October 17, 2013

Rote vs. Meaningful Learning

by Merid Belayneh, Pharm.D., PGY1 Pharmacy Practice Resident, VA Maryland Health Care System

“The mind is not a vessel to be filled but a fire to be kindled.”
― Plutarch (46 – 120 AD)


In pharmacy school I was encouraged to understand the material and not merely memorize it.  My professors were likely referring to the difference between rote and meaningful learning. Today, faculty and preceptors are strongly encouraged to use and frequently employ active learning strategies throughout the pharmacy curriculum.1,2  While active learning is often used to foster meaningful learning, it is important to recognize that active learning does not ensure that meaningful learning actually occurs.3  Rote learning is still important and often pre-requisite.

Rote learning frequently involves repeating information until it's remembered.  Learners often resort to rote memorization because they are unable to relate new information to prior knowledge.3,4 Meaningful learning is characterized by relating new information to prior knowledge.  When one recalls prior knowledge, all related information is more easily recalled.3,4  Rote and meaningful learning lie on a continuum — they are not two separate entities.  Novak et al. describe three required conditions for meaningful learning: (1) the learner needs to possess relevant prior knowledge; (2) the material to be learned must be conceptually clear and presented with language relatable to the learner’s prior knowledge; and (3) the learner must choose to learn meaningfully.3  The student’s willingness to learn in a meaningful manner is something that teachers have the least control.  It can be indirectly influenced by using instructional and evaluation strategies that foster meaningful learning such as using active learning and team-based activities and reducing the amount of verbatim facts tested on exams.3

In order to encourage meaningful learning many pharmacy schools have employed a variety of active learning techniques including: cooperative learning, problem-based learning, team-based learning, and case-based learning.5   These methods of teaching enable students to identify their knowledge deficits as they attempt to apply their amassed knowledge.3,5  However, these methods assume that students are willing to engage and have sufficient knowledge to convert their rote learning into meaningful learning.3  Unfortunately, students who lack (or unable to access their) prior knowledge often get very little out of these active learning sessions.  As pharmacy curriculums increasingly rely on these active learning techniques, there should be continued discussion on how to cultivate students’ abilities to develop a strong knowledge base.  Often this requires students to memorize material via rote learning.

To examine the importance of rote learning, let’s review two studies that looked at how students learn two different subjects: language and math. The first study evaluated two groups of 4th-5th graders.  One group had students that memorized root words for 20 different sessions and the other group did not.6,7 The group that had memorized root words learned new vocabulary and figured out the meaning of words in context easier than the other group.6,7  The second study evaluated the reasons for why students were making errors on complex math problems.  It found that most errors were due to fact inaccuracies (e.g. memorizable facts) and not algorithm errors (e.g. processes or rules that are used to meaningfully learn).6,8  These studies illustrate the need to know (memorize) the basics in order to use meaningful strategies for learning. Pharmacy can be seen as a subject matter that requires students to learn a new language (i.e. brand and generic names, acronyms, medical terminology) and math (i.e. dosing, compounding, converting).  These studies give us insight regarding the necessity of rote learning in pharmacy curricula.

According to the FDA, in 2011, there were 8969 molecular entities approved in the United States and each drug has indications, side effects, dosing, pharmacodynamics/pharmacokinetics profiles, and patient education requirements.9  Although health professionals have technology to assist in retrieving most of this information, it is essential that the pharmacists have a substantial breadth of this knowledge stored away in their long-term memory.  Active learning assumes that students have the relevant prior knowledge (Novak’s 2nd requirement) and that materials are taught in a manner that is relatable to the learner’s prior knowledge (Novak’s 3rd requirement).  Thus, it does not negate the need for students to learn in a rote manner because they must possess sufficient knowledge. Thus, curricula must also teach students the basic facts and develop techniques that enable them to efficiently acquire new information.  Some rote learning techniques that could be employed include: (1) using acronyms (i.e. MONAB, SAAB), (2) using mnemonics (i.e. Hot as a hare meaning hyperthermia), (3) using physical or electronic flash cards (i.e. Top 200 drug cards), and (4) creating and providing cheat sheets of the most important facts discussed in each class.

Rote and meaningful learning are both important. Plutarch’s famous quote suggests that the mind is “a fire to be kindled.”  What modern learning models tend to neglect is the fuel required.  Before meaningful learning can be achieved, students need to possess sufficient prior knowledge (kindling wood).  Only then can teachers ignite the fire through active learning techniques.

References

1.    Donohoe L, Mawyer M, Stevens T, Morgan A, Harpe E. An Active-Learning Laboratory on Immunizations. Am J Pharm Educ. 2012; 76 (10):198. 
2.    Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree (Guidelines Version 2.0). Accreditation Council for Pharmacy Education (ACPE).  2006 [Updated 2011, cited 2013 Sept. 21].
3.    Novak J, CaƱas A. The Theory Underlying Concept Maps and How to Construct Them. Technical Report IHMC Cmap Tools. Florida Institute for Human and Machine Cognition. 2006 [Updated 2008].
4.    Firestone M. Rote Memorization in Education: Definition, Techniques & Quiz [internet].  Education Portal; [cited 2013 Sept. 21].
5.    Gleason B, Peeters M, Resman-Targoff B, Karr S, McBane S, Kelley K, Thomas T, Denetclaw T. An active-learning strategies primer for achieving ability-based educational outcomes. Am J Pharm Educ. 2011; 75(9):186. 
6.    Murphy A. Why Kids Should Learn Cursive (And Math Facts, and Word Roots). Yew Chung Parenting Resources. Times Ideas. 2012 [cited 2013 Sept. 21]. 
7.    Bowers P, Kirby J. Effects of Morphological Instruction on Vocabulary Acquisition. Reading and Writing: An Interdisciplinary Journal. 2010; 23 (5): 515-537. 
8.    Cumming J, Elkins J. Lack of automaticity in the basic addition facts as a characteristic of arithmetic learning problems and instructional needs. Mathematical Cognition. 1999; 5 (2): 149-180.
9.    Huang R, Southall N, Wang Y, Yasgar A, Shinn P, Jadhav A, Nguyen D, Austin C. The NCGC Pharmaceutical Collection: A Comprehensive Resource of Clinically Approved Drugs Enabling Repurposing and Chemical Genomics. Science Translational Medicine. 2011; 3 (80): 80.

No comments: