How do relatively autonomous professionals retain and apply what they have learned on the job, years after training?

That’s the question a group of researchers asked to learn more about what makes heuristic learning stick.

Algorithmic training – task-oriented learning such as how to operate a machine or format a Web page – tends to stick through practice and application.

But what about the more murky and less quantifiable process of heuristic learning – the kind of high-level training that involves concepts, rules of thumb and judgment calls? How can you teach those skills in a way that keeps them accessible months or years later?

A longitudinal follow up to a medical educator’s year-long fellowship program offers some clues.

Researchers interviewed eight doctors who had completed the same program in different years, ranging from three years prior to the study to 10 years beforehand.

The doctors were asked what they remembered about their training program, what they applied, and how often.

Five-step structure
The biggest take-home for you, as a trainer, is that heuristic learning requires structure.

Specifically, doctors who were taught using a highly structured approach were better able to remember what they were taught and access it when they needed it.

It was a teaching method that each doctor said they had used and applied to train their own students.

In this case, the medical educators used a feedback method called the One-Minute Preceptor. It starts by presenting a case or problem or having the learner engage in an activity, followed by these five steps:

  1. Get a commitment from the student (e.g., “This is what I think the correct action should be”).
  2. Probe for supporting evidence (e.g., ask follow-up questions).
  3. Reinforce what students did well.
  4. Give guidance about anything the students did incorrectly or omitted.
  5. Teach a general principle. Offer concluding thoughts when possible.

Here’s a scaled-down example of how the process might work after a medical student presents a patient’s case:

  1. Commitment: “What do you think is going on with this patient?”
  2. Probe: “What factors support that diagnosis? What alternatives did you consider?”
  3. Reinforce: “Good job. Your diagnosis is supported by the patient’s history and physical.”
  4. Guidance: “However, you didn’t mention the patient’s vital signs when you presented the case. If you follow a standard presentation format, you’ll be less likely to omit important information.”
  5. Principle: “Standardized procedures can help you deliver consistent care and avoid oversights.”

You can see how similar steps could be used for a variety of heuristic training – for example, sales skills or leadership training.

Yelon, S.L., et al. (2013). Transfer over time: Stories about transfer years after training. Performance Improvement Quarterly, 25(4), 43-66.

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