Influence of Personality Types on Learning Preferences

By Margaret Curtin, Pharm.D., Ph.D., PGY1 Pharmacy Practice Resident,

Sinai Hospital of Baltimore

Pick one image below that appeals to you most.

Read more to interpret your selection.

A variety of learning theories, including behaviorist, cognitive, and constructivist, were developed in the twentieth century to explain how people learn.¹ These theories focus on different aspects of learning and the situations in which one theory would be more applicable than another. None of the theories, however, specifically address personality type.¹ It can be appreciated that personality affects how people learn and the type of environment(s) in which they will likely excel.  How a person learns is a motivational tendency that has been linked to personality.¹ Some learning models have been developed to include personality factors and some personality models have adapted post hoc to including learning preferences.² 

Personality is defined as an inborn temperament and features that arising in response to the external environment.  It is a combination of characteristics that separate one individual from others.¹ Since learning styles can be thought of as habits, personality traits inevitably affect learning behavior and serve a facilitative role with regard to motivation. It is critical to emphasize that no one personality type is superior to another and each occur at different frequencies within a given population. Each personality type has its own learning style (e.g. different preferences with regard to the approach to learning) and is motivated by different factors.¹ 

Many studies have been conducted which have found statistically significant relationships between learning style and personality type.¹ For example, one study showed a positive relationship between extroverted personality traits and active-minded learning styles.¹ Other studies examined outcomes based on knowledge of personality types, and the results indicated that both work and leadership outcomes were improved when personality types were considered by the learner during the learning process.²

Learning styles describe the way that we take in and process information.  Each individual has a preference for the way they learn and this gets strengthened with practice. Cognitive learning styles are defined as the consistencies in the unique manner that a learner acquires and processes information.³

Many different learning style models have been described, such as the Grasha-Recihmann Learning Style Scale (GRLSS), Goley’s Learning Pattern assessment (LP), and Felder and Silverman’s Index of Learning Styles (ILS), to name a few. ILS includes four domains of learning, as shown in the table below.³

Learning Dimension		Preferred Learning Style	Attributes
1	Perception	Sensory (S)	Likes concrete facts, figures, data, experimentation
		Intuitive (N)	Prefer theory and principles, solve problems through innovation
2	Input	Visual (V)	Remember pictures, diagrams, and flowcharts
		Verbal (B)	Remember spoken information that they had heard and discussed
3	Processing	Active (A)	Hands-on experience or discussion of information
		Reflective (R)	Requires time to think about what they are learning, learn best by understanding theory
4	Understanding	Sequential (Q)	Prefer logically order progression
		Global (G)	Gain knowledge by connecting individual aspects to big picture rather than learning individual parts

To address both learning styles in the first dimension (perception), the instructor should optimally provide a mixture of concrete facts and abstract theory. Visual (V) and verbal (B) learners can both be reached if the learning experience includes interactive discussions, visual materials, and illustrations of complex problems.³ Similarly, sufficient pauses (or breaks between learning events) to allow the reflective (R) learner to understand theory as well as including a hands-on activity for the active (A) learner would reach both processing styles. Most curricula are set up in a sequential fashion, but in order to reach the global (G) learner, the instructor should present the big picture prior to discussing details, allowing the G learner to make connections on their own.

The Myers-Briggs Type Indicator (MBTI) is a well-known personality test that has been used by many companies to build healthy relationships among employees.⁴ Personality types are divided into four domains resulting in 16 unique combinations.

• I (Introvert), E (Extrovert): how people focus attention and get energy
• S (Sensing), N (Intuition): how people take in information and ways they become aware of things
• T (Thinker), F (Feeler): how people evaluate and come to conclusions about information
• J (Judging), P (Perceiving): a person’s lifestyle and work habits

One’s personality traits, as identified by MBTI, has a clear influence on learning styles and preferences.⁴ Lessons can be constructed to best meet the needs of all students with varying MBTI personality types.³  Instructors may find it easiest to approach this task by presenting the same lesson content in multiple ways, in order to appeal to the preferences of all (or most) students.⁵

Strategies for effective learning based on S/N and T/F traits are outlined in the Table 1.  For example, extroverts (E) work best in situations that allow time for discussion or working in a group. These learners do well in activities that involve interaction with people.⁴ Introverts (I), on the other hand, are energized by the inner world of reflection and thought, and tend to enjoy reading and written work over discussions.  I types like independent work.⁴ In order to appeal to both I and E types, the learning experience should encompass both discussion and independent work, enabling all learners to optimize their potential. Additionally, judging (J) types live in a planned and orderly way.  J types do well with clear, consistent, and formalized instruction and want to complete defined tasks according to a specified timeline. Perceiving (P) types differ in that they are more spontaneous by nature and prefer to operate without deadlines.⁴ When appealing to both J and P subtypes, a learning experience could be structured so that clear expectations are set at the beginning but leaving it up to the learner to design their own timeline. Opportunities for elective projects and optional activities would appeal to the P subtype but less likely to interest the J type.

Through an understanding of the influence of personality types on learning preferences, the instructor can devise creative ways to customize the leaning process.⁵  In a large group of learners representing many different personality types (and learning preferences) it will be a challenge to offer something uniquely tailored to each person. By utilizing a variety of teaching approaches, one has the opportunity to appeal to all personality types.⁵ Simply put, knowledge of personality types and learning preferences put into practice can help educators communicate more effectively with students and deliver instruction in a way that maximizes the learning experience for each individual.

Table 1

Use the table below to uncover your personality based on the image you selected. Are the suggested strategies for learning accurate based on your personality?

If you picked the …	Personality Type	Type of Question	Learning preferences generally include:
Paper clip	ST (Sensing Thinking)	What?	immediate responses and feedback, details and sequential order, hands-on activities with a specific correct answer, clear concise step-by-step instructions, knowing expectations, drill and practice
Magnifying glass	NT (Intuitive Thinking)	Why?	planning and organizing before working, working independently, arguing and debating, analyzing and examining pros and cons, thinking about ideas and how they are related, logical and strategic games, designing a new way to do something
Slinky	NF (Intuitive Feeling)	What if?	learning without time constraints, praise for personal ideas and insights, using creativity and imagination, open-ended activities with many possibilities, working on many things at once, creative and artistic activities
Teddy Bear	SF (Sensing Feeling)	What does it mean to me?	getting personal attention and praise, sharing feelings and experiences, working in groups/being part of a team, having someone show how to do something, role-playing and personal expression, non-competitive games where no one loses, interpersonal activities

References:

1. Ibrahimoglu N, Unaldi I, Samancioglu M, Baglibel M. The relationship between personality traits and learning styles: a cluster analysis. Asian Journal of Management Sciences and Education. 2013; 2: 93-108.
2. Jackson CJ, Hobman EV, Jimmieson NL, Martin R. Comparing different approach and avoidance models of learning and personality in the prediction of work, university, and leadership outcomes. British Journal of Psychology. 2009; 100: 283-312.
3. Silver H, Perini M, Strong R. The Strategic Teacher:  Selecting the Right Research-Based Strategy for Every Lesson. 2007 Alexandria, VA: Association for Supervision and Curriculum Development.
4. Type and Learning. The Myers and Briggs Foundation. [Internet]
5. Winn JM, Grantham VV. Using Personality Type to Improve Clinical Education Effectiveness. Journal of Nuclear Medicine Technology. 2005; 33:210-213.

Two Heads Are Better Than One, Right?

by Ellen Varner, Pharm.D., PGY1 Community Pharmacy Resident, University of Maryland School of Pharmacy

As I navigate through my first year as a practicing pharmacist, I sometimes find myself acutely aware of just how much responsibility rests on my shoulders.  Occasionally, the requirement to make complex clinical decisions on my own seems overwhelming  and makes me wonder if I missed something important in a class I took.  Although I know it is impossible for one person to know it all, at times I wonder if the collaborative techniques widely used in my school’s curriculum inadvertently created some gaps in my knowledge.  In a profession that often requires a high level of independence, is placing a heavy emphasis on group-work and collaborative learning actually doing a disservice to pharmacy students?

“None of us is as smart as all of us.” ~Warren Bennis

In his book titled Organizing Genius: the Secrets of Creative Collaboration, Warren Bennis, an organizational consultant and leadership guru, describes the rise of the “Great Group.” ¹  The “Great Group” is one that is able to achieve tremendous success often with very limited resources.  The members of the group have high levels of commitment and their collective performance leads to high-output.  This fascination with group-work and collaboration has transformed U.S. corporate culture into one that tends to elevate teamwork above all else.  According to an article published in the journal Small Group Research, by the year 2000 half of all U.S. organizations had moved towards using teams, knocking down walls to create open-plan offices and shared workspaces.² 

Not surprisingly, the entire education system (pre-K to graduate school) in the U.S. has moved to adopt a collaborative approach to learning, hoping to teach students how to thrive in a team-oriented culture.  A report published in 2002 by the Center for Survey Research and Analysis at the University of Connecticut highlights this shift in the structure of classroom learning.  Among the fourth grade teachers surveyed, 55% identify cooperative learning in small classroom groups as their preferred form of teaching; 51% of eighth-grade teachers reported the same preference.  The results from this survey suggest that an increasing number of teachers have de-emphasized traditional methods of classroom instruction, such as lecturing or passing out homework assignments, in favor of creating teams.³ During my own elementary school education, I remember rearranging our neat rows of desks into “pods” – forming small groups we were required to work with throughout year.

Creating groups that facilitate teamwork has also become a major focus of the U.S. healthcare system, partly in response to an Institute of Medicine (IOM) report titled To Err is Human: Building a Safer Healthcare System.  The report details the high rate of preventable medical errors, many of which were thought to be the result of poor or dysfunctional teamwork.  The IOM report suggests that teamwork is required for effective patient management because treatments are increasingly complex, specialized, and risky.⁴ Medical education itself is also shifting to place more emphasis on team-based learning (TBL) and problem-based learning (PBL), which is often conducted using a small-group format.  In many institutions, lectures have been replaced with group-based projects or “fishbowl” activities where students approach patient cases together as a group.  While the importance of teamwork within medicine is difficult to refute, I am more hesitant to accept its dominating prevalence within medical education.

The Case for Individual Study

In Academically Adrift: Limited Learning on College Campuses, the authors question the value of group work.  The book details the findings of a University of Virginia study that tracked a nationally representative sample of more than 2,000 students who entered 24 different four-year colleges.  Surprisingly, the results suggest that college students who spend the majority of their time studying alone learn more than those who work together in groups.⁵  An experiment conducted by the University of Michigan found that people learn better after a quiet walk in the woods than after a noisy walk down a city street.⁶  The question is – why is solitude so important for learning? Anders Ericsson, a research psychologist, theorizes that solitude is so crucial because it represents the only time when a person is alone and can engage in something he calls “Deliberate Practice.”  Ericsson states that “Deliberate Practice” has four essential steps: 1. Identifying tasks or knowledge that are just out of your reach 2. Striving to upgrade your performance 3. Monitoring your progress and 4. Revising accordingly.⁷  For students participating in collaborative learning, it is almost impossible for them to do these important tasks.  Moreover, from an instructor’s point-of-view, group work makes it difficult to identify students who are struggling (step one) and provide individual feedback (step three).

When is Three (or even Two) a Crowd?

While groups and teamwork shouldn’t be avoided, I think it is important for educators to use discretion when designing their curriculum.  Although teaching students how to work in a team is important, putting too much emphasis on collaborative learning may actually be detrimental.  Instead of reserving complex patient cases for group projects, students should also be given the opportunity to approach these challenges as individuals so they can engage in “Deliberate Practice.”  Group projects with collective evaluations can make it difficult to identify knowledge or skill deficits in a particular student.  Further, students who spend too much time working in groups may find that they lack the confidence to complete a task on their own.  Asking students to perform clinical activities, such as patient interviews, on their own can help them to become more confident in their own knowledge and skills.  In addition, participating in a “fishbowl” activity, one where a student can time-out to ask his or her classmates for help while interviewing a patient, does not necessarily paint a realistic picture of real patient-pharmacist interaction.  For pharmacists who work in community pharmacy settings, the ability to work independently and make autonomous decisions is as crucial as being able to work effectively on a team.

References:

1. Bennis WG, Biederman PW. Organizing Genius:The Secrets of Creative Collaboration. New York: Basic, 2007.
2. Devine DJ.  Teams in Organizations: Prevalence, Characteristics, and Effectiveness. Small Group Research. 1999; 20: 678-711.
3. Barnes C. What do teachers teach? A survey of America’s fourth and eighth grade teachers. Civic Report no. 28. Center for Survey Research and Analysis, University of Connecticut, 2002.
4. National Research Council. To Err is Human: Building a Safer Health System. Washington, DC: The National Academies Press, 2000.
5. Arum R, Roksa J. Academically Adrift: Limited Learning on College Campuses. Chicago: University of Chicago, 2011.
6. Berman MG, Jonides J, Kaplan S. The Cognitive Benefits of Interacting With Nature. Psychological Science. 2008; 19: 1207-212.
7. Cain S. Quiet: The Power of Introverts in a World That Can't Stop Talking. New York: Crown, 2012.

Why Teaching Cultural Competency is Essential

by Samuel Houmes, Pharm.D. PGY 1 Community Pharmacy Resident, University of Maryland School of Pharmacy

Close your eyes for a moment and picture a community pharmacy. You are standing in aisles looking at the amusing cards when you observe a tan-skinned man approach the pharmacy counter. Based on the man’s curious looks around the store, it would be a reasonable assumption the man has never been to this pharmacy before. The pharmacist stops to assist the man. As the pharmacist begins to counsel the patient, it becomes apparent the patient speaks little English. The pharmacist realizes this, and to complete the required counseling, raises her voice and speaks slowly in an attempt to help the patient understand. After a confused look, the patient pays, takes the prescription bag, and walks out the door.

What is wrong with this encounter? The lack of communication between the patient and the pharmacist significantly increases the risk of a poor outcome. The pharmacist made no effort to find an avenue to elicit additional information about the patient’s past health history or cultural beliefs. What if, in this situation, the patient had a belief that alternative health practices should be used to supplement Western medicine? The patient may take something that diminishes the effectiveness of the treatments or cause a drug-drug interaction that leads to another physician visit ... or worse. In order for the pharmacist to provide patient-centered care, she needs to assess the patient’s cultural beliefs.

Culture is difficult to define—but includes aspects of language, thought processes, communication, values, beliefs, customs, personal identification, and actions relevant to social, ethnic, racial, religious, or geographic groups.¹  Achieving cultural competency requires the healthcare professional to take into account an individual’s beliefs and practices when making healthcare decisions and recommendations.¹

In a 2007 survey of pharmacy schools, only 51% of respondents indicated that they made changes in their curriculum to include cultural competency.² Research indicates that pharmacy students are ineffective when it comes to addressing cultural issues in practice.^3,4 This is problematic given the growing needs of a diverse patient population. While the integration of cultural competency into pharmacy curricula has increased, unfortunately, there is not a lot of research data on effective educational frameworks.² Ideally, the curriculum should address cultural concepts, instruction on health disparities, patient interactions with practitioners and health-systems, and the provision of patient-centered culturally sensitive care.²

This sounds great, but how should a school actually teach cultural competency? Considering how broad the working definition of culture is and the current lack of data on outcomes, no one knows what is the “best” teaching method. Thankfully, instructional strategies used to teach patient-centeredness may also be used to teach cultural sensitivity. Didactic instruction, active learning, and reflective assignments all play a role in assisting the student learn about cultural beliefs and how to practice in a culturally competent manner.

Service-learning provides an excellent learning opportunity for students to gain personal experience with patients who are underserved. Through service learning, students integrate patient care into the development of civic responsibility, empathy, professionalism, and communication skills by caring for a patient (or a group of patients) over a period of time.² This allows the student to learn to about cultural beliefs and practices and how they impact health problems.

Objective Structured Clinical Examinations (OSCEs) are another way for students to gain personal experience, but in a simulated environment. Students communicate one-on-one with their patient and work to reconcile the patients’ beliefs against the provision of patient-centered care.²  OSCEs enable student to learn competency skills in a safe environment.

International rotations provide another avenue to develop cultural awareness and competency. When students travel to another country, they are exposed to a culture and belief system they may otherwise have never encountered. Necessarily, if students want to provide effective healthcare to the new patient population, they need to understand the populations’ beliefs on healthcare and medicine.²

One activity that can be used in the classroom to teach small groups of students how culture impacts our daily lives is called ‘BaFa’BaFa.’ In this activity, the students are split into two cultures (the ‘Alphas’ and ‘Betas’). Each culture spends 15-20 minutes learning the intricacies of their assigned culture before interacting with one another.  The resulting stereotyping, misperceptions, and misunderstandings are discussed during debriefing.⁵

Ideally, cultural competence should be taught throughout the pharmacy curricula rather than in a single didactic course.  Indeed, a single course about cultural differences may only further solidify stereotypes. Within the first and second years, the goal should be to develop cultural awareness through the use of reflective papers, didactic instruction, and active learning activities (like an OSCE or BaFaBaFa). In the third year, students should begin to learn how to integrate patient-centered decisions making with an awareness of cultural issues. For example, this may be accomplished by utilizing diverse patient cases in a pharmacotherapy course. Finally, the fourth year should focus on exposing students to diverse populations while on advanced practice rotations and include discussions regarding cultural issues with their preceptors.²

More research is needed to evaluate effective methods of instruction, in and outside the classroom, that promotes the development of cultural competency.  By keeping abreast of the literature, educators can identify and implement effective learning strategies that motivate students towards becoming culturally competent practitioners.

References:

1. NIH.gov [Internet]. Clear Communication: Cultural Competency.
2. O’Connell MB, Rodriguez de Bittner M, Poirier T, Karaoui LR, Echeverri M, Chen A, et al. Cultural Competency in Health Care and Its Implications for Pharmacy Part 3A: Emphasis on Pharmacy Education, Curriculums, and Future Directions. Pharmacotherapy 2013;33:347-367.
3. Jungnickel PW, Kelly KW, Hammer DP, Haines ST. Addressing Competencies for the Future in the Professional Curriculum. AJPE 2009;73: Article 156.
4. Sears KP. Improving cultural competence education: the utility of an intersectional framework. Med Edu. 2012;46:545-551.
5. O’Connell MB, Jackson AN, Karaoui LR, Rodriguez de Bittner M, Poirier T, Echeverri M, et al. Cultural competency in health care and its implications for pharmacy Part 3B: emphasis on pharmacy education policy, procedures, and climate. Pharmacotherapy 2013;33:368-81.

The Flipped Classroom – Turning Student Engagement Around

by Amanda R. Bertele, Pharm.D., PGY-1 Pharmacy Practice Resident, Frederick Memorial Hospital

Imagine that you are a second year pharmacy student enrolled in a pharmacokinetics course. Your professor assigns readings prior to the class. She then spends the two-hour lecture period with her back to the class deriving equations. You are dismissed from class with 20 practice problems for homework. The topic seems understandable during class and you think that your note taking skills are adequate.  But when you arrive home and begin working on the first problem, you soon realize that you understand very little about the information covered during lecture.  Moreover, your notes are incomplete because you could not type or write as quickly as the teacher was speaking. As you wade through the 20 problems assigned the homework grows increasingly frustrating.  You feel defeated and you decide that pharmacokinetics just isn’t “your thing.”

Source: http://elearningindustry.com/flipped-classroom-2012-infographic

How can this scenario be avoided? The answer may be the flipped classroom. The flipped classroom is a learner-centered teaching model that reverses or “flips” the order in which learners are exposed to new material.¹ In the model, new course material is covered prior to class using common instructional methods such as videos, readings, podcasts, or powerpoint slides with recorded audio. Presenting new material to students prior to class provides the opportunity for learners to view and review the material as many time as necessary until it is understood.² The scheduled class period is dedicated to hands-on activities requiring higher levels of cognition (analyzing, evaluating, and creating). Activities may include discussions, exercises, projects, or cased-based role playing.² Instructors often use class time to monitor student’s progress, guide them in their approach to learning, and revise course content based on student response.

One of the potential advantages of the flipped classroom is that the model facilitates the implementation of in-class activities that can appeal to multiple learning styles. During in-class activities the teacher is better able to spend one-on-one time with each student and to provide immediate feedback.³ Additionally, providing new course material in formats that may be viewed more than once can be especially helpful for students with barriers to learning (English as a second language, attention deficit disorder, hearing impairment).¹ To be successful, students are required to be self-motivated and active learners.

The flipped classroom is not a new instructional model as it contains elements similar to the Socratic method (5^th century BC) and has been implemented in traditional undergraduate courses like physics for decades.⁴ However, it is a model that gaining more attention in pharmacy education. Until recently there was little evidence demonstrating its effectiveness. In 2012, the University of North Carolina Eshelman School of Pharmacy assessed the effect of implementing a flipped classroom model in a pharmaceutics course on student academic performance, engagement, and perception.⁴ The intervention consisted of pre-class assignments including readings and pre-recorded video mini-lectures.  During each class period, four active learning exercises were implemented. The effectiveness of the active learning exercises were assessed using several methods including clicker questions, think-pair-share, student presentations and quizzes. The assessments allowed instructors to gauge students’ knowledge in real-time and deliver micro-lectures (1-3 minutes) to clarify key concepts. Students were also assigned 2 course projects, given multiple quizzes, a mid-term exam, and a cumulative final exam. Based on data collected using pre and post course surveys it was determined that learning foundational content prior to the scheduled class period significantly enhanced student learning of course material in class (p = 0.001) and interactive in-class activities significantly enhanced student learning overall (p = 0.01). After completion of the course, more students indicated that they preferred the flipped classroom structure over the traditional classroom structure (p = 0.001). Despite positive outcomes related to student engagement and perception, student academic performance based on examination scores was not significantly improved using the flipped classroom model when compared to the traditional model (p = 0.31).

While there are potential benefits of the flipped classroom, there are potential pitfalls that educators should be aware. The first is student workload.⁴ If careful consideration is not given to the length of videos or volume of reading required prior to class, students may become overwhelmed, show up unprepared for class, and unable to engage in the in-class learning activities. Educators should also consider the time and effort required to re-design lesson plans to fit the flipped classroom model.⁵ Educators will need to dedicate more time to evaluating activities and projects designed to assess student learning. Lastly, educators and students must have access to certain technology, like high speed Internet.

The flipped classroom method will probably never eliminate the need for traditional models of teaching but, it is a method that should be added to the teacher’s repertoire in higher education. When educators observe that lecture attendance is low, students seem bored during class, or when course material needs to be refreshed, the flipped classroom may be an effective strategy for re-engaging learners and teachers alike.

References

1. EDUCAUSE: uncommon thinking for the common good [Internet]. Washington, DC: EDUCAUSE. 7 things you should know about flipped classrooms; 2012 Feb 7 [cited 2014 Jan 26].
2. Vanderbilt University Center for Teaching [Internet]. Nashville, TN: Vanderbilt University. Flipping the classroom [cited 2014 Jan 26].
3. Knewton [Internet]. New York, New York: Knewton Service. Flipped classroom a new method of teaching is turning the traditional classroom on its head; 2011 [cited 2014 Jan 26].
4. McLaughlin JE, Griffin LM, Esserman DA, et al. Pharmacy student engagement, performance, and perception in a flipped satellite classroom. Am J Pharm Educ 2013; 77(9): Article 196.
5. Edutopia: what works in education [Internet]. San Rafael, CA: The George Lucas Educational Foundation. The flipped classroom pro and con; 2012 July 10 [cited 2014 Jan 26].