Assessing Emergent Learning

Re: Assessing Emergent Learning

by Deirdre Bonnycastle -
Number of replies: 5

Occupational training programs are their own kettle of fish because there is a large amount of absolutely essential memorized content and skills that must be learned to a point of automaticity.

There is also an apprenticeship component where you work in real or simulated situations with an expert in order to learn to think like an expert. This is where emergent learning makes an appearance.

Diagnostic Reasoning requires taking the patient symptoms, matching this to what you know about body systems and coming up with a couple of predictions about what is wrong. Clinical Reasoning takes the predictions, and refines the diagnosis through patient history, physical examination and tests, then determines treatment. Compare, contrast, research, analyse, identify systemic problems, juggle multiple factors are important strategies that must be developed in medicine.

You learn to do this by seeing a wide range of patients over time but you also need a constant feedback system from patients, nurses, preceptors and self reflection. This is where training programs often fail their students. Poor feedback loops demoralize on one hand because of their severity and allow negative behaviour to continue on the other extreme. So formative assessment is a critical element. Summative assessment in occupational training is usually done externally and is a client safety step that confirms this person is qualified to practice.

So you have the prescriptive classrooms, emergent clinical experiences and the chaos of the unsupervised experience, all existing  and clamoring for more time.

In reply to Deirdre Bonnycastle

Re: Assessing Emergent Learning

by Scott Johnson -

Hi Deirdre,

Having been diagnosed by 5 different doctors and a specialist over a period of 5 weeks based on the simple fact that no one bothered to read further back on my record than my last hospital test, I think we can add the power of proper listening or observation to the things medical practitioners should know. Humans make mistakes and when they build simulated environments like schools they rob themselves of the juicy details of reality in trade for the convenience of rightness, prediction and further simulated performance. On the belief there are people out there so well trained they can imagine reality into existence we follow their proofs and not the reality we are presented.

To me, “qualified to practice” is a comfort (or maybe an approximation of a comfort) but as an assurance that the system behind it functions properly is not good evidence. By saying that I know there are many things to learn and many people more qualified than myself to learn them from. Yet this doesn’t diminish my ability process the world as I see it. Though of course we don't ask the receiver--we test them.  

In reply to Scott Johnson

Re: Assessing Emergent Learning

by Scott Johnson -

Correction: should had said "mis-diagnosed" though I'm sure everyone got it.

Diagnostic thinking can go beyond projecting specific chains of cause and effect onto to something to explain it. In the sense that dissonance illustrates something being out of place, we could measure novelty by noticing one part fails to be explained by those around it. That part should show as a mistake or a misinterpretation and could as well indicate emergence? Do emergent thoughts need to be novel and out on their own? If they slipped in as connections between things we knew but previously couldn't connect they would not necessarily be noticible.

In reply to Scott Johnson

Re: Assessing Emergent Learning

by Joyce McKnight -

Hi Scott:  I am sorry for your unhappy experience with the medical system.  I had a similar one in 2011 that nearly killed me and from which I am still recovering...mine had to do with the unfortunate tendency that modern medicine (at least modern Western medicine) seems to have developed to "play the numbers"...one "can't" have something because it is rare, therefore one can't be tested for it because it is "rare", and, of course, it is "rare" because it never shows up in tests!!!    My particular example is hereditary hemochromatosis...the tendency of my body to collect too much iron over the decades and the most common life threatening hereditary disorder found in people of nothern European decent.  I nearly died before a wise physician's assistant thought to check my iron levels which were 20+ times the normal level.  I tell this story to emphasize that all medical practicitioners need to observe and think, not just play the numbers...and because I feel folks need to know about hemochromatosis which manifests itself with arthritis of the hands and feet, feels a lot like fibromyalgia, kills vital organs like your pancreas, liver, and eventually your heart and is kept in check by old fashioned phlebotomies...other than the arthritis it shows up most commonly as middle age onset diabetes which by the numbers (again) is most usually called Type II diabetes and blamed on lifestyle especially being overweight.  In fact, in the US endocrinologists aren't even allowed to  order the relatively inexpensive blood test to rule out hemochromatosis because the numbers "show" it is so rare.   At any rate, Scott you are so right!  And folks with northern European ancestry...if you have some or all of the symptoms please don't be afraid to bring the possibility up to your health care providers..

In reply to Joyce McKnight

Re: Assessing Emergent Learning

by Scott Johnson -

Joyce, your situation sounds similiar to mine in it being a balance of a medical problem that can kill you combined with sloppy diagnostics. Long story short, the take away for me is that mastry of anything is useless without the willingness to listen beyond the voice of your well-trained brain.

The doctors and the specialist I saw are not unskilled but they made a decision on what to treat me for based on the first condition which satisfied their incomplete investigation. To say we train people isn't enough. We need to impress on them that neither the jolly endorphan rush of being right nor your degree makes your decision correct.

Feeling like you know is a very attractive sensation. It seems the more training a person gets the more suseptable to this distraction a person becomes. This undoes the whole concept of "mastery" for me and suggests we should look for characteristics of the search for "knowing" in the uncertain habits of the beginner. Habits that my be emergent.

In reply to Deirdre Bonnycastle

Re: Assessing Emergent Learning

by Jenny Mackness -

Thanks Deidre for explaining where you think emergent learning fits into relation to medical situations. I like the idea of emergent experiences and I'm now wondering how they differ from emergent learning. Stil thinking..... :-)