Medical Education 2010: 44: 440–448  Objectives As the medical profession continues to change, so do the educational methods by which medical students are taught. Various authors have acknowledged the need for alternative teaching and learning strategies that will enable medical students to retain vast amounts of information, integrate critical thinking skills and solve a range of complex clinical problems. Previous research has indicated that concept maps may be one such teaching and learning strategy. This article aims to: i! review the current research on concept maps as a potential pedagogical approach to medical student learning, and ii! discuss implications for medical student teaching and learning, as well as directions for future research.  Methods The literature included in this review was obtained by searching library databases including A"A#$%&" '$A("), $(&", $*'"+)ost, Psych&,-+, PsychA(T&".$', Pub%ed/%$#.&,$, "&,A). and $%*A'$. This literature review is a summary of both conceptual and empirically published literature on the uses of concept mapping in medical education.  Results The 01 studies reviewed here indicate that concept maps function in four main ways: i! by promoting meaningful learning2 ii! by providing an additional resource for learning2 iii! by enabling instructors to provide feedback to students, and iv! by conducting assessment of learning and performance.  Conclusions This review provides ideas for medical school faculty staff on the use of concept maps in teaching and learning. 'trategies such as fostering critical thinking and clinical reasoning, incorporating concept mapping within problem3based learning, and using concept mapping in group and collaborative learning are identified. ,ew developments in medical education include the use of serial concept maps, concept maps as a methodology to assist learners with lower cognitive competence, and the combination of group concept maps with structured feedback. Professional #evelopment 4 ,ew )ori5ons 4 6ournals 4 'pring 7898 4 The *rain Targeted Teaching %odel The *rain Targeted Teaching %odel Dr. Mariale Hardiman, Ed.D. "hair, &nterdisciplinary 'tudies in $ducation and Assistant #ean, :rban 'chools Partnership 6ohns )opkins :niversity, *altimore, %#

> they may say. they are often re. The model also assists administrators. many teachers feel pressured to prepare students to meet proficiency levels on standardi5ed tests. At the same time. . The *rain3Targeted Teaching %odel presents six stages. and assessing a sound program of instruction. especially current brain research. supervisors. &n this climate. Aet we also know that not all teaching results in learning. might contend that the term has no meaning since all learning is brain3based. therefore. many teaching practices that regularly occur in our schools defy what neuroscience tells us about the brain<s natural learning systems. The language of this model. as merely a fad that soon will be replaced by yet another new initiative. The *rain3Targeted Teaching %odel is designed to meet this need. At the same time. =After all.> all teaching is not. :nfortunately. As educators have increasingly recogni5ed their role as consumers of this emerging knowledge. Perhaps this thinking accounts for the fact that educational research is largely ignored by practitioners2 as a result little actual change has occurred in our nation<s classrooms during the last several decades. to become readily accessible to teachers. it would not be surprising for new teachers to feel overwhelmed and seasoned teachers to view any educational initiative. Thus. implementing. of course. evaluating leaning.#uring the past decade the neurological and cognitive sciences have produced a vast frontier of knowledge on how the brain processes. =we don<t think with our feet?> @e know. while all learning is =brain3based. and professionals supporting instruction as they guide teachers in implementing research3based effective teaching strategies. including perhaps research in the neurosciences. &n an era of high3stakes accountability for student performance. @hile each brain target is presented separately. for example. and retrieves information. &n order for any research. fragmented initiatives must be integrated into a cohesive model of instruction. translating brain research into classroom instruction often becomes a challenge for the typical educational practitioner. *rain3Target 'ix. or =brain targets> of the teaching and learning process and describes brain research that supports each stage.uired to implement a plethora of ever3changing educational initiatives and reforms handed to them by well3meaning school district supervisors. it might be wise to address those critics who scoff at the term brain3based learning. -or example. *rain3Target +ne describes the importance of establishing a positive emotional climate to foster high levels of learning2 these strategies are applied throughout the entire model. -irst. does not refer to brain3based learning but rather to brain3targeted teaching. is an integral part of each component or target of the model. stores. that all learning involves the brain. 'ome. &t provides teachers with a format for using research in the neurosciences as well as research3based effective instructional practices to guide them in planning. the components are interrelated.

The effects of stress and threat on learning have clear implications for educators. (esearch has shown that while threats impede learning. (esearch has shown that the brain<s limbic system. positive emotional experiences.euroscientists have recently described the intricate interactions between the emotional and cognitive brain systems.BRAIN !AR"E! ONE# $EARNIN" !HE EMO!IONA$ C$IMA!E %OR . @hile we may be unable to control all the factors of stress in the lives of our students. *rain3 Target Two fosters the careful planning of the physical learning environment. located in the frontal lobe of the cerebrum. At the same time.888 visual images per hour. teachers are encouraged to deliberately plan for positive emotional connections within the framework of a specific unit of study. is responsible for our emotional responses. can contribute to long3term memory. referred to as a learning unit. BRAIN !AR"E! !&O# EN*IRONMEN! !HE 'H()ICA$ $EARNIN" @hile *rain3Targeted +ne focuses on establishing a positive emotional climate. @ith information processing short3circuited first to the emotional center. 'uch connections include specific activities that will connect the students emotionally to the content. the adept teacher can minimi5e threat3causing practices within the classroom. during which the brain produces certain chemicals or neurotransmitters. the teacher should maximi5e strategies that promote positive emotion. chronic stress may impair long3term memory and deep learning. located Bust above the brain stem at the base of the brain. . &n the *rain3Targeted Teaching %odel.euroscientists tell us that information that comes to the brain is processed first in this emotional center before being processed in the cognitive or =thinking> center. with about ninety percent of . The infusion of the visual and performing arts is an effective way to tap into children<s emotional response systems to enhance learning and should be included within the activities of every learning unit. @e know that our eyes register about 0C.

&. unchanging environments with classrooms that provided students with stimulation through fre.uently adBusting and changing classroom displays. &magine completing a Big3saw pu55le without ever having seen the overall image that the pu55le displays.F T)$ . . 'cent can also be used to enhance memory. the active brain constantly scans the environment seeking stimuli. while performing tasks that demand high levels of concentration. then combines these concepts to create new patterns of thinking and understandingHa concept referred to as patterning.&. *(A&. and scent also appear to have an effect on learning. teachers carefully plan the physical learning environment by deliberately planning for novelty. 'oft background music can help to relax students and provide a comfortable learning environment. students are often learning disconnected bits of information . then. 'tudies compared the effects of bland.3TA(F$T T)($$: $GP$(&$. lighting. order. 'ound. as olfactory input moves directly to the limbic system or emotional center.euroscientists tell us that the brain categori5es new stimuli into concepts that are either familiar or novel. and beauty within each learning unit.uential order until all of the content has been covered. 7888!. &n the *rain3Targeted Teaching %odel. The brain filters new information through the lens of prior experience and prior knowledge in order to create new meaning. )owever.uiet setting appears to be most effective.ew information. this approach may in fact impede learning. &n studying the effects of lighting.$A(.the brain<s sensory input coming from visual stimuli."$ #$'&F. -indings revealed that children were off task more often in settings that lacked novelty. (esearchers tell us that the brain<s visual attending mechanism is strongly influenced by novelty in the environment. This accounts for the vivid recollection that an encounter with a familiar scent may invoke. . @hile it may seem natural for teachers to write lesson plans that present information to students in se. researchers have shown increases in achievement of students who were taught in classrooms with the most natural and full spectrum lighting compared to dark classrooms or those with cool3white fluorescent lights Dosik E )eschong. a .F *rain3Target Three encourages teachers to design the learning experience in a way that is compatible with the brain<s natural learning systems. becomes integrated into a holistic pattern of cognition. @ith this vast visual capacity. @ithout giving students =big picture concepts> of the content that they will learn in a unit of study.

uire 7887!. a process that re. #uring tasks that involve only working memory. and skills that they can use to build new knowledge. it is partially or totally forgotten. tells us that the most important factor in determining how well we remember information is the degree to which we rehearse and repeat that information. and long3term memory. and strengthens synaptic connections among neurons. 7889!. "ognitive scientists have identified three types of memory systems: short3term.ui5 then . .eading researcher on memory. The next stage of The *rain3Targeted Teaching %odel is to engage students in activities that will enable them to demonstrate mastery of skills.uires the use of long3term memory systems. too often what is presented in our classrooms is designed for students< working memoriesHstudents learn information so they can retrieve it on a test or .I$$). CON!EN!. students are referred back to the concept map to reinforce the relevance of each learning activity. 'hort3term and working memory systems provide a form of temporary storage2 short term memory allows us to retain information for a few seconds or minutes. or memory patterns. Activities are then designed to allow students to understand how the obBectives they will learn during the unit relate to the big picture concept. the brain uses proteins that currently exist in brain synapses (atey. content.that too often never come together into an overarching concept or pattern. . BRAIN !AR"E! %O+R# AND CONCE'!) MA)!ER( O% ). teachers must provide students with learning activities to create and sustain new engrams.ack of conceptual understanding typically results in loss of retention of the disBointed facts and details. teachers are encouraged to use content standards and curriculum guidelines to design overarching goals and concepts. memories consolidate as the brain reorgani5es. *rain3 Target -our promotes mastery of learning goals and obBectives by planning multiple activities to activate the brain<s memory systems.uire knowledge. while working memory serves as a =desk top> for retrieval of information when it is in immediate use. As they continue through the content. "learly the goal of teaching and learning is for students to ac. working. processes.uickly forget much of it as they move on to the next topic. *ased on the method and fre. then to display these learning goals in non3linguistic representations such as concept maps or graphic organi5ers. . and concepts. .arry '. &n teaching for mastery.uency of presentation. &n The *rain3Targeted Teaching %odel. :nfortunately. modifies. +nce the brain determines that the information in our working memories is no longer needed.

The best way to accomplish this is through the integration of artful teaching into content instruction.+@.#&. (esearch has demonstrated. kinesthetic.F A.F The ac. encouraging teachers to pair visual. *y providing students with multiple ways to manipulate content.3TA(F$T -&V$: D. mime. and creative writing. for example.uiring the brain to use multiple and complex systems of retrieval and integration. skills. :sing knowledge meaningfully re. language. 'uch repetition would be terribly boring for students and teachers too! if the same activities were presented multiple times in the same way. all represent separate sets of cognitive skills. and active learning.uire them to engage in higher3order thinking and problem3 solving skills. new proteins are created. $ffective teaching can result in biochemical changes in the brain? *rain Target -our of The *rain3Targeted Teaching %odel encourages teachers to plan for repeated rehearsals of content. use of the body. more analytical ways. *rain research supports what educators know to be the hallmark of effective instruction Hlife3long learning best occurs when students are able to apply content.A&. As )oward Fardner 9IJ0! states. from working to long3term memory systems. and processes to tasks that re. poetry. =The abilities involved with the visual arts. &ntegration of the arts encourages meaningful connection to concepts. skills. thus re. that the motor cortex. becomes activated when the brain engages in problem3 solving that includes such cognitive components as memory.> "ognitive learning and higher3order thinking can be enhanced with meaningful connection to the arts through such activities as musical performance. *rain researchers have used the concept of the modular brain to describe differentiated functions of brain regions. and concepts so that the information becomes part of students< long3term memory systems. drama. &nstead. teachers are encouraged to plan varied experiences so that students can manipulate information within a variety of modalities. visual representations. with drama. with music.$#F$ $GT$. with sculpture or painting.uisition of knowledge is only the beginning of a sound instructional program. teachers are not only promoting long3term memory but are providing the opportunity to differentiate instruction based on students< emotional needs. however.@hen information moves. %odules from one part of the brain connect to other modules when we perform complex tasks. *(A&. creative movement. role3 playing. .# APP. and concepts. academic goals. emotion.uires students to extend thinking by examining concepts in deeper. originally thought only to control motor functions. skills. and musical thinking with linguistic learning tasks. and cognitive learning styles.

it becomes more fun? Please visit #r. teaching and learning not only becomes more effective.uires them to think more deeply about instructional implementation. "ognitive science supports what teachers know by experience: &mmediate feedback strengthens learning and memory patterns. BRAIN !AR"E! )I-# E*A$+A!IN" $EARNIN" @hile *rain3Target 'ix is the last stage of the *rain3Targeted Teaching %odel. while it re. and problem3solving skills.ui55es. fostering more creative and innovative lessons. analysis. *y using the *rain3Targeted Teaching %odel. They have also related that the model re. . and self3grading tools.uires more =front3loaded> planning than a traditional planning format. once completed they can focus on lesson implementation rather than planning for the two or three week learning unit time segment. The *rain3Targeted Teaching %odel supports the use of an evaluation measure for each obBective and activity. designing experiments. &n addition to traditional grading methods . essays. !HE BRAIN !AR"E!ED !EACHIN" $EARNIN" +NI! *y using the following format of the *rain3Targeted Teaching . tests. teachers can be assured that they are implementing research3based effective teaching strategies as well as implementing what the neurological and cognitive sciences tell us about how the brain thinks and learns. student3generated reflections. analy5ing perspective. 'uch activities re. The goal of evaluation is to provide students with relevant feedback about their performance so that the student can adBust learning habits and the teacher can make sound instructional decisions. and engaging in creative thinking through the visual and performing arts. &t allows students to apply what they have learned in tasks that have real3world application. examining cause and effect patterns. @ithin the *rain3Targeted Teaching learning unit. each stage of the model includes evaluation activities. creating metaphors and analogies. )ardimanKs site on her *rain3Targeted Teaching %odel for 'ample :nits and a .earning :nit. *rain3Target -ive activities include conducting investigations.*rain3Target -ive promotes the use of performance3based instructional activities within each learning unit. etc! evaluation measures should also employ a combination of tools including scoring rubrics. grading keys. Teachers who have implemented this model are .uick to say that.earning :nit Template to help you plan your own units using this model.uire students to engage in inductive and deductive thinking.

9IIC!. 6. #ifferent . Daufeldt. The +wner<s %anual for The *rain. #iamond. "hicago: Oephyr Press. %. *egin with the *rain: +rchestrating the .ew Aork: *antam *ooks. $motional &ntelligence: @hy &t "an %atter %ore than &M. Connecting Brain Research with Effective Teaching: The Brain Targeted Teaching Model! is available at the . Re. . E )opson. Dosik. The emotional brain: The mysterious underpinnings of emotional life. Performance3*ased .ittlefield $ducation #amasio.anham. 1I 0!.earning and Assessment. 9III!. . F. 17311. 788C!. 7889!.orton E "ompany. (. The *rain. . D. The $thical *rain. *eals.#r. %#: (owman E . #aylight makes a difference: #aylight in the classroom can boost standardi5ed test scores and learning. 7880!. Atlanta: *ard Press. %. )ardimanKs latest book. Alexandria.@. . *erkeley: . "onnecting brain research with dimensions of learning. )ardiman. )ardiman.earning. 7888!. $ducational . . 9IIC!.eaner3"entered "lassroom. P.ew Aork: Touchtone *ooks. A. 7888!. 6.ew Aork: )arcourt. and the "ompetitive $dge. . 7888!. %. . Foleman. "onnecting brain research with effective teaching: The *rain3 Targeted Teaching %odel. 6. . 7881!. 9III!. .. .ew )ori5ons for .. 7880!. %. '.ew Aork: @. )ibbard. 'an #iego: The *rain 'tore. Fa55aniga. $. #.ooking for 'pino5a: 6oy.. $.earning About . "aine. E "aine. %.e#oux.ittlefield $ducation. &n 'earch of %emory: The $mergence of a . *arrett.. . 6ensen.. 9IIL!. 9IIC!.ew Aork: Penguin Froup. %. . D. #ifferent *rains. %#: (owman E . and the -eeling *rain. *ergman. 7889!.)' F$%'.earners: )ow to (each the )ard to (each. )oward. E )eschong. %. E #iamond. . D.6. %agic Trees of the %ind. D. VA: A'"#. .erences *arber.ew Aork: #ana Press.earning 'tore. $(&" #ocument: $# N19CJ Dandel.ew 'cience of %ind. $ducation.. 'orrow. .andam.eadership.

6.%ar5ano. P. Alexandria. 6. E Perini. 9III!. The -uture of the *rain: The Promise and Perils of Tomorrow<s . VA: A'"#.earning E %emory: The *rain in Action.$xceptional $ducation Muarterly. Alexandria. $. 7887!. A. VA: A'"#. 6. . &nc.. Tate. . VA: A'"#.. 'ilver.earning 'tyles and %ultiple &ntelligences.thebrainstore. .. 7887!. Alexandria. E %cTighe. 788C!. . 'trong. P%ay 7898 The 6ohns )opkins :niversity . '. A. (ose. Available: www. ). "A: "orwin Press. %. '.euroscience. Alexandria. 7888!.Bhu.earning. 7889!. Alexandria. N 7!. +xford: :niversity Press. '. Thousand +aks. 'prenger. and the -our Theaters of the *rain. 6.. VA: A'"#. . @orksheets #on<t Frow #endrites. (. 9IJ0!. 7880!. 6. 9IIJ! :nderstanding by #esign. E %cTighe. %ar5ano.com.uire. VA: A'"#.. #. '. &ntegrating #ifferentiated &nstruction and :nderstanding by #esign: "onnecting "ontent and Dids. A :ser<s Fuide to the *rain: Perception.ew Aork: Vintage *ooks. A #ifferent Dind of "lassroom: Teaching with #imensions of . %. Pickering. %. VA: A'"#. (atey.earning environments: A review of physical and temporal factors. @olfe.earning *rain $xpo: The *rain 'tore. 7889!.earn: &ntegrating . @iggins. -.edu . Alexandria. . (. 6.6. F. Pollock. VA: A'"#.. (. 'o $ach %ay .6. %emory systems of the brain. "lassroom &nstruction that @orks: (esearch3*ased 'trategies for &ncreasing 'tudent Achievement.@. 9II7!.ew )ori5ons for . Attention. Tomlinson. Alexandria..earning http://education. Oentall. *rain %atters: Translating (esearch into "lassroom Practice. 7881!. I8391. (.6.

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