Article Review: Medical education can learn from the neurobiology of learning

The brain is a mysterious thing. 
How do we learn? 

Can we apply what we know about the neurobiology and sociology of learning towards medical education? This review article in Academic Medicine presents 10 strategies to improve teaching and curricular development.

1. Repetition
Revising topics from varying perspectives helps to solidify learning. Currently much of medical school education focuses on non-overlapping curricular material to cover the gamut of clinical information. For the purposes of medical school, residency, and lifelong learning, we need to determine when it is best to revisit concepts to improve knowledge retention.

2. Reward and reinforcement
Gold star! Whether we consciously are aware of it or not, the brain has an intrinsic reward system that reinforces learning. Rewards can come in the form of money, praise, or self-realization that one has successfully accomplished a goal. Curricula and educators should incorporate some short-term rewards to encourage and reinforce learning. 

3. Visualization
Visualization, or a mental rehearsal of a process, triggers "neural circuitry in sensory, motor, executive, and decision-making pathways of the brain". This is a great skill to encourage learners to employ, especially after they have gained more experience and witnessed actual procedures or clinical practices. 

4. Active engagement
Learning occurs more when the learner is actively engaged in the process. This is the driving force behind why more large-group traditional lectures are being replaced with small-group workshops where the educator becomes more of a facilitator than an actual teacher.

5. Stress
A little stress is good. Stress helps to potentiate synaptic connections in the formation of memory. Small-group workshops, which put more accountability on the learners, adds stress... in a way which reinforces learning.  

6. Fatigue
Physiologically, the brain needs to recharge periodically. A period for rest/sleep is just as important as a period of formal active learning in the solidification of memory.

7. Multitasking
Today's medical learners are multitaskers. In a classroom setting, learners are constantly barraged by information from various electronic media. These cognitive distractions are often unrelated to the learning material at hand. The trick is to incorporate multimedia into the curricula. Instead of diluting the learning experience, real-time technology (eg. Twitter, Pubmed literature searches, Google Docs sharing of documents, YouTube videos) can enhance it.

8. Individual learning styles
It's known that there are different types of learning styles (approaches to learning). Some do better with one style over others. Generally, there are 3 types of learning styles: Auditory, visual, and tactile/kinesthetic learners. Educators should incorporate teaching styles to match the various learning styles.

9. Active involvement
This item focuses specifically on learning skills, such as procedures. "Doing is learning, and success at doing/learning builds confidence." This provides a strong argument for simulation-based teaching.

10. Revisiting concepts through multimedia/sensory processes
Teaching concepts redundantly through different sensory processess helps to retain knowledge more long-term.

Friedlander MJ, Andrews L, Armstrong EG, Aschenbrenner C, Kass JS, Ogden P, Schwartzstein R, Viggiano TR. What Can Medical Education Learn From the Neurobiology of Learning? Acad Med. 2011, 86(4), 415-20. PMID: 21346504
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