“Why is the subclavian vein the worst place for a tunneled hemodialysis catheter?” our attending asked us. My senior peer and I looked at each other and shrugged. He wagered a guess, and I said nothing. “Not quite,” responded our teacher, and she turned to speak to the bedside nurse, giving us time to deliberate amongst ourselves.
We are wired to want answers, and by not giving us the answer to our question right away, our teacher created an opportunity for us to build knowledge for ourselves. We began to dissect the purposes, processes, and potential pitfalls associated with hemodialysis catheters. We wondered if it was something to do with anatomy, infection risk, AV fistulas… We searched for articles on our phones in between seeing patients, thinking critically about every possible answer to the question.
Constructivist learning theory teaches that children learn through inquiry and experience, and I suppose adults are not very different. Interest motivates us to seek answers. As an elementary school teacher, I noticed that the majority of my work went into creating an environment that allowed my students to investigate and experience new concepts in order to build their own knowledge, scaffolding on what they already know to be true, experiencing cognitive dissonance before assimilating new information into schema in their malleable minds. During the actual class time, instead of presenting fact after fact, my job was to walk around the room, observing their projects, and continuously ask them “why?” in order to spur deeper thinking.
Looking back on the first few years of medical education, I have noticed that the instances where my teachers have asked me questions and waited for my responses have been more memorable than the instances in which teachers have provided information as I passively listened. I look forward to learning more about adult learning theory as I grow in my clinical skill and have opportunities to teach medical students during my residency.
