There are many things I wish I knew about learning when I was entering the profession (spoiler alert – delayed recall will save you an incredible amount of time and effort). If I was forced into choosing the two most important things I wish I knew it would be that understanding how memory works is essential to learning more and knowing which type of learning to enagage with when.
So in this (medium length) blogpost i’ll talk you through my reasoning and hopefully apply it to physiotherapy and maybe save you some time in the future!
Getting Your Micro and Macrodose of CPD
Think of a ‘microdose’ of CPD as a frequent small learning event which can be delivered via different mediums and a ‘macrodose’ of learning as a fixed more traditional longer form of learning activity. Both are absolutely acceptable ways of learning and both are equally essential for building a well rounded portfolio of skills. Both are normal ways of learning and are used at different times depending on context.
Traditionally ‘microdoses’ of CPD have been seen as a lesser form of learning compared to ‘macrodoses’ but things are not this clear cut. It is easier than ever to dip in and out of a virtual learning environment especially with social media platforms like Twitter and the Physiopedia app, which are available 24/7 and offer dynamic environments to pick up information or chat to collagues.
It’s this accessibility which makes ‘microdosing’ learning so powerful as it’s readily available and often for free without paywalls. This isn’t an argument saying all education should be for free, clearly that is unsustainable, however it is an excellent way to check your knowledge or quickly verify a piece of information.
There is a growing concern that although we have access to all this information we become over reliant upon instant information which disrupts diagnostic reasoning and clinical understanding. There is also the argument that microdosing CPD and reference apps only enable superficial learning and knowledge isn’ committed to memory. Personally I’m not sure this is the case. What we are seeing is an evolution in the way we are working and perhaps formal physiotherapy education should do more to incorporate information at our fingertips as part of the clinical reasoning process.
Technology Enabled Learning – Active Recall
There are a number of different learning strategies you can use to commit new information to your long-term memory. Active recall is considered one of the best ways to establish long-term retrieval of information. Great for that time you’re seeing an uncommon condition and you remember seeing something about it on social media or in that team presentation a few weeks ago.
Think of active recall as you actively stimulating your memory for information in essence it’s retrieval practice for your brain. This is in stark contract to passively reading or re-reading your notes or a book where you aren’t reaching into your brain to get the information out as it’s there in front of you.
Active recall works because it relies on you strengthening the connections between information and concepts. It’s like muscles the more you train the stronger you get – the same happens with the connections in your brain. The more you retrieve and recall the information the stronger the connection becomes.
There are a number of delayed recall strategies such as the Feynman Technique which is basically the learner teaching a complex concept to someone who is new to the information. Another strategy is flashcards which if using an app often adds in spaced-repetition to the mix.
The way these apps with active recall and spaced repetition work is quite simple. A flashcard is shown to you which you answer, if it was simple to get right then you rank it as easy, if it was partially correct or a bit of a challenge rank medium and if you got it wrong then difficult. Medium and difficult cards will re-appear fairly quickly to strengthen your connection and ability to recall the information by making you do it again.
Blended Learning – It’s Just as Good as Face to Face
Because physio is a hands on profession we have always seen in person / face to face learning as the only way to become a better clincian. When I was a younger I fell into this trap and I couldn’t have been more wrong. I wish I realised online, blended and distance learning was all a great way of developing both academic and hands on skills.
Physiotherapy curriculums are characterised by a combination of theory, practical skills training and learning in practice, and until now digital learning has not been fully embraced by our profession and digital learning has been criticised for not being grounded from a theoretical learning perspective.
This is interesting as for a long time there has been evidence to demonstrate the effectiveness of using digital learning for healthcare education. Since the pandemic there has been a boom in research evaluating digital learning for our profession. One example is a systematic review which aimed to readress this balance by identifying and investigating the effectiveness of digital learning designs in physiotherapy education.
The main take away from this systematic review is that blended learning showed at least equal if not statistically better learning outcomes compared to traditional methods. Of the different blended learning approaches flipped classroom was the most commonly used and also had the biggest positive effect on learning outcomes.
Interestingly multiple choice questions (MCQ) were shown to be a useful and effective learning tool which isn’t the same as active recall. In most cases all you are doing with MCQ is choosing the answer which seems right which is recognition not recall.
We have seen some awesome examples of novel approached to blended learning using Physioplus during the pandemic. Members of The Physiotherapy Association of Saint Lucia (PASL) chose a course to complete individually and then they came otgether to discuss the clinical implications and reflect on the new knowledge as a group.
This adds an extra active learning dimension to the online learning element by reflecting and sharing different interpretations on the new knowledge and skills together. By doing this motivation is kept and a culture of evidence based practice is built amongst the group.
Refelections on Learning
When I was younger no one really took the time to explain to me the importance of understanding how to learn and how to think of my own learning journey. Ultimately we are all on the same journey, just at different stages. This is no more evident then when watching the Wired ‘Explains’ series where an expert explains a difficult concept in five levels of difficulty starting at 5-year old ending at PhD level.
Ultimately the way for you to learn faster is to understand how to learn and remember more efficiently. Once you get your head around that you will take your understanding to new levels. One thing I hope is that the way we create Physioplus courses enables you to do this.