Digital Tools in the Learning of Neuroanatomy

This is an example of a concept I am developing before prototype stages. I pulled this from my final semester paper in an Instructional Design course at Harvard. I am interested in designing a system for learning that lasts.


December 13, 2014

This paper describes an interactive digital tool for neuroanatomy students. This tool delivers via the web. Operating as a flexible and individualized environment, the tool feels akin to a workspace that dynamically engages the learner’s brain and converges information. At the heart of this paper is the belief that learning complex information is accessible.

The act of learning describes temporal pairs between different things that are happening relatively or simultaneously. The idea for this tool was conceived to support a learner new to the study of neuroanatomy. The learner might use the tool to counteract overwhelming concerns about study effectiveness that stem from arduous and inefficient memorization (Qiao et al. 2014). The problem is that, in taking on the beast of neuroanatomy, learners have no previous knowledge base for new information to “bind.” Inserting the lexicon of imagery and function resembles a draconian exercise. A piece of information is more accurately represented cognitively as a “pattern” (Bliss and Collingridge, 1993). Associations that form around patterns of prior knowledge to new is learning (Medina, 2008, p. 147). This tool is designed with the objective of providing support to the learner, so that they may be effective at the beginning and over the course of their study of neuroanatomy.

For example: The learner may feel frustrated that they are not remembering the major landmarks of the brain stem. The tool would present the learner a means of cognition dividing those landmarks into small subsets, or chunks, that are memorable. Additionally, each chunk could be engaged with in multiple ways. Understanding the visual system as two pathways, the “seeing” parvocellular, aka the “what,” and the “how” magnocellular, aka the “how.” Parvo and Mango synthesize as “seamless perception,” implying the inimitable nature of visual information. As can be imagined, an intricate system such as this creates a mental imprint that for the strength of its impact, is recallable (Ratey, 2001, p.100. and 104)

The tool is informational, in that the learner is seeking to acquire content knowledge from general to very fine level of detail. The tool is informed by cognitive psychology and the tool’s activities are designed to simulate the gaming experience. The potential payoff of this model is that the learner may expect a high degree of competency in neuroanatomy.


Audience

The audience for this tool are advanced undergraduate students of psychology, biomedical engineering, medicine, psychology students. Importantly, the audience is expected to bring a high degree of responsibility, accountability, and motivation. There are many effective tools that support the learning process, but there are few examples of tools for high level learners. That said, this specific audience is well suited for this tool because the tendency is that learning aids are rarely developed for advanced learners.

This audience needs more integrative visuals and a more sophisticated means of interacting with these visuals. Difficulties of memorization can be related to lots of things. It could be said that the formation of memory and recall is primarily influenced by mood, surroundings, and gestalt at the time of the memory…” (Ratey, 2001, p.186). The audience can be more effective because the tool is creating a holistic mental model.

The human brain is exquisitely primed to process and remember imagery (Medina, 2008; and Ratey, 2001, p.48). Viewing disparate visual representations of the brain (such as: hyper symbolic representations, utilitarian cartoons of the cortex, or abstract CT scans) proves ineffectual. Repetition is one method of convergence that induces quality memorization because it synthesizes confluent data.

For example: The Basal Ganglia circuitry has multifaceted characteristics, appearing quite differently across vectors. Using simple gif-like animation should emblazon a sophisticated representation of a structure while establishing a strong and lasting visual link in the learner’s mind.


Activities

Simplistically, the path to learning success includes the following: 1) emblazon information in the learner’s mind by introducing information, 2) immerse the learner in the experience, 3) repeat information often emphasizing with various stimuli, 4) test the info, 5) retest on the info at regular intervals, and 5) push the learner to return later to that information.

Research has proven that experiential learning, or “interplay of multiple processes” (Young et al. 2014, p. 371) is an effective facilitator of holistic cognitive connections yielding greater cognitive gains (Vogel et al. 2013). The tool will incorporate gaming behaviors because they are experiential and goal oriented. Beneficial simulation of gaming offers “powerful opportunities not only to learn through experience, but to develop meta-level reflections on strategies for learning” (Facer et al. 2004). “Gaming” is defined by Gong et al. as either a “mental state or goal of the student” (2013). The benefit of incorporating elements of gaming into the design of some activities is that gaming can encourage the learner “to learn and master something that is long and challenging” (Gee, 2003). Gaming facilitates learners to explore the brain topically or to dilate concepts for deeper learning.

Examples of the ways learners may engage with this tool include:

  1. Personalization in Goal Setting
  • Learners may curate their experience by defining his or her core tasks and desired outcomes (Tighe and Wiggins, 2005). Goals steer engagement with the tool. Activity is self-determined in terms of pace and goal setting.

For example: A learner might identify a goal of 10 hours per week in using the tool to focus on optic radiations. The core task of this time interval will be reading and answering prompts related to authentic fMRI scans, and will yield competency of optic nerve structures, retinal signal processing, and relevant neurotransmitters.

  1. Making: Mise en Place
  • Construction activities help develop what perception research calls “attention specificity,” or mental salience (Ratey, 2001, p. 101). Visually building structures or neural circuits is a form of mind mapping that also tests the application and transfer of knowledge. Ritchhart’s “See-Think-Wonder,” “Zoom In,” and “the Explanation Game” thinking routines, which develops visual competency with cortical structures (Ritchhart, 2011, p.14 and p.50).

For example: A “structure bank” that feels somewhat like a game and offers a test feature to self-test by building or selecting/dragging circuit structures from a “structure bank.” The learner would need to have an internal model of the circuit in their mind in order to select the appropriate components (Sing, 2013; and Chao, 2013). This construction activity tests misconceptions the learner may have developed during study. Harvard Medical School based neuropsychiatrist, John J. Ratey, describes the brain’s cohesion of data as gestalt (Malamed, 2009), saying that “the brain is an analog processor, meaning, essentially that it works by analogy and metaphor. It relates whole concepts to one another and looks for similarities,” (Ratey, 2001, p.5).

  • “Effortful” (Medina, 2008, p. 133) learning activities have broadly beneficial implications. Additionally, active engagement bridges two facets of cognitive processing: spatiotemporal (where/when) and sensorimotor ( (Quaia et al. 2010; Facer et al. 2004; Brayanov et al. 2012; Chao et al. 2014).
  1. Association Building
  • After examining the learner will have opportunity to create personalized memory aids, a process called “postcuing” (Intons-peterson, 2014, p.312). Postcuing supports the reciprocal richness of memory, or the detail encoded within a chunk of information. Memory aids are unique and powerful cues that can also trigger memory.

For example: Textbooks suggest using “H.O.M.E.” to remember the limbic system functions: Hypothalamus = Homeostasis, Olfactory = Olfaction, Hippocampus =  Memory, Amygdala = Emotion. The hiccup is that Hippocampus = Memory are not an alliterative match. In devising a personal mnemonic, the learner could substitute make a substitution that better correlates with the learner’s unique associations, and thus be more memorable.

  1. Community Forum: Theory of Mind
  • The learner could choose to seek help or explanation from the broader professional community, or to seek out more information deeper on a given component of the circuit, as a recent article in the Journal of Neuroscience, or other media.
  1. Quiz/Testing-Typical Testing
  • Quizzes are reflective of the real world expectations of “performing effectively and with knowledge” (Wiggins and Tighe, 2005). Testing should be a highly visible option, peppering the tool environment so as to encourage the learner to engage. Testing frequently also provides the learner with immediate corrections of his or her mistakes.
  • Re-testing (testing the learner on a topic after a consistent length of time) (Medina, 2008, p.149), is an important element of re-exposing the learner to previous content. Previous content that was tested and successfully “passed” may have eroded or incorrectly amended. Retesting strengthens connections and ensures long- term potentiation (Bliss and Collingridge, 1993), as well as transferring information from working memory to long form memory via quality encoding (Medina, 2008, p.143; and Ratey, 2001, p.191).
  1. Hierarchy of Modules
  • Completing quizzes can release more complex features or levels within a selected topic. Inspired by Ritchhart and Church’s “3-2-1 Bridge” thinking routine, content modules present highly scaffolded material which fully informs the leaner on on a specific topic which prepares and primes the them to make informed judgements (Ritchhart, 2011, p.14 and p.50). Once the learner had demonstrated testing score or logged a number of hours, more complex levels will be “released” with more challenging questions or tasks.

For example: The learner would be presented with a scenario, showing two or three different neural structures in related but different systems. In positioning the systems in proximity, and in the same stage of the learning experience, the learner will merge them together mentally. The learner is hence encoding “elaborately” (p.135): structurally (the visual shape of the structure) and semantically (the definition or function of the structure) (Medina, 2008).


Understanding

Declarative memory is the process of the brain, saving new information to a temporary short term “space.” Working memory, interestingly described as “the mental glue,” (Ratey, 2001, p.195) selects different modes consolidating that information: semantic, automatic, procedural, or episodic (Hasselmo, 2012, p.31; Medina, 2008, p.133 and 145). These four kinds of memory processing help the brain establish a rich and complex base for acquired knowledge. Accordingly, the tool’s activities are designed to support the encoding process because the learner interacts with the tool’s activities in an “effortful” manner (Medina, 2008, p.134).

An important quality of the tool is that self-awareness and accountability are very important as they compel the student to use the tool and increase overall engagement. The tool endows learners with an awareness of the progress and a sense of what they need to do to get better. The tool, being largely self-guided, implies that the learner is impelled for growth and is somewhat aware of their personal obstacles in learning neuroanatomy. This awareness is assumed and so the learner will have constant awareness of their progress, a personal dashboard tracking their engagements, and a notification system such as smart phone reminders.

A reward system may inspire the learner to log in to the tool. Rewards motivate the learner to push through challenging material. The result is that memory is reinforced (Ratey, 2001, p.191). The learner’s personal dashboard provides space to track time spent with the tool and to track obligations such as future test dates, study plans, and lessons experienced. The notification system is able to send reminders and progress reports. A reward system provides reinforcement to encourage the user to continue interacting and returning to release more levels (Facer et al. 2004).

The challenge in designing this tool is to develop a very user friendly tool that offers a highly individualized curriculum. One way the tool delivers on this objective is that each session where the learner interacts content will build on each previous session. Similarly, standardized testing modules present a student with a question based on their answer to the previous question, the student’s sessions will build. The tool will not provide a learning experience of a finite sequence of content modules. Gong et al. define the effects of gaming are “efficiently learn from every practice opportunity” (2010).

Astrophysicist Neil deGrasse Tyson has stated that, “the absence of evidence is not the same as evidence of absence” of learning” (Chabris, 2014). However, it is critical to the core design objective that the learner needs to believe neuroanatomy accessible to his or her unique learning style and thus experience the feeling of improvement. Competency with information is achieved when memories “appear to be infinitely retrievable and resistant to amendment” (Medina, 2008, p.144). The committed learner may have expectations of demonstrating competency with the subject at an academic or professional level. With this objective, he or she will have the self-knowledge needed to understand their self-described learning goals and the scope of his or her progress to that objective. Elaborate connections equate to memorable content acquisition (Medina, 2008, p.139).


Enduring Understanding

Humans are sealed off and removed from the underpinnings of our cognitive processing. Undoubtedly, it follows that a learner experiences his or her own learning without clarity. Surely, there is no such thing as a prototypical brain so why continue to present advanced subjects like neuroanatomy to a single type of student? Ratey fabulously states the nature of human neural uniquenesses as “physical systems in need of training and practice” (Ratey, 2001, p.6). The implication in this perspective is that brains are malleable products of the learner’s actions. This tool was conceived to help remove exclusivity from the learning process. Education should provide access points for all different types of learners (Medina, 2008).

In summary, the early phase of introduction is critical as it can have bearing on the nature of the study experience and may also be predictive of the learner’s future success and enjoyment with the subject. This tool establishes the bedrock of knowledge required for success in the study of neuroanatomy. The crux of the learning process, encountering information that has been thoughtfully presented, does not demand exclusivity. More so, learning and memorization, essential to study, do not by definition preclude learners based on cognitive ability. As Ratey describes, the human brain will circumvent weak cognition abilities by enhancing another (Ratey, 2001, p.105). Neuroanatomy, therefore, is accessible to high level learners if presented with care to meet learners. For the fact that the tool presents a participatory, supported, and independent environment, learners will familiarize with neuroanatomical concepts efficiently and most importantly, solidify a foundation that bears profound support for future professional growth.


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