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What Can Medical Education Learn from Neurobiology: (Part 2) 0


While trying to stimulate a learner to consider a body of evidence about a biological process, disease mechanism, or planned course of therapy, trying to pay attention to other sources of information are really counterproductive.  I know that we all think we can multitask, that we study better when we have background media going on, or are surrounded by friends.  Our brains are simply not built to really multitask,  What we actually do is Rapid Sequential Tasking where we change our attentional focus from one thing to the next very quickly.  The problem with this is that it does not allow our brains to really build connections in and among the information you are actually studying.

Key Point: Don’t watch TV, text, or yahoo chat while you study. Studying the same material in many different forms will make it easier to remember.

Individual Learning Styles
Individuals have various types of intelligence and show differences in the types of learning that they employ best. Embrace multiple learning styles to provide opportunities to more effectively reach all learners, to provide opportunities for positive feedback and successes, and to reinforce information with multimodal strategies, even for those who excel equally with all approaches.

Key Point: Find out what works best for you and study that way. However, it can still help to learn using different styles as well.

Active Involvement
Doing is learning. And success at doing/learning builds confidence, as has been shown by recent neurobiological studies of human performance during episodic retrieval of remembered information.

Key Point: Get involved with free clinics, research, ect that allows you to use what you’re learning.

Revisiting Information/Concepts Through Multimedia/Sensory Processes
Multiple teaching approaches addressing the same information using different sensory processes are likely to enhance the learning process, potentially brining more neural hardware to bear to process and store information.

Key Point: Again, studying the same material in many different forms will make it easier to remember.

What Can Medical Education Learn from Neurobiology: (Part 1) 0



Michael J. Friedlander et. al. took a look at a couple of decade’s worth of Neuroscience research and came up with a useful “Ten” points about the biological basis for learning that all students and teachers would do well to know. In this particular case they focused it around learning in medical schools, but this holds true for all disciplines, especially ones in which a great deal of material must be learned (or memorized).

We get good at what we do! The more we do something, the less energy it takes to do it as our neural pathways become more efficient at doing the work. This means that less energy is used, resulting in more rapid neural execution, which in turn allows the off-loading to lower-order pathways leaving higher-order pathways available for additional cognitive processing). There is also considerable evidence for the importance of spacing of repetitive review of material to allow for something called memory consolidation. This is where basically we make sense out of all the material.

Key Point: Long-term and easily accessed memories are created by learning a fact, then not thinking about it long enough to “forget” it, and then trying to recall it and, if needed, relearning it.

Reward and Reinforcement
The neural circuitry of the human brain engages in something called “temporal discounting” — that is, the calculation of the relative value of a choice to realize a minor reward in the immediate future versus a reward of a greater value in the more distant future. Medical students have mostly long-term rewards ahead of them.

The students who derive joy and satisfaction from the more immediate goals of understanding as they proceed through their medical education may have a greater chance of using the brain’s capacity to provide rewards on an ongoing basis, thus effectively facilitating their learning process. Learning that engages the student in smaller, more frequent rewards may be more successful than those that rely only on sparsely distributed and high-stakes opportunities for reward. This is increasingly seen in the efficacy of game based learning.

Key Point: Build multiple, frequent, small rewards into your study plan or better yet, actually enjoy the information you are studying. A handful of your favorite snacks, or taking time for a workout is likely to be as reinforcing as the promise of helping your fellow man and/or making six figure income.

Ever heard of “Mirror Neurons”? One of the major breakthroughs in the last decade was learning that your brain can and will learn by seeing someone else doing something or even imagining itself doing something. It is likely that doing it physically yourself is still more effective since it engages the motor neurons in a way that only seeing it or imagining it cannot do. But lets be clear, when athletes and artists visualize doing something perfectly, they are truly learning how to do it perfectly.

Key Point: After someone shows you how to do something, visualize yourself doing the procedure step by step a few times.

Active Engagement
There is considerable neurobiological evidence that functional changes in neural circuitry that are associated with learning occur best when the learner is actively engaged (doing it rather than watching or hearing it). The neural activity during “engagement” is simply higher than when learning passively (lecture, slide show etc.) If there is one thing we are sure of it is that the more parts of your brain that are “lit up” the better your access to memory, the better you will be at making connections to that information when you need to.

Key Point: Go to a Problem Based Learning (PBL) class. Also, see one, do one, teach one.

Too much stress… BAD for learning; a moderate amount of stress… GOOD for learning. When the brain is placed in a moderately stressed state, the ease with which the neurons of the brain fire is increased. This is called synaptic potentiation improving memory (which as we all know is nothing more than a series of connected neurons).

Key Point: Create mildly stressful study situations, perhaps some minor competition in study groups, varying your study locations so you don’t become comfortable in one place, or creating little tests for yourself.

There is increasing evidence of the importance of rest/sleep for the consolidation of memories and the enhancement of their representations from working memory stages into long-term stable form. This research suggests that it is important to have appropriate downtime between intense problem-solving sessions or group venues where detailed quantitative reasoning skills are requested.

Key Point: Getting enough sleep and taking breaks will improve your learning performance.

The Teen Brain; Growing at High Speed 0


Current research indicates that the brain is primed for rapid learning and development in Adolescence. These same conditions also make the teenage brain at higher risk of impulsive behavior, irritability and making mistakes.

While the teenage brain may be slowing down a bit from the learning curve exhibited in earlier childhood years, the rate of formation of connections (synapses) is still in high gear. More importantly, this is also the time when the “pruning” or trimming of unused cells and their connections takes place. “Use it or lose it” has never been truer.

Additionally, the development of the brain takes place at different times, According to, “The frontal lobe, the brain’s self-control and judgment center, is the last to complete development, concluding sometime in the mid- to late-20s.”

Along with this neural growth come changes in sleep patterns. The Mayo Clinic notes “Before adolescence, the circadian rhythms direct most children to naturally fall asleep around 8 or 9 p.m. But puberty changes a teen’s internal clock, delaying the time he or she starts feeling sleepy, often until 11 p.m. or later” As a result, very few teens actually get the needed 9 hour of sleep.

Another area where teenage brain growth impacts all our lives is in driving., reports that “studies suggest that unlike older drivers, who were not affected by additional passengers, younger drivers make riskier decisions in the presence of their peers. Other research shows teen brains work harder to assess whether a scenario is dangerous, showing increased activity in the dorsolateral prefrontal cortex. This greater effort translated into longer reaction times, which could lead to trouble behind the wheel.”

In the coming week we will take a more in-depth look at the prefrontal cortex and the young adult years

Online EDUCA Berlin 0


Hi everyone. Finally back on the blog after a long hiatus getting settled in the new job. Today I am at the EDUCA conference in Berlin, what is probably the world’s largest e-learning conference. I must say, that after hearing so much of the same thing at conferences in the US year after year, it is refreshing to hear not only about new technologies in Europe, but just a subtle but palpable difference in perspective on digital learning.

One of the big differences is that I really have a several unique problems that need a technological solution. One is the need for really good lecture-capture software that also has live streaming built in. At Abu Dhabi University, we segregate the men and women (a cultural thing) but often need to teach them as one course due to enrollement size. Old style video conferencing has proven to be a very poor vehicle, and some of the major classroom capture companies are too expensive and/or need extra hardware to capture both the speaker and the other media. Enter Panopto. This one seems to have it all.

Good buy from Berlin for the moment

Sorry for the Absences 0


Hey folks, so sorry to have dissapeared there. I am in the process of moving to Abu Dhabi where I will take on the responsibility of creating one of the first Faculty Development Centers in the region for Abu Dhabi University. All that goes into wrapping up one job and starting another even before moving there has left me a bit short on time. Starting in August, I expect to be back, more regular than ever. Don’t write me off – more interesting stuff coming your way.


Males – Females and online learning 0


Working with a student of mine, we just completed a study looking at the relationship between gender and a number of variables in online learning. We were fortunate enough to have access to a large sample of high school students taking courses online via Michigan Virtual High School.

There were a number of predictable resulst such as more males than females took computer courses online, and that there were a wide range of reasons for taking online courses such as it being a required course for graduation, personal interest etc.

What was a bit more interesting was the apparent contradition between survey results and some of the established wisdom:

Established wisdom: Females have a more empathetic brain type (Simon Baron-Cohen) and that they are more collaborative by nature. Conversly, Males are more systematic and tend to divide and conquer as a work methodology.

The study revealed that while it was true that the females missed the personal contact and feedback from the professor, they rated themselves everybit as comfortable with the systematic layout of an online course including science and math courses. In fact, the women indicated that they were more likely to sign up for an online course than the males. The males annecdotally indicated that while the courses were of no particular problem content-wise, that they had trouble with the self-management required to be timely in their work.

What we can conclude from this study is that in order to make online learning more gender friendly (at least at the high school level), we need to do at least two things:

1) For Females especially: build in a higher communication constant in the course. Make sure that their are group discussions, well maintained FAQ’s, and that faculty respond quickly and personally to emails and submitted assignments. I emphasize the “personally” since the warmth of human collaboration can only be communicated in the words of an email or work product feedback. A couple of simple examples include making sure that the teacher use the student’s name in the salutation i.e., “Hi Amanda…” and commenting (even briefly) on the course discussions, showing that the teacher is reading what is being said. Again, there needs to be a personal component in the message i.e., “The comment about your uncle being a math savant…”

2) For Males especially: make sure that there is good tracking of course participation. Let them know that you are tracking their engagement. Most online learning platforms include usage statistics. Be direct with the males and let them know that it has been four days since they last logged on, or that they only read 20% of the discussion postings. This type of feedback will help the Male student self-manage their time more effectively and be more accountable.

Designing Games to Help Boys Reading: 0


Let’s start this conversation by dispelling a common myth that women speak three times more words everyday than men do. According to Matthias Mehl of the University of Arizona, after placing digital recorders on 400 college students, the differences in verbalizations was minimal. In fact, he contends that the gaps throughout life are there, but minimal. However, the U.S. Department of Education concludes that after several decades of collecting data, that boys are 12 percent behind girls in reading skills when they begin Kindergarten and that by 12th grade 47 percent less boys graduate as proficient readers than girls. Researchers attribute only 3 percent of a toddler’s language ability to gender and genetics whereas they attribute at least 50 percent to their environment and language exposure.
I think we would all agree that reading is the single most important skill in school achievement. Students who do not read well struggle in almost all subjects.

Ask any elementary or middle school teacher and they will tell you that boys are much more likely to read subject matter that interests them. No doubt that boys have a wider range of interests, but one area that we know belongs almost exclusively to boys is first person shooter games. According to the Pew Research Center 50% of teenage boys play mature first person shooter games like Halo where only 14% of teenage girls play this type of game. So what if minor modifications to first person shooter games (FPSG) could enhance the reading skills of school age boys?

Think for a moment about the last FPSG that you saw or played. How much reading was required? Now think for a moment about real world military mission planning. My friends in the military tell me that mission planners and leaders read intelligence reports, fitness reports, cultural background information, weapon specifications, and situation reports. Often this work involves acquiring passing familiarity with another language when deployed to war zones overseas. Can game designers embed these types of written materials in the game? Of course they can. Written materials may be the easiest form of material to include. Let’s take the traditional tiered level of game design. Players start out mastering the basic movement and/or fire commands. They begin to practice those skills, getting killed quickly at the beginning, but quickly gaining skill and knowledge about the operational controls. As they progress, their characters, gain weaponry, strategic advantages until they become proficient at defeating the enemy. Levels of difficulty increase, the enemy becomes more adept, better equipped and the player has to respond.

Now switch to real-world combat. Units and individuals who are deployed to hostile lands adapt, gain skill, become better at using their weaponry and hopefully survive their first firefights. The big difference lies in mission intelligence. Safety lies in the ability to know what enemy they face and what the conditions are. Mission planners spend considerable effort and resource trying to gain meaningful intelligence on the enemy’s movements, armament, strategies, location etc. This information is transmitted in great part in written form to the mission planners who then brief the field commanders who then pass this on to their troops in verbal form.

I would suggest that in a typical FPSG that as the player progresses through the levels that continued success increasingly demand higher and more complex reading skills. Readability level tools are available on the web to ascertain reading level (i.e., 4th grade, or 7th grade etc). A good one can be found at For more information on readability scores check out Wikipedia at:
It has long been known that we get good at what we do. Practice makes us better at anything. Malcolm Gladwell in his book Outliers claims that to be truly great at anything, a person needs innate ability, dedication, perseverance and drive. But above all, they need approximately 10,000 hours of practice. If we want our boys to be proficient readers they probably need at least 5,000 hours of reading practice before graduation from high school. Do the math. 5,000 / 10 years of school (let’s take out grades 1 and 2) this means 500 hours of practice reading a year. Divide that by 365 days and we see that children need about 1 ½ hours of reading a day, every day, for ten years to reach half the number required to be an “expert”. And all this assumes that there are no learning disabilities.

Clearly adding reading to FPSG will not provide 1 ½ hours a day of reading, but every little bit adds up. Besides, the kind of reading that these games could contain could be fairly high level reading driving the motivated player to engage reading material well above their grade level in order to survive in the war zone.

What do you think?

The Digital Snake Oil Salesman 0


The Washington Post recently reported that a growing number of devices (BabyPlus, Lullabelly, BellySonic) that claim to enrich a baby’s long term learning potential, reduce developmental delays, absorb more of their environment etc. Could this be possible? I guess anything could be possible.

Before I go any further, I need to let you know that I have not yet gotten my hands on the original research from a Rene Van de Carr in 1986 or Brent Logan’s reearch in 1987-88 which the BabyPlus claims are the scientific foundation of the prenatal enrichment devices, but I confess that I am sceptical that there is some scientific way to prove it works. Think about it a moment. The testimonials from parents on the website are all glowing accounts of how well their children did after they were born. So… most children do really well after they are born. How does the parent know that the child would have done less well without the classical music. It’s not like you could do a twin study where one twin got it and the other didn’t. I was especially fascinated by the parents who claimed that their child was born prematurely and came home from the hospital right away and had no problems. Could I have a little more data please? How premature for example. Or another mom who claims that her second child, with whom she used the stimulator, was so much different than her first child. Really! No kidding! I’ve never heard of such a thing as two children being different without this developmental accelerator. (sarcasm intended).

In fact, I have nothing against the idea. We know that music activates areas across the brain, and that as plastic as the brain is, it is totally possible that in-utero music could improve cortical connections across the brain. But without any real science to back this up, it just sounds to me like overachieving parents trying to push their children at even earlier ages, kind of like they did during the big 1980 – 90 fancy preschool boom – that turned to bust.

What do you think?