CHAPTER 1
Learning

Introduction

By reading this book, you may have already made a decision to reflect on how you teach and learn. You may be thinking about experiences you have had, positive and negative, and want the opportunity to understand why sometimes education is great, and sometimes it really is not. Or perhaps you have been told that you have to read this text and feel just a bit resentful about that. Whatever your motivations this is a chance to explore some of the issues that underpin our responses to education, whether we are teaching, learning or engaged in a bit of both.

Theories of learning have historically been based on observations of the way people learn, and for academics they help to bring some understanding to learning behaviours. The educators who write the curriculums and course materials for life support courses have applied some of these theories to ensure that learning is optimised for our target learners.

In this chapter, we will give a broad overview of relevant learning theories. We will then look in the rest of the book at how we can apply these principles when we are facilitating others.

First, however, we will consider a number of evidence-based strategies that can be used to make us better learners, so that we can consciously and mindfully use this knowledge when we are teaching.

Learning outcomes

This chapter will enable you to:

• Identify how our brains hold and retrieve information
• Employ effective learning strategies
• Compare and contrast teacher-centred and learner-centred approaches to education
• Consider some of the educational theories that underpin life support courses

How we learn

Working memory

It is generally agreed that we have a long-term memory and a working memory (short-term memory). Long-term memory has a limitless storage system. You might, for example, have stored your childhood car registration in your long-term memory and be able to recall it years later. In contrast, working memory is thought to only last around 30 seconds. An example is remembering a phone number for long enough to type it into your phone. Unless this specific piece of information is attended to multiple times it will not pass into long-term memory and will be forgotten.

The role of our working memory is not only to hold pieces of information for a short period but also to process that information (i.e. do something with it).

All new memories have to pass through working memory in order to make it into long-term memory. Working memory has a limit and is easily overloaded. Most of us, without any specific brain training, are able to hold in our working memory a surprisingly small number of discrete pieces of information. This has implications for our capacities as learners. If we are presented with too much new information, we cannot process it all. Imagine needing to check the oil level in a car. For somebody who already knows where the dipstick is located and what it looks like, the new information is just the process of checking how far up the oil level reaches. However, for the person who does not know where the dipstick is located, what it looks like, how to open the bonnet of their car, etc., there is a lot more new information to take on and this second person has significantly less working space available to use for processing. It seems inevitable that in this instance they are less likely to retain all of the steps, and therefore to successfully check the oil level, without considerable guidance and input.

Schema

Fortunately, we have ways of managing the limits of our working memory. Our brains are good at finding and forming patterns or structures that help us group pieces of information and understand how complex processes work. This is described as 'chunking'; creating groups or sets of familiar concepts to help retrieve more information, more quickly. We instinctively organise our knowledge, and, as we engage in new learning and take in new information, we connect it to pre-existing knowledge, beliefs or experiences.

Example

If asked to remember a random number such as 48792361 you might struggle. If asked to remember 24681357 it is likely that your brain will 'chunk' this information into 2468 and 1357 so that you are only having to remember two discrete pieces rather than eight separate ones. In order to chunk this information, you will probably have drawn on pre-existing knowledge about number sequencing, odd and even numbers or your 2 times table.

Experts typically have a host of these short cuts which save them expending valuable working memory on too many discrete 'pieces' of information. A professional tennis player does not have to think through all the details of each return shot that they make, they make rapid decisions based on a number of previously experienced episodes. The novice watching them might be overawed by their processing capacity, as they seem able to assess more information with greater speed than a beginner. Essentially, we use existing experience to make sense of new information, and the more experiences we have, the more short cuts we have to draw on. This is a particularly useful concept when trying to make ourselves increasingly adept as learners. It helps if we take as many opportunities as possible to link new learning with knowledge we already have. Equally it helps if teachers or facilitators provide spaces for the learners to make connections that are personal to them.

You may have observed expert team leaders at a cardiac arrest, and noticed their capacity to make quick decisions, rapidly evaluating information through chunking. Their use of schema is essential and efficient, and, through providing structure and frameworks, allows experts to achieve far more than they would if they always had to re-remember and re-process each of the separate elements of any action or knowledge. The problem with this method of information retrieval is that it can lead us to employ stereotypes or make assumptions without always considering the bigger picture. This is referred to as 'cognitive bias' and it is because of concerns about the negative effects of cognitive biases that we need to use the rest of our team to help check our actions and prevent ourselves from making mistakes based on erroneous assumptions. We explore more about cognitive biases, team working and team leadership in the non-technical skills chapter of this book (Chapter 12).

Retrieval practice

The transition from working memory to long-term memory can be arduous but rewarding. For most of us, it is not quite as simple as attending to a piece of information once and then it being miraculously stored in our long-term memory. The information has to be actively retrieved and attended to multiple times in order for it to be fully embedded in long-term memory. This process is referred to as retrieval practice. If you have ever used flashcards to help study for an exam with a question on one side and the answer on the back, you have done retrieval practice. The more this is done the stronger the neural pathways become, and the easier that piece of information is to retrieve.

Sadly, for good learning to occur, anything that feels efficient is likely to be the opposite. Take as an example a habit you may or may not have of reading through a text book in preparation for an exam and highlighting the important bits of information. You might even find that you are highlighting the same bits you identified last time you read it. The act of highlighting is such a low-level activity that very little is required of you in terms of active investment. The chances are that this, like taking photographs of a lecturer's slides, might make you feel good, but will not guarantee that you have learned much. What is far more beneficial in terms of long-term learning is to do any of the following:

• Challenge yourself to write the concepts in your own words, or to draw a concept map
• Make a list of the key facts
• Explain them to a friend or teach a less experienced colleague

These strategies will all take much longer than using a highlighter pen but will avoid what Brown et al. (2014) call 'the illusion of knowing'. Reading something that we have read before feels familiar, we recognise some of it and therefore feel like we know it.

Retrieval practice is such a useful tool for us to use because it shifts information into our long-term memory: the more often we retrieve it, the better we learn it; the more connections we make with other pieces of information, the stronger the connections become.

Retrieval practice is also useful as it highlights gaps in our knowledge. If we test ourselves, and do not come up with the right answers, we have clear evidence that we do not know the answer. Unfortunately, as Kruger and Dunning (1999) explain, we are rather bad at judging our own abilities, particularly non-technical skills, and we tend to overinflate our abilities. This is also discussed in more detail in Chapter 12.

Retrieval practice can be done at four different levels of increasing difficulty (Figure 1.1).

Figure 1.1 Retrieval...