SOS Glossary

Teacher-centered approach: This approach to medical education can be called the "conventional" approach. Teachers deliver factual content to students who transfer the factual material back to the teacher at the required moment. Objective criteria can be set to establish minimum achievement levels. Those students that achieve the minimal level, "pass", those that do not, "fail". To teach is taken to mean that the teacher conveys information to students and the teachers decides what to teach, how to organize the subject material, and the means of communicating the material to students. Learning is judged by how well students can report back what the teacher has told them. How students learn is irrelevant in this approach.

Student-centered, or Learner-centered approach: This approach stresses a knowledge of how students learn. Students learn when incoming information can be related to knowledge that is already stored. To "teach" in this approach consists of getting students involved in the actual construction of knowledge. The roles of teacher and student are reversible whereby students teach each other, and they teach the teacher, not only about the subject matter, but also about how people learn. Problem-based learning is an example of this approach. A group of students, facilitated by a teacher, determine what knowledge is needed to understand and manage a clinical scenario that typifies an actual clinical case. The group works together to construct the necessary knowledge base. The student-centered approach takes advantage of the fact that new knowledge is acquired by extending and revising prior knowledge, that new ideas acquire meaning when they are presented in relationship to one another, and that knowledge becomes usable when it is acquired in situations where it can be applied to concrete problem solving. This approach also teaches the skills necessary for students to become life-long learners.

Short term and long term memory: Learning refers to a process that mediates a change in behavior as a result of experience. Memory is the end point of the process and refers to the actual storage of the information. Memory involves various stages. The number of stages and the underlying mechanisms of each are areas of debate. However, the distinction between short term and long term memory have clinical importance as well as some usefulness in thinking about "learning". Short term memory is that which is affected by head trauma that results in retrograde amnesia. Memory for recent events, or the events surrounding the trauma, is lost, but memory of older events remains unchanged. Short term memory banks have a limited capacity and the information stored in the banks is very labile. That is, the information does not hang around the brain very long unless it is acted upon, used, rehearsed or reviewed in a repetitive manner. Then the information is presumably moved into long term memory. Once in long term storage, the information (knowledge) forms the framework around which new ideas and knowledge gained from experience can be organized. The term working memory is applied to the mental activity that occurs when problem solving entails a series of decision processes, many of which require conscious attention. The decisions depend upon information that derives from "thinking" that draws on long term memory stores. If more information is needed, the problem solver can seek out that information and , using the frame of previous knowledge, incorporate the new information into and around the long term memory traces.

Motivation: Students admitted to Kansas University School of Medicine all have been achievers during their premedical education. All have high GPAs and have achieved above standard on the MCAT. Most have been in the upper 10% of their classes. Most were motivated by the understanding that high performance was needed to get into medical school. For that performance, most received many positive strokes, not for being a person, but for being an achiever. Unfortunately, not every student admitted to medical school can be in the top 10% of their class. Also unfortunately, the self image of many medical students is affected by how well they perform academically. The fear of failure motivates some students to obsessively strive for the highest standing in their class, often with little feeling of accomplishment. I have had students come into my office sweating perfusely on a cold day because they had only achieved a 90% on an examination. Their self image of perfection had been tarnished by an examination score. Some medical students on the other end of the performance scale, with self images that are badly scarred, simply withdraw from the fray because working very hard for long periods and doing progressively worse on exams is just too much to bear. Neither of the two types of students will tell anyone else of their fears because of the "shame" of not being perfect or not doing well, and the need to maintain a successful image.

So, what does motivation mean? It means that self image is not tied to performance. It means a change of attitude if self image is tied to performance. It means a strong desire that is acted upon when change is needed to be successful. It is basically the fire that you bring to your whole life, including your medical studies. It will supply the heat that will make your learning reaction produce a yield that satisfies you in the balance of things. A smart student will not let the school pour water on that fire. A smart student will also click on SOS-Connections to seek out a qualified counselor to assist with problems or as a preventative measure against problems.