The Content Jungle
The overgrown content of undergraduate medical education creates a jungle in which teachers and students alike become entangled and where some even meet their death. Many of you may have had a near-death experience as students. In this Pod Cast I will outline the pathophysiology of the overcrowded content jungle, the resulting syndromes, and some effective treatments.
I am Marcel D’Eon, Director of Educational Support and Development. I completed my PhD in Educational Administration at the U of S in 1997 and immediately joined the College of Medicine. I had a short career as a naval officer and then worked as a classroom teacher for 16 years. My interests are in faculty development, educational change, and how people learn.
Overcrowding in the curriculum has been with us for decades. Even Abraham Flexner at the turn of the twentieth century noted the debilitating effect of cognitive stuffing and educators since him have added their voices to the common lament: there’s too much to learn. However, we must do something about it. Students, when faced with an overwhelming amount of material to learn initiate a survival mechanism known as cramming (cognitive stuffing) which produces Bulimic Learning. They stuff as much in as they can for a short period of time and after the examination their brains empty. Clearly this is a waste of time and effort on the part of students and teachers.
Effective and efficient learning occurs as new information is connected to existing knowledge networks within the brain. In fact, nothing can be learned that is not in some way connected to what is already known. To commit something to memory it must have some connection to what is already in memory. The more significant the connection is the better and more durable is the learning. When our capacity is overwhelmed through overcrowding we do not have time to make the necessary connections to existing knowledge networks that will allow us to remember what we have studied. Our metaphoric knowledge receptors are overwhelmed. Little bits of information float freely in the virtual knowledge space within our minds and are rapidly lost. Students hope they do not escape until at least after the exam!
Students apply themselves to the task of learning a mountain of information, (a little like trying to take a drink from a fire hydrant) but do not seem to be learning. They cram untold amounts of information into their brains and think they are learning but they are not. They suffer from an illusion of learning because they merely recognize a term. They remember having seen it once but they can’t quite remember what it means or how it related to medicine. In the most extreme form students may not even remember ever seeing the word before!
The solution to Bulimic Learning is to teach less and hence create the conditions by which our students will learn more. Less is more. What happens when we attempt to ease content overcrowding and deny cognitive stuffing? First, students have more time to make the necessary connections and practice their new understandings through application to cases and exercises provided by astute teachers. This results in firm and lasting learning. Then, these newly modified and enhanced knowledge networks become anchors, hooks, and connections for further learning which might happen in class or through self-directed learning. In the end, the students will remember more for longer periods of time and be able to pick up additional knowledge skills and attitudes more effectively and efficiently. Though we have taught less and worry that we have done our students a disservice we have actually helped them to learn more and to be in a position to build quickly and easily on that foundation.
Don’t let the content jungle trap you and your students. Trim down the amount of material you try to teach in a session to a reasonable amount based on the prior knowledge of your students. Meet them where they are and help them to build solidly on the existing learning that is already in place. Engage them in active learning exercises such as case discussions in teams where they can integrate their new knowledge with what they already know and avoid giving your students any reason to turn to Bulimic Learning that will trap them in the content jungle.