Make it Stick: Shaping Our Teaching Using Effective Learning Strategies
Federico Puerta Martinez, MD, Matthew Gao, MD
Published December 2, 2024 | Clinics in Medical Education
Issue 4 | Volume 1 | November 2024
As anesthesiology educators, we hold the key to guiding students toward learning strategies that don’t just get them through exams but equip them with the skills for real-world situations. Let’s explore some evidence-based approaches that transform the learning experience, deepen understanding, and build lasting retention of complex concepts—making learning truly “stick.”
Understanding How We Learn
Broadly speaking, the process of learning can be broken down into three stages. It all starts with encoding—transforming sensory perceptions into meaningful representations in the brain to form short-term memory. This stage requires attention and focus; without these, information is quickly lost. Next is consolidation, where new information is stored in long-term memory. Finally, retrieval allows us to access this information when we need it. So, beyond just paying attention, what can we do to effectively learn—and help our students learn better?
Why Active Learning Matters?
Cramming, highlighting, and rereading notes might feel productive, but research shows that these passive techniques often create an “illusion of mastery,” where students feel they’re learning with- out actually retaining much. An example of this could be to start some classes or lectures with low- stakes, quick-fire review questions on key concepts from the previous session, especially practicaland relevant points. But remember, this isn’t about evaluation (i.e. measuring knowledge) but about using testing as a learning tool. Accompany each quiz with constructive feedback, explaining both the correct answers and the reasoning behind them. This approach, known as Retrieval Practice, is one of the most effective ways to learn. It encourages students to actively recall and consolidate knowledge, strengthening their memory and reinforcing prior learning.
Retrieval, Spaced and Interleaved Practice: Building Stronger Foundations
While many of us have crammed for exams, spaced practice—revisiting material over time—is far more effective. Pair this with interleaved practice, which involves mixing topics in a way that requires students to differentiate and connect them. Consider, for example, a teaching session on neuromoni- toring during vascular cases. It might be appropriate to revisit cerebral blood flow and brain protection concepts during endarterectomy surgeries. Or, in an arrhythmia workshop, interleave discussions of cardioversion and pacing procedural steps. The key concept here is that by interleaving principles or rules that differentiate types of problems, students develop “discrimination skills,” helping them select the right approach even in unfamiliar scenarios. This approach leads to a deeper, more flexible under- standing, making it easier to apply concepts in unpredictable clinical settings.
Beyond Memorization: Foster Effective Reasoning Skills
To deepen understanding and retention, encourage students to engage in cognitive processes that go beyond memorization. These strategies help students develop critical thinking and a more comprehen- sive grasp of the material. Some principles with suggested examples include:
Elaboration: The process of linking new information to previous knowledge (making connections). Encourage students to explain concepts in their own words and link new information to what they already know. Case-based learning (CBL) is an excellent strategy for this, as it allows students to justify specific approaches based on prior knowledge of related topics.
Generation: Involves the act of trying to solve a problem before being taught the solution. This is believed to enhance learning, even when the initial answer to the problem is not correct. Generation is the theoretical foundation of the Problem-Based Learning (PBL) approach.
Reflection: Prompt students to reflect on what they’ve learned and how they applied it. This is evident in debriefing sessions after simulation scenarios but can also be used in many other contexts.
Calibration: Help students align their perceptions with their actual performance by providing regular, constructive feedback. This works hand in hand with self-reflection and objective assessments, improving their ability to accurately judge their own knowledge.
Encourage a Growth Mindset for Development and Resilience
Cultivating a growth mindset means students see their skills as continually developable through effort and learning from mistakes, unlike a fixed mindset, in which they view their abilities as unchange- able—a perspective that can lead to frustration in challenging situations.
Consider for example observing a student failing at an attempt to place an epidural catheter, instead of focusing on the outcome, one could provide feedback that focuses on their technique and progress, rather than just the outcome. For instance, one could say, “You’re not quite there yet, but here’s how we can improve.” This approach helps students see setbacks as part of their learning curve, reducing performance anxiety and encouraging persistence.
Use Concrete Examples and Deliberate Practice
Abstract concepts can feel daunting, but using concrete examples makes them more accessible. Combine this with deliberate practice, where complex skills are broken down into manageable steps, allowing students to master each component before putting everything together.
By embracing these evidence-based strategies, we can foster a dynamic, supportive learning environment where students don’t just memorize but understand, apply, and grow—transforming them into more competent and, hopefully, more resilient anesthesiologists.
REFERENCES
1. Brown, Peter C., Henry L. Roediger III, and Mark A. McDaniel. Make It Stick: The Science