cognitive apprenticeship
DESCRIPTION
Cognitive Apprenticeship. Presented May 19, 2014 Gloria Kuhn, DO, PhD Vice Chair, Academic Affairs Wayne State University School of Medicine. CME Information. Objectives: At the conclusion of this activity, learners should be able to: - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/1.jpg)
Cognitive ApprenticeshipPresented May 19, 2014
Gloria Kuhn, DO, PhDVice Chair, Academic Affairs
Wayne State University School of Medicine
![Page 2: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/2.jpg)
CME InformationObjectives: At the conclusion of this activity, learners should be able to:•List the components of the cognitive apprenticeship and its value in teaching•List the steps in deliberate practice and how it fosters competence and eventual expertise•Compare and contrast the cognitive apprenticeship and deliberate practice•State strategies for integrating both of these methods into teaching CME Accreditation and Credit DesignationWilliam Beaumont Hospital is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
William Beaumont Hospital designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity is eligible for meaningful participation (MP) credits.
View the CME handout for instructions on claiming credits.
![Page 3: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/3.jpg)
Medical Education Week PostersAvailable for viewing May 19-23 at:
• Beaumont Royal Oak – Administration Building & Suite 100
• Beaumont Troy – Atrium*
• Beaumont Grosse Pointe – Healing Garden Corridor
• OUWB O’Dowd Hall
Abstracts available:
www.oakland.edu/medicine/mededweek2014/posters
*Due to Magnet Site visit, posters only available May 19 & 20
![Page 4: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/4.jpg)
Consultation Session: Preparing Dossier Promotion Packets
Deirdre Pitts, Director of Faculty Affairs and Professional Development, will be available to answer questions about the process of preparing a dossier promotion packet.
Hours and locations:
Monday, May 19 and Tuesday, May 20, 2014 9 a.m. – 3 p.m.Administration Building West Conference Room B
Wednesday, May 21, 2014 9 a.m. – 3 p.m.Administration Building East CEME office
![Page 5: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/5.jpg)
DisclosureDr. Kuhn and all other individuals involved with this activity as planners or content reviewers have no relationship(s) with industry to disclose relative to the content of this CME activity.
Dr. Gloria Kuhn is the Vice-Chair for Academic Affairs for the Department of Emergency Medicine at Wayne State University School of Medicine. She completed a residency in emergency medicine at Detroit General Hospital. During this time Dr. Kuhn became interested in medical education. In 1982 she started the first emergency medicine residency at Mt. Carmel Mercy Hospital. This program was the third emergency medicine residency in Detroit and is now one of two emergency residencies sponsored by Wayne State University. In 1990 Dr. Kuhn entered a doctoral program in the College of Education at WSU and received her doctorate in Instructional Technology 1998. Her stated goal during this program was to “teach doctors to teach and assist residents and medical students to learn.” In pursuit of this goal she has been active in faculty development in her department, in the medical school and at a national level. Evidence of her dedication to faculty development is seen in her service on school of medicine committees for faculty development, teaching courses pertaining to education both in her department and at other universities and performing research in education and faculty development. Her work developing national seminars for the Council of Residency Directors in Emergency Medicine that aid junior faculty in their development, and her teaching at the national meetings of the Society of Academic Emergency Medicine on both instruction and faculty development have provided profound direction for her specialty
Faculty Information
![Page 6: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/6.jpg)
"Teaching How to Think Like a Doctor"
“Making Thinking Visible”
Beaumont Hospital2014
Gloria Kuhn, D.O., Ph.D.Wayne State University School of Medicine
6
![Page 7: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/7.jpg)
Overview and Objectives
Define
Components
Traditional apprenticeship
Deliberate practice
SBAR
Advantages
7
![Page 8: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/8.jpg)
The Goal of Medical School?
8
![Page 9: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/9.jpg)
9
![Page 10: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/10.jpg)
The Goals of the Residency?
Become doctors
Study a lot
Serve patients
Be professional
ACGME Competencies
Milestones10
![Page 11: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/11.jpg)
11
![Page 12: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/12.jpg)
12
![Page 13: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/13.jpg)
The Goal of a Residency??
13
![Page 14: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/14.jpg)
Overview and Objectives
Define
Components
Traditional apprenticeship
Deliberate practice
SBAR
Advantages14
![Page 15: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/15.jpg)
Outcomes
1. List the components of the
cognitive apprenticeship and its value
in teaching
2. List the steps in deliberate practice
and how it fosters competence and
eventual expertise
15
![Page 16: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/16.jpg)
Outcomes cont.
3. Compare and contrast the cognitive
apprenticeship, deliberate practice, and
traditional apprenticeship
4. State strategies for integrating all of
these methods into teaching
16
![Page 17: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/17.jpg)
My Goal
Three ModelsCognitive Apprenticeship
Deliberate PracticeTraditional Apprenticeship
SBAR
17
![Page 18: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/18.jpg)
DefinitionCognitive Apprenticeship
Use of the apprentice model to
support learning in the cognitive
domain to gain cognitive and
metacognitive skills.
18
![Page 19: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/19.jpg)
Cognitive Apprenticeship
Purposes:
–see the “thinking of the expert”
–understand the “reasoning” expert
uses to solve-problems
– learn by solving real life problems
–“situated” learning19
![Page 20: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/20.jpg)
Strategies for implementation
–Faculty / learner development
–Classroom
–Bedside Discussion
20
![Page 21: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/21.jpg)
21
Strategies
![Page 22: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/22.jpg)
Proven Model
Deliberate Practice
22
1. Goal oriented task 2. Motivation
6. Reflection 4. Feedback
3. Practice
6. Repetition
![Page 23: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/23.jpg)
Why ???
What Happens in the Classroom Stays in the
Classroom
23
Workplace
![Page 24: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/24.jpg)
Examples
Brazilian children
24
![Page 25: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/25.jpg)
Myself : first case of shock
25
![Page 26: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/26.jpg)
TransferTraditional classroom education–Learning???
–Unable to use solve real problems
–“inert” knowledge
–“real life” abilities not used in classroom 26
![Page 27: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/27.jpg)
Cognitive Apprenticeship
Modeling
Coaching
Articulation
Reflection
Exploration
Scaffolding27
![Page 28: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/28.jpg)
Purpose
Expertise
–Thinking
–Metacognitive skills
–Become
28
You
![Page 29: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/29.jpg)
Definitions
Cognitive
Metacognitive
Strategies
Classroom Situation (situated learning)
29
Transfer
![Page 30: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/30.jpg)
Comparison
Traditional Apprenticeship (TA)
Long history
Has worked for thousands of years
Empirical proof
Cognitive Apprenticeship (CA)
Recent
Theoretical support
Research support
30
![Page 31: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/31.jpg)
Comparison cont.
TA
Embedded in work
Steps / end products
Obvious
Competency based
CA
Thinking of expert
Strategies problem solving/ monitoring
Speech
Competency based ? 31
![Page 32: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/32.jpg)
Radical???
Apprenticeship
32
Modeling Coaching
Scaffolding / fading ArticulationReflection
Exploration
![Page 33: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/33.jpg)
Theory
Deliberate Practice
33
Goal oriented task Motivation
Feedback Reflection
Repetition
![Page 34: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/34.jpg)
Proof is in the Pudding
Reciprocal Teaching
Multiplication
Writing
Mathematics
34
![Page 35: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/35.jpg)
35
Implementation
![Page 36: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/36.jpg)
Not as Big a Rock
Have Trad. apprenticeship model
Deliberate practice model
Cog. Apprenticeship model
Thinking and explanation
36
![Page 37: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/37.jpg)
Culture Change
Faculty and residents–Shared development
–What
–Why
–How
37
![Page 38: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/38.jpg)
ImplementationBegin in Classroom
Case based teaching
Learners
38
1. Modeling
2. Reflection
ScaffoldingCoaching
CorrectionElaboration
Decision makingArticulationRefection
You
![Page 39: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/39.jpg)
Bedside
Beginning of rotation
Set the ground rules
How you will teach
Demonstrate and discuss
Medical students
Interns
39
![Page 40: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/40.jpg)
Preparing to See a Patient
CC
Vital signs
Information to obtain
–History
–PE
Discuss40
![Page 41: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/41.jpg)
The Presentation
Who
What
When
Where
“I have a 36 year old man with a CC of abdominal pain for the last 8 hours. Came on suddenly….
41
![Page 42: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/42.jpg)
Their Turn
Setting up for success
Looking at the chart
What information??
Permission to write it down and read
42
![Page 43: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/43.jpg)
Steps
1. Get chart
2. Reflect on information: chief complaint
3. Ask for help
4. See patient
43
![Page 44: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/44.jpg)
Paper
Organize thoughts Supports presenter Enables them to answer some questions Compare your decision making with the
learner Presentation more efficient Higher level discussion
44
![Page 45: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/45.jpg)
SBAR
Situation CC and Vital signs–HPI–Pertinent PMH (meds, allergies), FH,
SH, –PE
Background– Other information
45
![Page 46: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/46.jpg)
46
Paper
![Page 47: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/47.jpg)
SBARAssessment
Differential diagnosis
Why??
Information gathered
47
![Page 48: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/48.jpg)
RIME????
Reporter
Interpreter
48
![Page 49: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/49.jpg)
SBARRecommendations
49
![Page 50: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/50.jpg)
Reflection
Questions for me
Reading What I Learned
Changes
Questions for attending
50
![Page 51: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/51.jpg)
SBAR
Situation: HPI and PE, Meds, Allergies
Background: other information
Assessment
Recommendations
51
![Page 52: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/52.jpg)
52
![Page 53: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/53.jpg)
Uses
All residents– Faster
Struggling resident
Remediation
Feedback and evaluation
53
Expert thinking
![Page 54: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/54.jpg)
Why?Struggling Resident
Memorization
Confusion
Frustration
54
![Page 55: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/55.jpg)
SummaryMaking Thinking Explicit
Talking
55
![Page 56: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/56.jpg)
56
Deliberate Practice
![Page 57: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/57.jpg)
Thoughts
57
![Page 58: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/58.jpg)
SummaryCulture
Cognitive apprenticeship
Deliberate practice
Traditional apprenticeship
SBAR
Development
Integration
58
![Page 59: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/59.jpg)
Questions and Comments
59
![Page 60: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/60.jpg)
A Final Thought…
“Tell me and I forget. Show me and I
remember. Let me do and I understand.”
Confucius
60
![Page 61: Cognitive Apprenticeship](https://reader030.vdocuments.net/reader030/viewer/2022012918/568130af550346895d96bfe9/html5/thumbnails/61.jpg)
Reminder: Claim CME/MP Credits Online
https://www.surveymonkey.com/s/ouwb14
IMPORTANT ----- Credits must be claimed online by July 2, 2014; after this time, CME credit will no longer be available.
CME Activity Code is Required to Claim Credits – See CME Handout(Code varies based on viewing location)