Cognitive Apprenticeship Statewide Campus System, Michigan State School of Osteopathic Medicine 2011

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1 Statewide Campus System, Michigan State School of Osteopathic Medicine 2011 Gloria Kuhn, DO, PhD Wayne State University, School of Medicine The is a method of teaching aimed primarily at teaching the thought processes that experts use to handle/solve complex tasks and problems. The focus of this learning-through-guided-experience is on cognitive and metacognitive skills, rather than on the physical skills and processes of traditional apprenticeships. Applying apprenticeship methods to largely cognitive skills requires the externalization of processes that are usually carried out internally. This is done by verbal communication between the learner and teacher. This method of teaching includes a number of components. It was first proposed by Alan Collins and colleagues in It is widely used in both adults and children. Studies have shown it to be effective although few studies have demonstrated it to be statistically superior to other forms of education (this is extremely difficult to do in educational research). Comparison of the Cognitive and Traditional Apprenticeships Table 1 Traditional Apprenticeship Thinking is made explicit by Observing performance of a task which explanation, answering questions, and is obvious. Cognitive component not asking learner to explain/elaborate to obvious and may be open to ensure understanding. misinterpretation. In complex domains such as medicine and law a great deal of knowledge is acquired in formal didactic settings. When the learners enter the workplace they are not always able to use (transfer) what they have learned for solving problem s. All learning takes place in the workplace and actions and steps taken by the expert are copied until the apprentice is skilled enough in performance of the subtasks and sequencing to advance to more complex tasks. The apprenticeship advancement is based on competency. It is obvious to the apprentice when a task is not performed to the correct level of competence. 1

2 Table 1 cont. The challenge of the cognitive apprenticeship is to present a range of tasks in a real world setting (situated learning) while at the same time making explicit the reasoning of the teacher and encouraging students to think about the reasoning, construct a mental model (mental schema) and reflect on how this new knowledge can be used and expanded upon. Cognitive apprenticeship adds to the traditional model a structured way of teaching both cognition (content) and metacognition (skills of learning and correct performance of problem solving). Not only is knowledge needed in problem solving but also the learner needs to practice in decision making and problem solving. The skills to be learned are inherent in the task itself and so success becomes self-evident. The use of the apprenticeship model continues to this day in medicine as well as other fields and serves an important purpose. 1. Modeling Components of the 2. Coaching 3. Articulation 4. Reflection 5. Scaffolding and Fading 6. Exploration 1. Modeling -- involves an expert's carrying out a task so that student can observe and build a conceptual model of the processes that are required to accomplish the task. For example, a teacher might model the reading process by reading aloud in one voice, while verbalizing her thought processes (summarize what she just read, what she thinks might happen next) in another voice. 2

3 Medical example: Taking this analogy to medicine, an attending physician could model the obtaining of a history from a patient with a particular complaint. The physician would describe why they are asking the questions they ask and how this information will help them determine a differential diagnosis which then tells them what elements need to be included in the physical exam, what tests to order, and finally how they are integrating all of this information to form a diagnosis. 2. Coaching - consists of observing students while they carry out a task and offering hints, feedback, modeling, reminders, etc. Medical example: observing a learner perform an exam of the abdomen and giving feedback on the performance. 3. Articulation - includes any method of getting students to articulate their knowledge, reasoning, or problem-solving processes. Medical example: having a medical student or resident present a case. 4. Reflection - enables students to compare their own problem-solving processes with those of an expert or another student. Medical example: Asking a resident what they learned as a result of having seen a patient. 5. Exploration - involves pushing students into a mode of problem solving on their own. Forcing them to do exploration is critical if they are to learn how to frame questions or problems that are interesting and that they can solve. Medical example: Allowing residents to function as captain of the code team. Glossary of Terms Cognition: the act or process of knowing. The term refers to a faculty for the processing of information, applying knowledge, and changing preferences. : is a method of teaching aimed primarily at teaching the mental processes that experts use to handle complex tasks. Inert Knowledge: The term was first coined by Alfed North Whitehead. Inert knowledge is that information which the student can express but not use. It is one of the reasons learners have difficulty with the transfer of knowledge. Medical students frequently have inert knowledge. This explains why they may have 3

4 information which they can t apply in the clinical setting to evaluate and treat patients. The knowledge is not "forgotten" exactly, but it is inaccessible. Metacognition: knowing about knowing. Metacognition refers to one s knowledge concerning one s own cognitive processes or anything related to them, e.g., the learning-relevant properties of information or data. For example, I am engaging in metacognition if I notice that I am having more trouble learning A than B; if it strikes me that I should double check C before accepting it as fact. J. H. Flavell (1976, p. 232) Mental schema: A mental program or formula that has been proposed by Jean Piaget and other psychologists as a means by which people represent the world and regulate their interactions with it. The term "schema" is used in psychology to refer to a mental framework that allows you to make sense of aspects of your environment Situated cognition: knowledge or knowing is linked to doing and all knowledge is situated in activity bound to social, cultural and physical contexts. Knowledge taken out of context may not have any meaning and is thought to be one of the reasons it is difficult to use what has been learned in a classroom setting to solve real world problems. Proponents of the cognitive apprenticeship believe that learning using this method is situated learning and leads to better transfer of knowledge both from the classroom (when the cognitive apprenticeship is used as the method of teaching in the classroom) and in the workplace setting. Transfer of knowledge: use of what has been learned in one setting to solve problems or learn new material in another setting. When students know something but can t transfer it, it is often referred to as inert knowledge. Further Reading[1] [1-7] 1. Anderson, J.R., L.M. Reder, and H.A. Simon, Situated Learning and Education. Educational Researcher, (4): p Collins, A., J. Brown, and S. Newman, eds. : Teaching the Crafts of Reading, Writing, and Mathematics. Knowing, Learning, and Instruction: Essays in Honor of Robert Glaser, ed. L. Resnick1989, Lawrence Erlbaum Associates: Hillsdale, New Jersey. 3. Collins, A., J. Seely, and Y. Brown, : Making Thinking Visible. American Educator, 1991(Winter): p Flavell, J.H., ed. Metacognitive aspects of problem solving. The nature of intelligence, ed. L. Resnick1976, Lawrence Erlbaum and Associates: Hillsdale, NJ:. 5. Franzese, C.B. and S.P. Stringer, The evolution of surgical training: perspectives on educational models from the past to the future. Otolaryngol Clin North Am, (6): p , vii. 4

5 6. Kassirer, J.P., Teaching clinical reasoning: Case-based and coached. Acad Med. 85(7): p Paz Dennen, V., in Educational Practice: Research on Scaffolding, Modeling, Mentoring, and Coaching as Instructional Strategies. 2nd ed. Handbook of Research on Educational Communications and Technology D.H. Jonassen2004, Lawrence Erlbaum Associates Publishers Mahwah, NJ, US. pp