for remaining current.
 Limit 3 pages
 E-mail to me before July 19 class
 Format- see handout
 Copy and paste your official picture from
the web page to your title page
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Informatics Intranet Site
Go to Intranet from main web page
Click on Sites
Click on Academic Affairs
Click on Informatics
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Next Time
Finding Reliable Medical Information
Bring your laptops
Upload your assignment from this
week before coming to next session
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