PARADIGMS

Cognitivism emerged as a major paradigm of education in the 1950’s, largely in response to the behaviourist paradigm which offered no satisfactory explanation to account for certain types of learning (e.g. problem solving). Scientists wanted to open the black box of the mind and explore what was going on between stimulus and response.

Cognitivists are concerned with what learners know and how they come acquire it. Similar to behaviourism, changes in behaviour are observed, but as an indication of what is going on in the learner’s mind.

The overall purpose of education is for learners to be able to remember and apply information. Learning is not simply due to external stimuli, it is a result of mental or cognitive processes. The desired outcome of learning is perceiving information, processing, storing and retrieving this information (memory) and applying it (transfer). Learners are active participants in the learning process and teachers pay particular attention to how learners structure, organize, and sequence information to facilitate optimal processing (learning).

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Key Principles

Purpose of education is for learners to remember and apply information
Learning is a change in symbolic mental constructions (or schema)
Emphasis is on structuring, organizing, and sequencing information in the mind
Learners are information processors
Teachers facilitate optimal processing

Key Theorists

Noam Chomsky, 1928-

Noam Chomsky is an American linguist, philosopher, cognitive scientist, historian, political activist, and social critic. Chomsky argued that language could not be acquired purely through conditioning, and must be at least partly explained by the existence of some inner abilities.

Chomsky’s theory of universal grammar posits that native speakers are born with an innate ability to develop language because they are born with a cognitive sense of language. Chomsky suggests that there are patterns in grammar that children cannot learn simply through watching and listening to their caregivers. He also concludes that children must have some innate capacity for language that is independent of outside stimuli. By the age of about five years, almost all children have learned the same basic speech patterns, regardless of their home environment. Chomsky rationalizes that children innately posses the ability to construct grammar patterns on their own.

John Sweller, 1946-

John Sweller is an Australian educational psychologist best known for his theory about cognitive load.

Cognitive load refers to the total amount of mental effort being used in the working memory. Intrinsic cognitive loadis the effort associated with a specific topic. Extraneous cognitive load refers to the way information or tasks are presented to a learner.

Consider describing a square to a student. One can describe it visually or verbally. Certainly an instructor can describe a square in a verbal medium, but it takes just a second and far less effort to see what the instructor is talking about when a learner is shown a square. This is because it does not unduly load the learner with unnecessary or extraneous information.

Cognitive load theory informs instructional design decisions. Examples include: minimal information on slides, providing definitions ahead of time, and deleting extraneous examples.

Concepts & Practices in Health Professions Education

Test enhanced learning

In test enhanced learning, testing is used to help enhance long term retention of concepts or facts. Different types of tests (i.e. short answer, multiple choice, a combination of the two) are equally effective, suggesting that the benefits of testing are not tied to a specific type of retrieval practice, but rather retrieval practice in general. Progress testing is an example of test enhanced learning in practice, providing learners with repeated, spaced opportunities to practice retrieval of content knowledge.

Integrated instruction

Integrated instruction involves the purposeful and explicit integration of basic and clinical science knowledge during teaching. Basic science knowledge helps learners understand the causal mechanisms that govern why clinical features are associated with a specific disease. Understanding the “why” helps learners reason through their diagnostic decisions, based on what makes sense, rather than on the memorization of isolated features.

References

- Bandiera G, Kuper A, Mylopoulos M, Whitehead C, Ruetalo M, Kulasegaram K, Woods NN. Back from basics: integration of science and practice in medical education. Medical Education. 2018;52(1):78-85.
- Castillo JM, Park YS, Harris I, Cheung JJ, Sood L, Clark MD, Kulasegaram K, Brydges R, Norman G, Woods N. A critical narrative review of transfer of basic science knowledge in health professions education. Medical Education. 2018;52(6):592-604.
- Chandler P, Sweller J. Cognitive load theory and the format of instruction. Cognition and Instruction. 1991;8(4):293-332.
- Cheung JJ, Kulasegaram KM, Woods NN, Moulton CA, Ringsted CV, Brydges R. Knowing how and knowing why: testing the effect of instruction designed for cognitive integration on procedural skills transfer. Advances in Health Sciences Education. 2018;23(1):61-74.
- Chomsky N. Explanatory models in linguistics. In: Nagel E, Suppes P, Tarski A, eds. Stanford, Studies in Logic and the Foundations of Mathematics. California: Stanford University Press, 1966; pp. 528-550.
- Chomsky N. On the nature, use, and acquisition of language. In Ritchie WC, Bhatia TK, eds. Handbook of Child Language Acquisition. San Diego, CA: Academic Press, 1999; pp. 33-54
- Chomsky N. Poverty of stimulus: Unfinished business. Transcript of a presentation given at Johannes-Gutenberg University, Mainz. 2010 Mar 24.
- Evans N, Levinson SC. The myth of language universals: Language diversity and its importance for cognitive science. Behavioral and Brain Sciences. 2009;32(5):429-48.
- Mylopoulos M, Borschel DT, O’Brien T, Martimianakis S, Woods NN. Exploring integration in action: competencies as building blocks of expertise. Academic Medicine. 2017;92(12):1794-9.
- Roediger III HL, Karpicke JD. Test-enhanced learning: Taking memory tests improves long-term retention. Psychological Science. 2006;17(3):249-55.
- Smith MA, Karpicke JD. Retrieval practice with short-answer, multiple-choice, and hybrid tests. Memory. 2014;22(7):784-802.
- Sweller J. Cognitive load during problem solving: Effects on learning. Cognitive Science. 1988;12(2):257-85.