Whitney talks with education specialist Patti Shank on what the current research tells us about the most effective methods of learning. In Episode 17 Til and Whitney talked about how massage and manual therapists chart their own path of learning, so here we talk to an education expert to help us figure out more about what makes a good learning experience. Things we cover include:
- Common myths around learning, such as "learning styles"
- What makes a good video lesson?
- What is best done online vs. in the classroom?
- How important is feedback in the learning process?
- Is text better than video or vice versa?
Scroll down for the full video and transcript!
- Follow Patti on Twitter: @pattishank
- website: pattishank.com
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(The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)
Full Transcript (click me!)
The Thinking Practitioner Podcast:
Episode 93: Evidence-Informed Education (with Patti Shank)
Welcome to The Thinking Practitioner podcast.
A podcast where we dig into the fascinating issues, conditions, and quandaries in the massage and manual therapy world today.
I'm Whitney Lowe.
And I'm Til Luchau.
Welcome to The Thinking Practitioner.
And welcome to The Thinking Practitioner podcast, which is supported by Handspring Publishing. Their catalog has emerged as one of the leading collections of professional level books written, especially for body workers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness. Handspring has recently joined with Jessica Kingsley Publishers Integrative Health Singing Dragon Imprint. So head on over to their website at handspringpublishing.com to check out their long list of great titles, and be sure to use the code TTP at checkout for discount. Thanks again, Handspring.
And welcome everyone to The Thinking Practitioner. I am absolutely delighted to have a guest with me today, Patti Shank, who I've been following your work for almost probably going on two decades now or something like that. I think I mentioned this to you the other day. I'm a ranking member of the Patti Shank fan club, so thank you very much.
Thank you. I appreciate that.
Yeah, thank you. There's so much for being here today, and I'm going to dive into some interesting topics around education in our field. So Patti is an education specialist. Patti, can you tell us a little bit about your background, what you do, and where you are in the world? What's happening there?
Right. So my background is mostly in business and workplace learning. I started out in business related to operations and that sort of thing. And like many people who train others, I was good at training people, so I got tasked with training. And I realized pretty quickly that there was a lot more to training than just talking in PowerPoint slides.
So I went back to school. I have a PhD in instructional technology, and most of my background in the early years was healthcare. I'm a health educator and still do a lot of work in that field. I love working in healthcare. It's what I know. But today, mostly I help people select and implement strategies that are better for learning than typical.
Yeah. Wonderful. Well, one of the things that I wanted to do today is, Til and I got into this a little bit back on episode 17. We were talking about the issue that in our field for advanced level training, many of the practitioners essentially choose their own path of learning once they get out of entry level training. And without a standardized curriculum for a lot of the things that are necessary to work as a healthcare professional, you end up choosing a lot of your own educational options from continuing educational workshops and short training modules and things like that.
So I wanted to talk about some of those issues around, how do we choose good training, and how do we recognize things that are being done there? We're going to also go into a few other things as well.
One of the places that I wanted to start was one of my favorite things in following your work over the years has been how much you have delved into the learning science research and really shared with a lot of folks some things that we hear about a lot or thought were true that maybe weren't so true or maybe not so accurate. And a couple of big things like learning styles, which is something you hear about a lot. Tell us a little bit about that. We've sort of learned in the recent years that that's kind of a myth.
Yeah. And you would not be surprised, I think, to find out that I've had people who didn't hire me for help because I told them that what they were trying to do, which was to design for everybody's learning style, was just not even, first of all, even if it was true, which it isn't, it's not possible. What we know is that we all learn pretty much the same way.
Now, there are people who are divergent. I'm one of them by the way, who have to figure out how to learn better for themselves. And there are of course specialists on that for people with issues about learning. And I actually have friends who have used experts on that to help their children who were neurodivergent. And I just figured it out. I learned like everybody else does too, but I also have some issues. So what we want to do, with learning styles, the idea is that everybody has a style of learning. And if we don't use their style, they're going to have a harder time.
Well, that's not true. People may have preferences. For instance, I tend to like to read transcripts rather than watching videos, reading the transcript of it because I can go real fast. But that doesn't mean that's how I learn best. And in fact, we've learned from a lot of learning science that we don't learn best the way we think we learn best.
For instance, video is a really, really popular means of learning. But there's also a major downside that video is easy to watch and hard to learn from because you can just watch it, and let things move on the screen, and not process it. And that's one of the biggest things I learned from the research that I'm doing currently on video, that we have to put in things that make people process. Because otherwise, they can just go right through it and not learn anything. Just like the movie you watched last night.
Yeah, right. And I know you've been doing a lot with research on video and coming out with some really good stuff with your recent video series. I'd like to delve into that a little bit more, because we see more and more video instruction in our field as time goes on. So if video is maybe not always necessarily the ideal, what would be an ideal balance of video content and other things to make really good long-lasting learning experiences?
Well, in your field, body work, I think showing and telling at the same time has a major advantage. So it's probably one of the best for your field. There's a couple of things about it. One, that when you're showing somebody how to do something, show it from first person so that they can put their hands where the hands are, as opposed to from third person. And so showing how, or showing someone how to fix a computer. Or show it as if they're doing it, and the hands on the screen are their hands. And I thought that was fascinating, but really not super surprising. Because if you show it from third person, they have to transpose the image. How do I do this?
Yeah. What would be an example of third person as opposed to showing that in first person?
Showing the full person doing it. And you're watching someone else do it, but you're not doing it from your point of view. And you could still do that, but move the camera. So you're seeing it as if you're doing it.
So this is a lot about camera angles and the way in which that actually frames the image that you're creating there?
Right. Exactly. If you're showing someone how to fix a computer, rather than having a camera showing someone else fix the computer from their point of view, show it from the viewer's point of view.
And there's other things. And the big one on video, for me, the big aha for me is one, figure out what insights you want to show in that video. And make sure that people have to process those insights. The most common way to do this is through stopping the video and asking questions. And then answering those questions. Just going through a video and stopping them.
And you should tell people in advance. The video's going to stop and you're going to be asked questions. And it's the insights you want them to get from there. It's like, "What did you just see Brianna do that might have caused pain?" That sort of thing. If that's one of your insight. If another insight is at the position that someone's going to be in, the patient just said that it hurt, what position should you put them in? And those kinds of questions that stop, it doesn't have to be on screen. You can give them a PDF. But if you put it on screen, they're kind of stuck.
Where if you give them a PDF, they may or may not process.
Right. There's a lot of talk nowadays about video length in terms of, is there an ideal? For a while, it was big long form where we were watching DVDs of hour or more kinds of things. And now everybody's just into the shorter. The shorter, the shorter, the shorter, the shorter. It's got to be on TikTok for 10 seconds or something like that. So is there a sweet spot in terms of timeframe for good acquiring learning content from an instructional video or something like that?
Yes, but I take it with a grain of salt. The research that was done, I think by G-U-O, Guo in 2014 I think... And I can't believe I remember this, but things just come. He did research on length of videos for instructional videos. And he found that if they were over six minutes, they started decreasing in what people watched.
And here's what I would say. Look, we watch video all the time that's two hours. It's entertainment, right? We know that previous research has said that about 20 minutes is an attention span length. And I know that there's research out there that says we have the attention span of a gnat, but that wasn't actual research. And I've written about this. This was somebody talking about something somebody else said in a Microsoft presentation. It was a game of telephone where-
It was, yeah. That was the goldfish one, wasn't it? Wasn't that the-
Goldfish. Thank you. The goldfish one. So we don't really know. We know that people have longer attention for stories, that sort of thing. And so stories can be good, but they're not good for everything.
But I tend to think six minutes. Look, it depends on whether the person who is watching wants the information, and you have provided it in as concise way as possible, but not more concise than needed. Right?
Because I don't know how many times you've watched a video and said, "Wait a minute, what did they just do?" And you rewind it. And rewinding is fine. In fact, that's one of the things that I found out in the research, that one of the top benefits of video is if you put the player in, that they can rewind it. And we should not stop people. But sometimes it goes too fast.
Six minutes isn't very long. I would caution people who are developing video to maybe think, what's the right size chunk and what should be in this? Everything that should be in this, and nothing that shouldn't. Because people can make a video an hour and a half by just talking and bringing more people in to discuss it. And is that important for your learning objectives?
Yeah. One of the things that I see not only in our field, but across numerous fields too, is a battle about getting away from information dumping and towards more engaging types of learning experiences. Is there anything that you can highlight that we've seen from the research about how lasting learning experiences are if they're more something that's more engaging, as opposed to just spitting content out in a one way transmission to people.
Right. And it's one of the reasons why we recommend things that force people to process. Right? They're going to remember what they're forced to process. If we don't process much, we don't remember much of anything. So processing really helps that.
And it can happen in numerous ways. You could have a video and ask questions on screen. You could have a sheet that they fill out afterwards and send back into you. Most of us don't love that idea, because that makes the expense of doing training higher, because somebody has to review it. But you can do that same thing by giving people, "At the end, click on this and it'll take you to a page with the answers."
As far as en engagement goes, the real engagement from what I see is that it gives people what they need in a form that isn't problematic, and just cutaways, and all these things, and background music just makes the format problematic for learning. A lot of people do background music.
And we're talking over that, or we're trying to figure out what somebody's doing on that screen. If we can do simple, concise, everything that's needed for that topic, but nothing more. And when we say short, as short as we can, but not shorter.
So I don't see a problem with 20 minute videos, if that's how long it is to cover that one specific topic. And adding things into it that help them process, like, "What's going on here? What do you see happening?" And I mean, you could even do some engagement with somebody on the side who after it stops, talks about what they've seen, maybe in the top left corner. But again, you want to make sure that you're not having so much going on the screen that people don't know where to look.
Yeah, right. One of the other things that I wanted to look into a little bit here is that certainly I think... And this of course happened globally across the world. We saw just immense, tremendous changes in the education space because of Covid, and the whole emergency remote teaching thing that came on. Everybody just having to rush to put things online because they couldn't... It's like, "Okay, we got to turn this into an online course tomorrow," kind of thing, which we know is absolutely awful.
But I wanted to see if there's any of the things that have been explored a good bit in the research. Because I know there was a lot of stuff that was going on for so many years, trying to look at the comparisons between traditional classroom and training and online education. And was there a benefit, was one of them better than the other? And my interpretation of what we learned is it depends on what you're trying to do in the situation you're doing. But is there a difference in terms of acquisition of good learning experiences between something that's done in a classroom versus done in an online environment, if it's done well in both cases?
Right. Yeah. That's a really interesting question. And there's been lots of research on that. And the research that I'm thinking of right now is the use of video with other things. So cheat sheets, some reading, along with video. Video and online learning in general can be, and often is better. Not by a ton, but we tend to think more concisely when we're doing online for a number of reasons.
One is nobody wants to sit through six hours... I mean, that's one of the reasons that emergency online teaching failed. It failed because that's not good teaching. Making kids sit in front of a computer all day watching somebody teach, that's not what happens in the classroom.
In the classroom, somebody doesn't just teach. They ask questions. They stop and do thought experiments. They have people practice. In a classroom, we do all the things if it's good. And you said that if they're both good. The problem is that you can have bad online teaching and bad... I mean, we've all had horrible in-person teaching.
So if they're both good, they all have to include the right content, the right focus, answers to questions that people are going to have, the ability to practice. And people say, "Well, you can't practice body work online." It's like, you don't have to practice online. Everything doesn't have to be plugged in. Right?
One of my mentors, Joni Dunlap, said to me, "Digital learning doesn't have to have a plug." Some of it does probably, but you can go practice somewhere and you can have coaches. And we have to practice. We have to have activities. If we're just sitting in front of a computer talking to people, that's not good. I mean, it's information, but it's not great instruction.
So the research on video said that video instead of instruction of good instruction was slightly worse. Video with the other stuff was slightly better. So there's nothing wrong with video except that... I mean, there's some things that are harder to teach in video, like thinking skills and that sort of thing. And I don't know. I've had videos which could have been put into a two-page PDF that I would've understood better. And I don't know whether it's just because I'm neurodivergent. But we just have to do the same things that.
So the classroom, the K-12 classroom involves lots of stuff. And they replaced it with somebody talking at them. Well, of course it didn't work, and our kids suffered. But we really can't blame them. I mean, they didn't have time to get trained.
In the research, on video, in comparison, let's say a lot of times we have in our field something that might be moderately complex, topics around let's say anatomy and physiology or some things that are more complex. Is there a significant difference in terms of reading text as opposed to watching content and video in terms of acquisition and being able to really understand things that way?
Well, it depends how good the video is. A lot of times, I don't know about you, but when learning from text, there's things you can do that you can't do with video. And on video, you can do things. So it seems to me that... Because I haven't read research on one versus the other, but I have read research on both, and they have different capabilities.
So I'll give you an example. One of the things you can do with text is you can have a table of contents. And if you write that really well, so people know what's in there and how to find something quickly, you don't usually see that on video. But you can do that on video, and it's not hard to do. You just start out with a table of contents, and people can go back to the beginning and click on something, and it'll take them to that segment.
So that's certainly possible. There are things that are hard to understand unless you see them. And video is certainly much better. I mean, to me, one of the best things would be PowerPoint. Not PowerPoint, PDF with embedded videos. And you could move through the thing in order or go back to things earlier. And I've been playing with that a little. There's a problem. Some of that's really hard to make accessible. And I really don't want to create inaccessible training.
So we're getting to tools now that can take what we've said and put it on the screen for us. We don't have to go through the problem of exporting the audio out and importing it back in. There's tools now. I mean, our tools are getting better and better. So that's a problem, a lot of PDFs with lots of media in them. Because I'm thinking that would be a great way to do it. But yeah.
So one of the other things that we seem to have encountered a good bit in our field as a lot of the educators were forced to go into this online education thing during the pandemic, and a lot of people stayed doing that kind of thing, is a lot of them didn't have a fair amount of technical knowledge of what goes on to produce more complex learning experiences. So there was a lot of production of simple video, and PDFs, and things like that. And oftentimes, that makes a learning product where the teacher is absent at the end product, so you're just loading this onto the web and a person can go look at it anytime they want to and see things anytime, but there's nobody to ask questions to. And so how important do you think that is in terms of a good learning experience to be able to have access to whoever created the course, or the instructor, or some kind of mentor or coach around doing that?
That's actually a pretty complicated question. The issue of having a teacher as part of the training is nuanced. And seeing the instructor, on one hand, it causes cognitive load. On the other hand, if the instructor's really into what they're teaching, it increases engagement. So if it's simple, what's going on in a screen is simple. Having a teacher there who is really an engaging person themselves can be really helpful for engagement.
And you asked the question about, who do I ask questions? Because I always have questions when I'm watching videos, pretty much. It's like, "Well, what about this and how would I do it in this circumstance?" And allowing people to ask questions is really important for their learning, because we know any misunderstandings that people have completely color everything else they see. So they may not get it. They may get the wrong thing.
And so what I've done with my own course, I teach a multiple choice questions course. And I was teaching it with a lot of live se sessions so that people could ask me questions. The problem was I got people from Asia and we couldn't sync time zones. And I had someone from Australia who was watching the live sessions at 1:00 AM, which is not okay.
And so what I did instead is put in a discussion for them, and I monitor it daily. Probably three, four times a day to see what questions people have. And I answer them.
Two effects from that. One is you can ask a question any time. It doesn't have the engagement. And the research is clear about this. Asynchronous discussions don't have the engagement of synchronous discussions. They just don't. But people can get their questions answered.
There's another effect. The price of my course went down by a third. Went down by two-thirds. It's two-thirds less. Because I didn't have to be available every few days for two hours. So I suppose you could also have 30 minute, office hours. That's what I was looking for, where you're available to answer questions.
Again, if somebody is like... I have this in my course on a regular basis. It's like, "You said this, does that mean?" And I answer it that day and it's like, "Okay, I had that completely wrong." Well, what would've happened with that person if they didn't ask and they didn't get an answer? The rest of my course would've not made a whole lot of sense. "Why is she doing this when she said this?"
So I think asking questions, the ability to get quick answers, quick help with technology if they're having problems. And by the way, I get very little in terms of tech questions. Which either means people know how to use these things, or that the system works fine.
I have run into problems with, they're at work, they're trying to take my course, and my quizzes don't work. They're coming from Google, and that's lockdown. So I'm dealing with that as a technology issue. But quizzes, by the way... When I mean quizzes, I mean something that doesn't have a grade. It's just like help you remember, help you figure out if you understood. So that you know if you need to ask a question. Throughout are really, really helpful. And of course, it's something we do in the classroom.
"Okay. I'm going to stop right now. I'm going to ask three questions. Okay. Hold your hand up if you know the answer to this one." That sort of stuff we do in person classes. We don't tend to do online. We should do them online.
Yeah. One of the other things that I wanted to ask you about here too is, I know this is not unique to our particular field, but it certainly happens for us a lot. Which is that a lot of the people who end up teaching a lot more of the advanced training programs or teaching in the schools for entry level training programs were originally practitioners, and they were practitioners who then migrated into doing a teaching activity. We don't have a track or an academic course in our field for people to learn how to be good teachers.
And so my question is, number one, how important is that in terms of looking at some of the learning sciences? And how do you get other people to learn more about being a good teacher so that they can really help the practitioners learn better?
That's a really good question. And it's hard to teach, and it looks really easy. You just talk, right? I think the onus should be, especially on organizations that do a lot of teaching with practitioners. And that's where I came from. I was a practitioner, but I realized really quickly I didn't know what worked. I didn't know how much I could talk and then what should I do after that. What was important for people to do afterwards, what activities were... I didn't know any of that.
I started out with thinking because I was put in a training position, I just talked to people. It didn't work. It does work. It works a little, but it doesn't work... If they're really interested and asked you a specific question, and you answer that, and they get it, and you don't have to show, there's just all these things.
So faculty. Faculty in higher ed, or community college, or in a big organization that does a lot of teaching. The onus I think is mostly on them. Now, are they going to do it? They don't do it.
So I quickly realized I don't know how to do this well. People liked me because I was funny. But people liking you isn't the end result you want. You want them to be able to do what you're teaching.
Yeah. I think that's a really big one because we seem to have this... Not only us, but there certainly is a challenge of that division between entertainment in the learning experience. And a lot of people when they go to continuing education workshops in our field, will just say, "This is great. This is going to be a great trip. We're going on a cruise in The Bahamas to go to class and to learn all this kind of stuff." And they try to make it a wonderful, fun, and engaging experience, which definitely checks the box on interactivity between participants and that sort of experience of socialization, which is an important part of learning.
But then is it really checking the box on what are the outcomes that you get out of that learning experience in terms of really being able to apply those things appropriately. And I don't know.
I read some research recently about workplace leadership training, and how they tend to be fun, and you leave. And if you're really deep minded like I am, you say to yourself, "Well, that was a fun day. What can I do as a result of it? Nothing, but it was fun, and it's fun enough." And the answer is no.
If it's instruction, maybe fun is okay. Sometimes, fun is not, because it's very serious and it's hard. You talked about complex learning. That's hard, and people don't tend to think of that as fun. But we're there to teach people to improve their skills. Not just their knowledge. Knowledge is usually very important, but the knowledge allows them to perform skills.
Specifically because there's a lot of times in all of our work where we have to make decisions, decide what to do next, all that stuff. And that's using knowledge and that's problem solving a decision. These are skills that come from having adequate knowledge. It's complicated, again.
I remember when I was younger, somebody asked me in the middle of a big presentation in a room full maybe of 1,000 people, "How hard is learning anyway? I mean, you just listen and you learn." And I had to decide, do I rip this person apart? Well, of course no. And I said, "Actually, it's really complicated."
And I started talking about sensory memory, and working memory, and long-term memory, and how does something get in our head so that we can recall it later? And he came up to me later, he said, "I had no idea. I thought it was just talking." It's not. And I don't consider a conference presentation instruction in most cases, because do we practice? The boat trip might have small groups, maybe 20 people, and you're practicing. But 1,000 people, we're not really practicing.
I ask questions. I may pass out something that gives information about somebody, and we're going to decide as a group, and they may talk together in groups. But it's not really instruction. It's really important. I don't know the answer to that. How do we get people to make instruction instructional when they don't know what instructional means?
Yeah. And so this is back to a whole thing of early on training teachers and educators in this kind of stuff. And again, we have no formal process doing that. So everybody's out there just kind of winging it, it seems.
And some people are naturals, or they seem like naturals because they're fun and everybody likes being around them. But can they go back and do it? It's a problem in every field. I see it in my field that in my bachelor's and master's degrees, I did not learn anything about teaching. I learned a little bit in my PhD, but it was very, very theory based, and we didn't apply it to things. Schooling sometimes seems to be devoid of what you need.
And yet, I had a statistics teacher who knew... She was the best of the best. She knew what we needed in order to learn statistics. And I'm a math nerd, so I love statistics. But I had three levels in my PhD, and I had one incredible teacher. And then the two higher levels were... So I had to teach myself. I got resources. I just jumped into it. And it's a hard subject, very complicated. So I'm not as good at the higher levels because I only learned what I figured out how to teach myself. And then that goes to what you said early on, how do people form their own curriculum wisely? And that's nuanced too. It's like who's teaching, and do they know what they're doing? Will they actually teach you?
Right. Because one of the challenges that practitioners run up against constantly is that they don't necessarily know if this is going to be a good course. And they're expensive. These continuing education courses that they have to spend money on, and they have requirements that they have to meet every year to do these kinds of things. And you want to know, am I going to get value for my money, or I'm just going to go to this thing and I'm not going to learn anything? Or worse, this is just going to be a really bad experience, or somebody's going to-
Or boring, and I got nothing from it. And that's my biggest fear when I go to courses is will I just be sitting there freaked out because I don't think I'm going to learn this? And you're kind of stuck. You're in a location somewhere. Right, I totally get that.
I've taken courses on just a whole variety of subjects because I'm interested in pretty much everything. And I went to one that was two days long, and the teacher was a psychologist teaching a specific subject. And she didn't lecture for more than 20, 30 minutes, before she gave us something to do with it. And I felt really confident that I would be able to take the next steps after leaving. It was about family stuff. It's like, "Here's how to deal with this." And come up with a plan. And then we would talk about the plans we came up with it. Here's a major problem with teaching. People need to, and I'm going to put this in air quotes, "Get through the material."
Right. That's not your role. Your role is not to get through the material. I always tell people when I'm teaching, "This is what I hope to get through. But we're going to make sure that we're going to stop on a regular basis and assess where we are, assess what you're thinking, assess misunderstandings, and then allow you to practice." And it's going to be at least as much practice, maybe more than it is going to be teaching. People say, "We can't spend that time." Well, what happens when we don't? When we don't spend the time, people don't get as much.
And I think in many cases, courses should be ongoing. "Here's the place where we're meeting in person." And if you've looked at any of the research on flipped learning where we give you the content upfront, we practice together and all the social stuff around, "How would you do it? Why would you do it differently?" So I can learn from you, and I can learn from the instructor, happens in a in-person or a virtual in-person space. And then, there's some kind of mentoring afterwards where we get online and we can talk about problems we're having.
The problem is that's not our model. It's the model of some higher ed. I don't see hardly anybody doing that with workplace learning. That would work better. If we give people something ahead of time to read or look at, they don't. They just come to the session, because they're not used to being asked to be that involved.
Yeah. You mentioned this term of workplace learning. And I've really watched this interestingly over the years. I've sort of developed a better understanding of a lot of the learning science, and the learning processes, and the methods used in these different environments. And a lot of this has to do with learning software tools and things like that too, that there seems to be a significant division between that learning that is mainly aimed at short-term content. "You need to learn how to do this task because we got," let's say, "This new sales system we're implementing here at this business. And you got to learn the new sales system. And that's some new software stuff. You've got to learn these skills to be able to keep going in your job."
That's in opposition to the training that we do in an academic environment, like the basic entry level training is, "You need to learn this content, and you're going to be tested on it for your licensure." And then you're probably going to forget a lot of it very shortly after that point.
But what happens is that we go through this basic training process for licensure and that whole thing. And then, we transition the rest of our whole career into a workplace learning model, which is going to short courses, these kinds of things that are just about learn this skill, or learn this technique, or learn this new thing on a short piece of content. But there doesn't seem to be a process of validating learning really set into that, baked into that kind of model there. And I was wondering, how important do you think that is in terms of trying to validate what people get out of a learning experience more like that?
I think it's really important. Are we going to do it? I mean, it's not done. I teach people how to write valid and reliable multiple choice questions so that they can certify that their instruction works. It's important for two people. It's important for the person learning. But again, usually we're validating something on the short term and not the long term. And if they're not going to use it right away, they're probably going to forget a great deal of it. Look, if we teach people how to do X or Y, we need to know if our instruction works. And if it doesn't, we need to fix it. Right? So validating.
And there's lots of ways. One is at the end of a module or at the end of a course, you don't have to use multiple choice questions. If they're there with you, you can ask them to do acts and watch them. The reason multiple choice questions are used so often is they're super efficient compared to that. And the reason I decided to teach people this is because if you write them poorly, it's just total garbage.
And almost 85% of a licensing exam for nurse anesthetists had significant... 80% of the questions had significant problems. It's like, I don't want someone giving you anesthesia who doesn't know how. And that's how common this is. This is so common that they are poorly written, because they are difficult to write well. I use that one example a lot because it's awful.
I was having a conversation with some educators just last night when we were talking about advising them on curriculum building in their school, saying that a lot of times I see teachers in our training programs being put in this position of having to say, "Here's what you need to know for the licensing exam, and here's what's reality." And that's a difficult place, because we know that a lot of things are not done well on the licensing exam, but you have to train people for that. Otherwise, your school ends up with very poor statistics on pass rates and that kind of thing.
And you don't want that. I think that's true. And I don't have a real answer for that one. If everybody who taught others got together and said, "We need to teach the right way using the methods that we know work, and we need to assess the right way," knowing how we can assess whether somebody got what we intended them to get. It's more time-consuming. So people aren't going to do it.
I don't have an answer for you. They do it more in schools, because in K-12, it's part of their job is teach then assess. Teach then assess. And they don't always do it well, but it's their culture, right? It's why it takes 12 years.
Maybe we could fit it into a three-year online series, but no. We know that people need to know how to learn. They need to know how to do things, all sorts of things. So it's done that way. I've thought about this a lot, that there's probably a sweet spot where we don't have to go overboard, but we shouldn't go under-board either.
There's a lot of times where people will hire me and I say, "Well, there's no practice going on." Practice is not optional. We remember and we learn from practice, and the feedback from that practice. There's a whole bunch of people who just put stuff online and call it a course, and it's not. It's information and it might even be really good information. But as a teacher, how do you know what I got from that? Because no two people come to instruction with the same previous knowledge, the same lens through which they view what they're doing.
So this, it's like cutting hair. It's a personal thing. You can't cut hair online, you know? You can't just put stuff online and call it training for cutting hair. We know it's personal, and you have to feel the hair, and you have to look at it, and you have to do things. Instruction is personal, and I have a problem with instruction that isn't personal. But I also get pragmatically, how are we going to get all this done?
Here's what I think. One thing is we teach too much in everything we teach. If we could come up with, "These are the things you must leave with," and we'll give you a little optional stuff if you want it. Although for people who are new, optional is bad because they're like, "It's too much." You're overloading them. If we were much more clear about what we wanted to teach, and what outcomes we wanted to have happen, and spent a lot of time on that. "We're going to include these four things, but these three things are out and they'll have to be later." Because we want to make sure these three things are done or four things are done, and we're going to assess it.
If we took out all the optional extra crap stories about bad patients I've had, that sort of stuff. Just people who've been in the room and were problems, just take it all out. Later. People who are more expert can handle more stuff thrown at them, because they hopefully have a correct mental model of what they're doing, and made things more concise yo begin with.
Yeah. I absolutely agree with that. And one of the big challenges that I would say I have found as an educator in our field doing this with these types of shorter continuing education workshop courses and things like that, is that frequently, in a class of 20 people, I'll have two people who just got out of school last week, and two people who have been in practice for 35 years. And you got to deliver the same thing to that whole group. It really makes it challenging to find out where is that sweet spot in between them.
Right. I don't know. There's times where people ask me to help them design instruction and I'll say, "Who's your audience?" And so you would say body workers, right? Massage therapists. It's like, what level of expertise?
Because what you want them to get are different, even though it's the same skill. So I'm wondering whether there's part one and part two. And don't come to part two until you've been in the field for a year.
That's just a guess. I mean, I tell people with my multiple choice questions, "If you're right out of school on this, you haven't written these yet, and you don't even know what I'm talking about. This will be a nightmare for you."
And there are considerable skills that go beyond what I'm teaching. People say, "Teach me to write scenario questions." It's like, "I can, but not at the same time I'm teaching you what the research says about making them clear." Mostly clear. But the other one is make it so that people can't guess. Because if people can guess the answer, what the information is giving you isn't what you want. So those two things.
So some stuff we just have to... Look, I get it. I come up with solutions, and sometimes they're just impractical. So I don't know. Maybe you can even have two different things they have to practice. You're teaching the same thing, but you have two different things they have to practice, and they choose which one.
This is hard. A lot of people tell me, "I'm teaching everybody." It's like, the whole thing about figuring out what the outcomes are, does everybody have the same outcomes? And the answer is always no.
I'm teaching financial whatever to this wide group of people and the CFOs in the room, and so is the person who puts in the information for paychecks. And so everybody's sitting through something that half the people already know and the other people aren't getting enough information on. And again, I don't have an answer.
Yeah, it's a challenging. Well, we'll have to make that part two because this is certainly something that I'm very passionate about right now, looking into this emerging world of personalized learning, of creating more unique kinds of learning experiences that are tailored for where you are personally at this point. So that's for me, a very fascinating edge of where we're going in this.
Yeah. Well Patti, we could of course keep riffing on this for quite some time. I really appreciate your time today. And where can people find you and find out more about what you're doing, and access any of the resources that you've mentioned here?
Great. So probably the best place to find me is on my website, which is pattishank.com, and Patti is spelled with an I. So it's P-A-T-T-I-S-H-A-N-K.com. And I'm also on Twitter and post a lot there under the same thing, Patti Shank.
Great. Wonderful. Well, thank you again so much for coming here to visit today, and I really enjoyed getting a chance to talk with you on some of these things. We'll have to bring it back again here so--
Yep. So today's show is also sponsored by the Academy of Clinical Massage, where our mission is to help you become a better practitioner working with pain and injury conditions. You know it's challenging to find high quality training in your location when you need it, and we bring exceptional orthopedic massage training to the comfort of your home through our innovative online programs so you can learn anytime, anywhere, and immediately help more of your clients.
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