Week 1 Question/Assignment

After you have completed your reading for this week, please think about how certain learning
theories fit within what you have experienced in your clinical experiences so far. In one page or
less, describe an experience you’ve had where an instructor utilized a learning theory you read
about. Additionally, discuss how you might apply what you have read to future teaching
opportunities.

On reflection, a majority of my clinical learning experiences in the last two years of

medical school and in residency have been constructivist in terms of learning theories. Much of
my foundational training has relied on the basic constructivist concept of learning by “creating
meaning from experience.” This contrasts the first two years of medical school, which relied
more on behavioralism (multiple choice tests, oral exams, anatomy exams) and cognitivism
(problem based learning seminars, clinical skills classes). Once a basic foundation of knowledge
was established, the focus of learning shifted to learning by doing and experiential learning.
I have always appreciated instructors who have allowed me to jump right in and learn
by practice. One example that stands out to me goes back to when I was tasked with disclosing
bad news of tests results concerning for cancer to a patient and their family. My senior resident
took the approach of talking me through how they might approach the disclosure, and then let
me go into the room and disclose the results on my own. While I had received many lectures
and even had practice simulations on disclosure of bad news, the act of doing it on my own,
allowed me to develop my own style of communicating by getting real time feedback on what
worked and what didn’t. I was able to construct my own fund of knowledge based off that
pivotal experience.
Going forward, I think I would attempt to utilize all three theories (behavioralism,
cognitivism, construcitivism) to teach depending on the context. In a more formal didactic
setting, such as a powerpoint presentation on a basic concept, behavioralist concepts of
repetition and associations can be helpful to establish a foundation. For example, pediatric
board review presentations would benefit from this approach.
This contrasts with clinical bedside teaching on rounds which would draw from a
cognitivism and constructivist approach. These approaches are especially important in
pediatrics where clinical practice is not as protocolized and has a higher degree of the “art of
medicine” compared to other specialties. This type of learning is best done by collecting
multiple experiences, opinions, and contexts and synthesizing them into your own clinical
practice.