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On The STATMed Podcast: Back to Class with Dr. Culhane Part 2

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From Doing the Homework to Thinking Like an Entrepreneur, Academic Educator Dr. Jim Culhane Shares His Top 10 Takeaways from the STATMed Study Skills Class 

Host Ryan Orwig is back with Dr. Jim Culhane, Assistant Dean for Student Academic Success Programs and Professor of Pharmaceutical Sciences at Notre Dame of Maryland University School of Pharmacy. In this miniseries, Ryan and Dr. Culhane debrief from a recent STATMed Study Skills Class where Dr. Culhane participated as a student. In part two of this series, they dig the importance of frameworking, doing your homework and thinking like an entrepreneur. 

“That’s an illusion of productivity that we always talk about. I think if you asked any student and gave ’em a choice, ‘do you wanna be an office drone or an entrepreneur CEO?’ I mean, who’s gonna choose [drone]? But yet most of them, I think, fall into that office drone mentality. And I think the reason is that they just don’t know how to escape it. They don’t know how to act like the CEO, like an entrepreneur. So I like that mentality and attitude. And, the reflection, the insight, the constantly looking at ‘what can I do better? How can I deploy these resources more effectively to take control of my learning?’ I think that’s incredibly empowering.” – Dr. Jim Culhane 

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Transcript

– [Announcer] Welcome to the STATMed podcast, where we teach you how to study in med school and how to pass board style exams. Your host is Ryan Orwig, a learning specialist with more than a decade of experience working with med students and physician. In episode two of this multi-part series, Ryan and Dr. Jim Culhane, Assistant Dean for Student Academic Success Programs and Professor, Pharmaceutical Sciences at Notre Dame of Maryland University School of Pharmacy, continued debriefing after attending the STATMed study skills class alongside struggling medical students. From doing the homework to thinking like an entrepreneur, Dr. Culhane digs into his top 10 takeaways from the class.

– [Jim] It is such a profound shift in thinking this whole idea that, it’s all about agency. You are the master commander of your own ship. You’re gonna run into storms that you’re gonna have to sail through and different issues navigating, and all that you can’t control. But if you have the right tools and the right approach, you can navigate just about anything that people throw at you.

– [Ryan] Next one was, and I love this one. You had, do your homework. Oh my gosh. So why did you choose that as one of your takeaways?

– [Jim] Yeah, I mean, the do your homework phrase has a lot of meanings to it. The first thing that was, that really resonated with me and I really like because I tried to do it when I was writing my book is to ensure that the examples and the materials that you have your students working with are authentic. Like if you’re gonna give them, let’s say a lecture to framework. Which is, maybe some of your listeners are familiar with. It’s gotta be something that’s authentic and so that they could look at and say, oh yeah, this could be something that I could see in class and I have to deal with and I have to navigate. It’s ugly, it’s dense, it’s disorganized. And I’m stuck with it and I gotta deal with it. And I think that that was… And then giving them the opportunity to go outside of class, and really wrestle with it. Take the methodology that they learned in class that day and go outside and wrestle with it. And these guys did. I mean, they did their work, they did their homework really well. And then to come back again the next day and talk about, okay, this is and understanding too. And I think the other thing that I really appreciated about your approach to this too, is telling these students and reinforcing the idea that these are skills that they’re developing. It doesn’t happen overnight. It requires practice, you know, feedback, failure.

– [Ryan] Failure.

– [Jim] Failure is important. It’s not a bad thing, you know, I mean, it’s a bad thing if it gets you launched outta med school. But it’s, but failure’s part of the, is an important part of the learning process, you know? And I think that you handle that in a really very productive way with these guys. Like yeah. You know, I, my framework was great last night. I got a lot out of it and I followed the approach and it’s, you know, I’m extracting that, you know, the infrastructure of the lecture or boy, I just didn’t even know where to begin. I’m like, okay, well, we can work with that. Let’s, let’s take, you know.

– [Ryan] It’s when the student, you know, and we set this up, like we tell, like, how’s a kid gonna learn to ride a bike. If the kid gets on the bike, like, you know what, dad, I don’t know how to balance. Like, I guess son, you will never ride the bike. Like we would never, like kids are learning engines. They mess up, they reflect, they adjust. I think that that has been beaten out of our students as they become adult learners. I think that our, our med students and our STATMed class population is used to being pretty smart in getting things earlier than their peers prior to med school.

– [Jim] And not failing.

– [Ryan] Right. Not failing. Right and what they want in their heart is like, have Ryan tell me how to do it, and I shall do it right. Yeah. And this is not how it works. No, so these homework assignments, number one, are crucial for skill development. We disseminate, we do little workshops right there in the moment and then give immediate feedback. It’s the homework and then the feedback, it’s the attempt to try. And then the feedback, then they go do their homework. They’re independent practice. We have curated these homework assignments for 15 years. It’s not like, oh, this is gonna get you a good grade on your boards. I don’t care about that. Like that’s fool’s gold. It’s like, no, you’re gonna do this. And it’s gonna like spring some booby traps on you. There’s some pitfalls built into this homework assignment that I know is real. You’re gonna spring it. And then the final part is the debrief. ‘Cause you like, think about what the framework assignments, when we do that, right. The dynamic reading and marking, I already have canned debriefs that we go through. So yeah, we’re talking about your experience and her experience and his experience. And it’s all great and interesting, but then we tie it all together with a pre-created thing, that I roll through that illustrates all my main points, the teaching points. That curated homework is so important, but the reason I like that you say, do your homework is you could just, like, I could tell you how to do it and then show you that debrief. But you’re only gonna get like 15, 10, 15% of the value out of it. If you had not tried it out and taken that sucker for a test drive. And I don’t care if you nailed the course, or if you, you know, like the obstacle course, or if you wiped out all along the way, any which way you shake it, if you gave it a run, good, bad, ugly, whatever you’re going to then benefit from the debrief that is at the heart of how I teach these skills. When viable, you know, you can’t always give the dry runs for some test taking stuff for a first year med student, for example, you can’t always do the dry run for certain time management tools. But with the hardcore skills, those runs and doing that homework is great. And again, the luxury of a STATMed class student is they’re gonna do it. 98% of my students are gonna do the homework. Now, if you’re one of the ones that aren’t gonna do, the homework I’ll have a conversation with you. You know, now sometimes it’s like, they’re so afraid. They’re so beat up. They need that little extra conversation. But if it’s not that, I mean, I’m not gonna, I’ll tell you like, Hey, you know, you’re not doing your homework, but I’m not again, like, what am I gonna do? Give you a bad grade? I mean, I’ll give you a stern look, I might confront you on it and be like, look, man, like, this is a bad, like, you gotta do this homework. Yeah. Well.

– [Jim] I would say that to any of your future students. I mean, I think that, you know, to get the, you know, to get the maximum amount of benefit from this course, you’ve got to engage in the activities outside of class, do the homework and entail at it.

– [Ryan] Yeah and we, you know, I think we create a very safe environment.

– [Jim] Oh, Absolutely.

– [Ryan] Without being cheesy about it, it’s like, nah, like it’s cool. Like fine mess it up, I don’t care.

– [Jim] Well, you know, and that brings up a really interesting point too. You just, something you just said resonated with me, as I was listening to, you know, part two of the student, you know, you interviewed the students that were, in this cohort with me and I was listening to part two the other day. And I think it was Elise who mentioned something about, you know, what was really, I think helpful for her is she was in a class, she’s in this class with a diverse group of learners from different health professions, disciplines. Right, we had a PA student, we had a vet student, we had medical students in various levels or, you know, parts of their medical education. And what she mentioned was resonated with me is that it gave them an opportunity to work together. And that’s something that, you know, we really strive to do in all the health professions education with regards to interprofessional education, you know, most health professions programs are required by their accrediting bodies to provide their students with didactic and experiential experiences where they interact with students from other health professions. Yeah. And this was really neat because I think Elise’s insight is that this program allowed these students to be vulnerable with one another and to say, Hey, look, nobody has all the answers. Right. Right. It’s only when we work together as a team, as we, you know, and share our unique knowledge and experiences with one another, that we can really most effectively help our patients. And it was so interesting for me to see a student in the class make that kind of connection, you know, make that huge leap. Right. Because I, would’ve never, you know, I, would’ve never thought to bring, you know, kind of an interprofessional education component into this, our discussion here today. But when I heard Elise say that, I’m like, boy, she’s, that was super profound. But that’s, I think educators could learn a lot from this.

– [Ryan] Oh, so much. I mean, look, yeah, these students are bringing so much to the table and part of the mission is like those outside the box thinkers, or those kind of connective thinkers might be some of the ones that get run out of the system, their learning needs. And so part of the mission of the STATMed class is to make sure people like her are staying in the game because then they get to the other side. And they’re the ones that are more likely to change things on the other side, if you wanna get more lofty in your, in your outlook.

– [Jim] Yeah, absolutely. No, absolutely. You never know what the ripple effects of these kinds of experiences are gonna be and they can be long lasting and profound.

– [Ryan] Yeah. I mean, I’ve done this long enough now that I see where some of my people have ended up and it’s humbling and mind blowing. So to think that they could’ve been run out because they just couldn’t manage the sheer volume as a second med student or something silly like that. Alright. So that’s your homework stuff. And then, I mean, I guess we sort of talked about this, number eight, was for you are not alone in this.

– [Jim] Yeah. You know, I think, I think one of the things that’s was again, really striking for me. And I knew this already because I’ve read the research in this area and it’s, you know, a lot of the studies that have been done point to the same thing. That, you know, students in undergraduate and professional degree programs when left to their own, their own methods that, you know, they gravitate towards these passive, largely ineffective methods of learning, like reviewing, like that’s a bad word. I know it’s a bad word for you. When I work with students in academic coaching, I don’t wanna hear, I reviewed my notes or I, I studied my notes. What does that mean? Right. Right. You know, and, or re-copying notes or condensing notes or highlighting all, re-watching lectures, all these things. And, you know, to hear, you know, these incredibly bright, intelligent people, these are the methods that they use prior to coming to you and this it’s not their fault. It points to the brokenness of our educational system in this way, in that we need to do more to teach students how to learn, how to become independent self-regulated learners.

– [Ryan] Well, and I would say more importantly, we need, I mean, I think that applies across the spectrum, but probably an emphasis to teaching are highly intelligent students, how to learn.

– [Jim] Everybody.

– [Ryan] Right, everybody. If there’s a bar of like the 50th percentile of our students, most education is for whatever the arena is probably arranged aimed below that bar. And that’s why that’s one of the reasons why so many of these bright students can just get through without ever learning to study. That’s what they tell you. I’ve never learned to study, I never really had to study. I just sit there and soak it up or I could just cram. They, you know, I could just cram the night before. I’m so sorry. So you’re confessing guilty. You could cram for three hours the night before the test and get A’s, that’s not your fault. That’s the system’s fault. So, and then they get to these health science fields where in med school, vet school, Pharm B programs, and then the volume is just, it’s such an astronomical jump. They don’t have those tools. Now again, a large percentage of them are gonna figure it out. But then within that large percentage of quote, unquote, figure it out, some are gonna be better than others. So you’ve got the ones that have figured it out, but it’s not comfortable and optimized. And then you got the ones that just don’t figure it out. But yeah, you’re not alone in this, meaning that so many students go down these paths and that I think is part of what I call the pattern recognition. We see these patterns repeated again and again and again. And I guess that should be, I mean, I think that should be like encouraging for someone who’s struggling. Right?

– [Jim] Yeah. You know, and I, and I think also too, a couple of things, I think if you were to survey medical students across the country, I, you know, I wouldn’t be surprised if 95% of medical students surveyed said that their first two years, regardless of how smart they are or how well they did. Their first two years of medical school were a complete nightmare. Right. It’s not a fun experience. It’s not about learning, it’s about survival. Right and I think that, that, you know, I think that any student, whether they’re struggling in their medical school program or their other health professions program, or Hey, they’re doing well, but their experience is so miserable that they could benefit from this methodology because it offloads a lot of that stress and anxiety. I think that as a medical educator, one of the things that I see, and it’s one of the charges of that national committee that we’re, you know, that I’m involved in, is that we are facing a kind of a mental health crisis in higher education, higher, you know, health professions education, where, you know, we’ve got students that are severely depressed, they’re anxious, they’re self-harm, suicide rates. Those sorts of things. COVID has done nothing to help with that. And you know, what I found, at least in my work on a day to day basis is that when I teach students evidence based tools that they can use to become more effective, independent learners, and help them to, you know, assess their learning on a day to day basis so that they, when they go into an exam, they know where they’re at. They can predict what their grade is gonna be okay. That it takes a huge amount of anxiety away and removing the failure, you know, helps with the depression. So, you know, I think that the implications for the learning sciences and as it is applied to this high level of learning are vast. It’s not just about getting students to learn better, which is, which is incredibly important, but it also has a very important secondary effect.

– [Ryan] Oh yeah. I mean, agency is a big factor here.

– [Jim] Oh yeah, exactly. Thank you. That’s I mean, that’s exactly the word.

– [Ryan] I tell people like, I’m not, I’m never gonna guarantee you success. I don’t know what your abilities are. I don’t know what your ceiling is. Right? But we can definitely, especially when you talk to ’em and they tell you what they’re doing study wise, and it’s like, yeah, we can definitely unlock this and help you optimize your innate ability by equipping you so that you have a true fair shot at, at least leveling the playing field for yourself and having a clear go at this thing. And yeah, the number here that these are staggering, like they’re, every people are everywhere and I don’t care what undergrad you went to from, you know? Yeah, local state run school to an Ivy league school. I’ve met people from all walks of life on this. And it just depends on, on your wiring. I had somebody ask me, like, I’m a repeating first year student. I hope that my class is full of repeating first year med students.

– [Jim] Yeah. You said that in the, yeah. Right, right.

– [Ryan] Yeah. But, I’m like, it doesn’t matter. What matters is that they have a similar learning experience. I can have one veterinarian student, one like one veterinarian, one med student, one PA, you know, med student and rotations, whatever. And they could all have a great small class experience because it’s about the shared nature of their struggle and that’s what’s, and I think that’s pretty encouraging.

– [Jim] And when you realize that you’re in the trenches with somebody else, you know? ‘Cause I have a military background. And so I, you know, I kind of understand the, you know, the bonds that form between people that when you’re put in high stress situations. Right? And you know, I could see a class where you had, you know, a med student, a PA student, a pharmacy student, a nursing student, you know, just, you know, and bring them all together and taking ’em through this course. Wow. You know, not only would it impact their learning and their ability to be academically successful, but coming out, you know, now they’ve got this bond with their other fellow health professions. And I just, I just, like I said, I think the ripple effect of that could be amazing.

– [Ryan] It is. Yeah, it is.

– [Jim] They work together outside of school, when they get into their respective professions and someone working together in a hospital or other health professions, healthcare setting.

– [Ryan] Yeah. Makes you make, I think it does open up other connective tethers to you as a professional and empathy and all that stuff. So number seven, counting down, we had number 10, methodology matters. Number nine, do your homework. Number eight, you’re not alone in this. Number seven, again, this is one of my things. Think like an entrepreneur. Why did this resonate for you?

– [Jim] Yeah. So I will tell you, I heard this phrase from one of my students who took your course. When I was doing it during an academic coaching session, they were like, yeah, I gotta think like an entrepreneur, not like an office drone. And I’m like, what? And they explained it to me and I’m like, you know, it was just like, wow, that is hugely powerful. So Ryan, I’m gonna, I’m just gonna go public and say, I am stealing this from you. I use this phrase with my students all the time, because it is such a profound shift in thinking, this whole idea that you it’s all about agency. Right. You know, you are the master commander of your own ship. You’re gonna run into storms that you’re gonna have to sail through and different issues navigating and all that you can’t control. But if you have the right tools and the right approach, you can navigate just about anything that people throw at you. And I think, you know, looking at things like your time, your energy as resources, right. And how do you effectively deploy those resources and use them? That’s how CEOs and entrepreneurs think versus the office drones who check in, you know, clock in clock out. They do what they’re told, they put their time in. They do time and a half, you know, they’re not in control of their situation. And I think that’s a source of a lot of anxiety for my students at least, is that they feel like they don’t have any control over their education. That there’s all these, you know, instructional and administrative types of pressures that, you know, are pushing on them. And they feel like they don’t have any control. And in fact, they have a ton of control.

– [Ryan] Well with the, with the tools. But also, to me, the office drone mentality is when somebody calls me and they say, I’m struggling. I don’t get it, I study eight hours a day. I study 10 hours a day. Why am I struggling? I’m like, oh man, I don’t even know where to begin with that. Right. So to me, that speaks to I’m punching the time clock. I’m willing to suffer. To make my money. But what does that mean underneath the surface? And that’s the office drone I’m punching the time clock. Why am I not getting paid? Like I should be, if I’m putting in 12 hours, I should be getting some kind of specific yield. And that’s just not the case. Like as an entrepreneur, as a business owner, I can be like, I’m working 12 hours a day. Why is my business not flourishing? Like, whoa, dude, like where, where do we begin? So it is about accountability too, along with agency. And the idea that logging the time has a direct correlation to outcome is an office drone, to me.

– [Jim] Yeah. That’s an illusion productivity that we always talk about. And I think, you know, I think if you asked any student. If you gave ’em a choice, do you wanna be an office drone or an entrepreneur CEO? I mean, who’s gonna choose. But yet most of them, I think, fall into that office drone mentality. And I think the reason for that is because they just don’t know how to escape it. They don’t know how to act like the CEO, like an entrepreneur. So I like that mentality and attitude. And, you know, the reflection, the insight, the constantly looking at what can I do better? How can I deploy these resources more effectively to take control of my learning? And I think that’s incredibly empowering.

– [Ryan] It’s a really good dichotomy. Yep. This drone versus entrepreneur type thing. And again, it’s hard to unlock the entrepreneurship without ’cause like that does get into time management as well. A lot of our time management and time maximization tools we teach, I adapted from reading about entrepreneurship. That’s where a lot of that stuff comes from as opposed to from the education field, because entrepreneurs are crazy about their time. Right? As well, I should be like, it’s like, man, all I’ve got is so many hours in the day. So how can I optimize that? And I don’t teach time management tools without teaching the study skills. Right? They have to be parallel and symbiotic with each other. So that’s a key, it’s a big piece of it. But I do, I just think that every student that’s leaving the class is very aware of that dichotomy and they know how to unlock it. And it’s a good way to self check yourself and say like, wait, what am I doing here? Am I like, am I punching that time clock? Or am I really working here? Am I, getting more bang for my buck time wise and then that can be a way to reset, but no, that’s one of my favorite things and I do love it when I have that conversation with the student after the class or if I hear them say that. Yeah. ‘Cause it shows me that it’s a great way to have ownership. Then the next thing you have, number six, it’s all about the framework, you know, you’re preaching my language here.

– [Jim] Yeah. So I mean, you know, I know frameworking is one of the core skills that you teach students in terms of, and it’s a method for, again, this is the way I think about it. It’s a method for interfacing effectively with highly dense. Maybe sometimes disorganized, lengthy learning materials, whether it’s a, you know, 80 slide, PowerPoint presentation, or, you know, a board’s book or chapter from a textbook, this skill can be used in many, many different ways. And again, this is where I see your reading and learning background come in. And I think, you know, one of the things, you know, ’cause I’ve known about frameworking for many years and I’ve watched it evolve over. You know, as you’ve told me about different improvements and changes that you’ve made. And you know, I’ve always known that it was important, but I think, you know, taking the class really just struck that last nail home was, you know, that, yeah, this you’ve got to be able to find a way to effectively interface with the types of learning materials that med students or pharmacy students or vet students, you know, or PA students have to interface with. And frameworking is it, you know, I’ve tried to.

– [Ryan] Framework is the plugin, it’s the first step plugin. It is learning at this level. It probably all levels. But at this level has to start with the learner finding organization. Some learners in med school and in these related fields are able to do it in the background. Like the magic elves can build the structure. Those are those high structure builders. Those are the ones that are bottom up learners, can learn from fragments. Those are what I used to call two trackers on track one. They can build structure on simultaneously on track two, they can put the items where they belong within the structure. Those are the students that are gonna thrive in med school. Those are the ones that can learn from doing just a bunch of practice questions. Those are the ones that can learn from just drill, drill, drill, connect, connect, connect. But there is a large slice of the population that are not wired like that. And those are the ones that are low structure builders, low structure builders in the literature, top down learners in my vernacular, single trackers in my vernacular. And it’s about the framework at the beginning and then binding that framework all the way through. I love the idea of making it external and explicit, which again is another area that breaks down and then we can flip it and use it for retrieval practice on the back end. So it’s about the framework and if you don’t and I know people that maybe are listening to this and are like, I wanna know how to framework. I mean, again, either the tip is, find the structure up front or you do the class and you learn. ‘Cause I mean, it takes a few days to learn how to do it.

– [Jim] And you have to practice it. Yeah.

– [Ryan] It’s gotta be practice. It’s gotta be given feedback. We can accelerate your learning with it. But it is. I mean, if this is where things are breaking down for you, that’s where it’s at, but it does take some time to teach. Nothing wrong with that. I mean, it’s not rocket science.

– [Jim] It’s important.

– [Ryan] But it’s like, there’s just so many, like it’s not intuitive. It’s like, you think you want the opposite. So that’s just why people don’t do it innately. So anyway, yeah, it is all about framework.

– [Announcer] Thanks for tuning in to this episode of the STATMed podcast. If you liked the show, please be sure to rate it on iTunes, Stitcher, Spotify, or wherever you listen to your podcasts. You can find more test taking and studying strategies, specifically designed for med students and physicians over at our blog at STATMedlearning.com. Thanks for listening.

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