1 Learning and Teaching TheoryMaster class concepts incorporate coaching, experiential learning, live hands on learning and using the active experience. (Note even in music literature the spelling is varied – two words, one word master class, master class) Ask audience – background Any musicians in the group? How many of you have had master class experience? How did that turn out? Natascha – music performance degree, cellist Hayam – Egyptian background where direct feedback is expected (HAYAM INSERT) For this section does everyone have a handout? We also have a few copies of articles we found very helpful in the back for airplane and snacking reading. Editor First edition Publisher Info. Berlin: N. Simrock, 1896 Reprinted Great Romantic Cello Concertos (pp ) Mineola: Dover Publications, 1984. Copyright Public Domain Master class Concepts Lautenschläger, MD Shaker, MD Dvorak Cello Concerto 1896 Public Domain

2 Objectives Describe key features of experiential learning theory – how it applies to excellent teaching Demonstrate three “master class” learning techniques that apply to excellent clinical teaching Discuss common barriers to the master class teaching approach – and how to overcome them. Teaching is an essential and integral part of our professional life Our goal is to have learning tools, habits and environments that improve our performance in teaching, learning, and communication skills. Describe key features of experiential learning theory – how it applies to excellent teaching and learning. Demonstrate three “master class” learning techniques that apply to excellent clinical teaching. Notice we said Learning – not teaching. We will discuss as we progress. Discuss common barriers to the master class teaching approach – and how to overcome them. Develop ideas on this format in medicine education – barriers to this approach and how might you incorporate these ideas. Master class format in music – demonstrating the feedback dialogue and those theories in this concept

3 Musicians and Medicine: LearningPerformance to clinical practice Pedagogy and core repertoire Coaching and experiential learning Self Regulated Learning There are surprising similarities to medicine and music teaching and learning – the overall experience for the music student. Musicians learn both by the ‘books’ (who has sat through music theory?) and by cycles of experiential learning, hands on with their instrument, usually from day 1. The end result is the performance or successful clinical practice involving the active audience (patients, families, communities). To get here, the musical student has to acquire the core ability – practicing those scales and etudes to develop the dexterity and muscle memory. Pedagogy (in music, the back bone – scales, etudes) becomes the core skills, the core music the advanced topics. Our arpeggio is your MMSE or algorithm. Musicians spend a lot of time in self-regulated learning – Those hours in the practice room. Just like you studying for boards, exams, reading that article. Then precepting private lessons, group learning in master classes. Coaching with hands on, experiential learning which is live and in real time, hands on, reflection and learning how to see yourself and the performance from your point and also all over. In medicine as in music, endless performance without feedback drifts into stagnation. There is constant movement between the performance zone and the learning zone. The development of musicians is based on the experience of being a musician. SLR = self thoughts, feelings, and actions that are planned and cyclically adapted to the attainment of personal goals” (Zimmerman, 2000, p. 14). (Bradner 2016, Davidoff 2011, Ericsson 1993)

4 What Musicians can teach DoctorsExperience vs. talent 10K hours Repertoire, improvising the score Art; technical skill & musicality “Science using interpretive activity” Experience and talent: Training and practice and real experience beats “natural” talent every time and studies back this up. . While there are cases where folks may not be cut to be a certain profession (if you faint at blood every time, phlebotomy is not a good option), and those are rare. Talent may be more that youngsters show an interest in an activity and then start doing it earlier or more often than those “without talent.” Studies on expert performers in music vs. the good is the result of more frequent practice over many years of learning. Are the “talented” more skilled at practicing, self reflecting and adjusting, versus what we call “noodling around?” Practicing is goal directed to improving and growth. Time of training: It takes 10 years to make a bad cellist, 20 years to make one “you don’t run away from.” Not unlike all of us here. Great stars in music (and medicine) are often not great teachers, and great teachers are often not the most amazing performers. Coaching and performing may require different skills, personalities, understanding. Davidoff. What musicians can teach doctors. Ann Intern Med. 2011;154: Ericsson KA et al. The role of deliberate practice in the acquisition of expert performance. 1993 We also all improvise. Art is the lie that tells the truth. In medicine and music there is room for interpretation. Novices learn “the rules” and as they progress grow into interpretation. There are numerous recordings of the same piece, such as Beethoven’s 9th or Cohen’s Hallelelujah? We also interpret the guidelines to the individual patients, communities. The joy and sometimes torture for the novice and experienced alike is that interpretive grey zone. “Don’t ply the butter notes,” Mile Davis – the piece is the same, just like the chief complaint and presentation. Yet listening beyond the butter notes, rounding them out – each hall, each day, the weather, the audience, yields a difference as do patient who may present with the same butter notes of heart failure. The ‘butter notes’ are the differential diagnoses workup of a patient's chief complaint – core knowledge that every medical student needs to master for multiple-choice tests and national board requirements. The artful medical student needs to be coached to find the more subtle notes present in any patient encounter. Unlike the differential diagnosis, each patient is unique, the illness is unique, the story is unique – these themes run as an undercurrent to any patient presentation. Science using interpretive activity in the care of patients and communities. Counterpoint in music is like hearing the many voices in a patient encounter – what they want, what you want, what they need, the community, etc. – hearing the patterns simulatneously and knowing which to bring to the forefront and which is counterpoint and supporting. We have similar worries and conflicts: Solo and team work conflicts and tensions. We are all team-based until the lawyer calls – then it’s all on you. In music and medicine there is a powerful drive to specialize – the must know all instruments and the complete score to negotiate the orchestra, yet there are far more jobs for the violist that for the conductor. Then there are those quality metrics. We have those in music too – nothing like reading about my tepid performance in this morning’s paper. To be successful, in both professions we need to become master learners. Bradner M, Harper DV, Ryan MH, Vanderbilt AA. “Don’t play the butter notes’: jazz in medical education. Medical Education Online. 2016;21: /meo.v doi: /meo.v (Davidoff 2011, Ericsson 1993, Kingsbury 1988)

5 Master Learner Life long learning skill Learning TheoryUSE DRY POSTERS – AUDIENCE TO DEFINE A LIFE LONG LEARNER – WHAT IS IT? WHAT ARE THE SKILLS? BUILD ON AUDIENCE INPUT: Group 1: Traits Group 2: Skils Consider: Medical students and physicians and phDs at al levels are both learners and teachers depending on the context. “a learner who demonstrates the most advanced level of lifelong learning skills.” Indeed, previous research suggests that a focus on the practical implementation of principles from learning theories improves learning. I am hearing a lot about __________ experiences …. Master learners learn from real life, from experiences, basically are experiential learners. (Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment. 2013) Master Learner

6 Experiential LearningBriceno, 2010 Concrete Experience abilities Reflective observation (Self) Abstract conceptualization Active experimentation (Kolb D 1984)

7 Experiential LearningConcrete Experience abilities Reflective observation (Self) Abstract conceptualization Active experimentation HAYAM One to the aspects of Master Learner is the idea of Experiential Learning – learning in the real world. The PROCESS is the driver of learning. With experiential learning – ideas are formed and reformed, it is a continuous process, try it out and experience it, then experience it differently. Learning is grounded in experience and the tension and conflict that comes from the process – tension from ideas and feedback that may not match what we are doing, want to do. Ideas are formed and reformed through our experiences. Learning is a process not an Outcome. The continuous loop of four concepts of experiential learning was emphasized by Kolb in his paper “Experiential Learning.” Concrete experience and our abilities Self Reflection –Looking at our performance from many different perspectives. Who can’t leave your body and see how you look from the outside? YOU. This is where input from the outside comes in and helps align the self observation as we move to Abstract conceptualization – we make concepts and theories. After we reflect on the what – looking to the process of why did this happen and what could be different so it does not happen, what do I change, what ideas do I have so I can have a different outcome? Goal directed practice – break it into the parts. Experimentation – try out those concepts and the results become those experiences and we cycle through the process. Back to the “prewash.” Then rinse and repeat. The Impulse of experience gives ideas their moving force, and ideas give direction to impulse. Now the coach helps continue the cycle. These four steps / concepts of experiential learning move into learning rules. There are many iterations of these, and we are going with the more common concepts iterated in several papers as learning rules. Taylor DC et al. Adult Learning Theories Med Teach 2013 Kolb D. Experiential Learning (Kolb D 1984)

8 Master Class Transforming experiential learning theory into practice Incorporates: Social Learning Theory Learning Environment (Gottlieb 2017, Schumacher 2013, Reed 2013)

9 Now to the Master class HAYAM / N?The over all theme is experiential learning – building on an experience, reflecting and abstracting what to adjust, trying out and back to the loop. Building our real life experiences. Now coming back to music education and learning. A well known conductor visited several medical schools in the USA – what do you think he saw when he visited? Precepting, core classes? “If musicians learned to play their instruments as physicians learn to interview patients, the procedure would consist of presenting in lectures or maybe in a demonstration or two the theory and mechanisms of the music producing ability of the instrument and telling him to produce a melody. The instructor, of course, would not be present to observe or listen to the student's efforts, but would be satisfied with the student's subsequent verbal report of what came out of the instrument.” - George Engel, after visiting 70 medical schools in North America (Davidoff article) Per a formal definition “A class given by an expert, especially a musician, for exceptional students, usually presented in public or on television.” Not necessarily – the master class seminar is a backbone of music education. Teacher and Peer coaching. Concentrated public coaching – sometimes performers take turns, have only 20 minutes or so with the teacher. Defined loosely as “dialogue” between master and student with student’s performance as focal point. Feedback and instruction during the concert and makes a new effort then and there. Though seen as a vital aspect to music teaching – even in music literature – there is not a lot of research done on this format. A staple in music is the master class seminar where students and professors take turns giving feedback to a perfomer – where as here it is the outside expert. There are not many examples of videoed seminars. Before we go to a video master class, let’s recap those learning rules: and experiential learning – combines the performance and learning zone in a safe environment: Concrete experiences, self reflection, abstract concepts, experimentation Bring experiences – all different, ready and able to work Accountable for their own learning – problem needs to be relevant Learn in the here and now and apply those concepts immediately. Learn best when integrating the learning with their lives. Make them work to learn. Learn best when motivated and engaged. Get them working: Bring expectations of the teacher - be collaborative. What are they taking away from this? Experiential Learning loop: experience, reflection (what went well / what did not), abstraction (how to change, practice, adjust, adapt), active experimentation (Try, try and try again). Differences were also found in modes of delivery, from a master-dominant approach to a more collaborative, student-centred approach. This indicates that the term master class covers many different forms and formats, but a common denominator is that it involves teaching a student or an ensemble in front of an audience, small or big. The presence of an audience will in itself offer both learning opportunities for the students performing as well as for the audience, but it also poses some challenges which are not present in one-to-one tuition. A master class is a concentrated public coaching for the singers who participate. Because each turn is much shorter than an actual lesson or coaching and because the master must explain everything to an audience that may know little about singing, they'll focus on only one or two very specific aspects of each performance. That way, everyone learns: the singer receives a valuable nugget of information that they can later apply to the rest of their repertoire, and the audience experiences how the master's advice improved their performance. You'll definitely benefit from singing on master classes if you're the kind of person who performs well under pressure! There's incredible leverage and support created by the situation. Not only are you face to face with a prominent expert, but there's a whole audience rooting for you to succeed. So if you can handle it, a master class creates conditions where breakthroughs are likely to happen, and when they do it's exciting for everyone - the singer, the audience, and of course the teacher. 

10 https://www.youtube.com/watch?v=n2i6UuCAw0Y VIDEO Master class https://www.youtube.com/watch?v=n2i6UuCAw0Y Fast Forward to past the performance to when teacher starts. This movie 18 minutes after her performance. Watch for teacher and performer teaching and learning techniques. What about the audience? (fellow performers). How are they learning, how is he teaching for them? Thomas Hampson Master class 2012 – Manhatten School of Music – This is cut / spliced to save time and emphasize the highlights of the teaching technique. Full case on line 20min. AUDIENCE PREP: This is an example of a master class where an outside wellknown expert is brought in to teach. The audience is made up of fellow musicians, in this case voice students. The performers are at an advanced level and she brings a prepared piece to perform. He is going to give her a lesson while the experienced audience looks on. While you are watching this – please think back on what we discussed earlier – experiential learning, learning rules, on developing the master learner. After we watch this snippet we would like you to break into two groups: GROUP What did you see from the teacher? GROUP What did you feel / see from the performer? GROUP What about the Audience? Is he kind of harsh on her? What about the audience? What are they doing? How do you feel? Is she open to feedback? (Have audience write/ discuss what they see, what is good and what might be hard) 5 Factors: Performer, instrument, audience, hall/environment, piece # # # Comments about Master class from Music literature Sharing balance of power, joint collaborators with audience. Mutual support and interest from the audience – everyone is generally rooting for the performer to do well. It is excellent practice for the real thing. Socio-cultural learning theory – situated learning and guided participation. Team collaboration (when you bring in the audience)), the supervisor scaffolds the student learning. Develop a professional identity by the process of becoming, interplay and dissonance of identities of us learning together. Within a learning system, a safe environment. When the performer experiments and has a breakthrough the audience may as well. Watching others  accepting of new ideas Teach and learning in front of others – conflict tension and building of ego? Open dialogue – back and forth clarification. Also the audience participates or watches and draws on their experiences Valuable practice in public performing. Practice a suggestion on the spot. Creates a Community of Practice – a group of people who share a passion for something they do and learn to do it better as they interact regularly. Also builds that learning space. Research into the Master class format (master student pianists) All noted worth doing even if disagreeing with suggestions. Generally seen as a positive to self esteem, musical self efficacy, acquiring new music skills, stimulated participants to energize their peers. Discuss experiential learning here. Learning principals: a room full of different experiences, they chose to be here and learn – they can go home an try it out, apply a technique to a piece they are working on, even more intense if they are working on something from the same time period, the same composer, the same opera? What did they learn today? Maybe a pearl about posture to a more intricate phrasing to a larger concept of the aria in the whole piece? Review the adult learning rules, how did they apply? Review the experiential learning 4 concepts: What about the Coach/ Master? Having to know the repertoire, having experience. Has to come up with on the spot lessons and pearls and demos unique to that particular learner- their input closes that learning loop by giving the input Note the self directed learning and ‘sandwich feedback’ – ask – tell – ask. Probing to find out her experience with the music, the motivation. Why did she choose this piece? Behaviorism theory – watching and learning (stimulus and response) Social Constructivism – ideally learning is in the zone of development, and then needs a more “expert cohort inorder to advance.” (But not too expert, because then it out of the depth of the learners. Performing in front of others Teach and learn in front of others Open for audience comments and critiques Dialogue for all involved Shared balance of power Experiment on the spot

11 Techniques Feedback dialogue Metaphors, nonverbal, gesturesReflection / scaffolding / dissonance Demonstration, follow me Live experimentation Self - Feedback Receiving Signpost relevance to audience / learner Here are several techniques used in a master class. The feedback dialogue - bringing out self reflection, then helping with this. Also asking if the learner understands? The dialogue may not just be verbal – student responds to the demonstration. Everyone is drawing on their past experiences and note the respect for those. The master is constantly adjusting, checking for understanding as he builds rapport and feedback dialogue. Self reflection, drawing on past experiences and also bringing out the nuances, discussing how to break it apart – practice? Studies show that students who become more active in the dialogue – offering performance, offering feedback become more confident performers. Use of metaphors, nonverbal communication, demonstration, discussion. Thinking back to cognitive theory – sometimes a different metaphor or bridge is needed to build a connection to past experiences, to understanding a concept. Imitation – learn by doing before understanding. In medicine, think of the bedside rounds or wards – how to find that heart murmur before you know what it signifies. Live experimentation – this learning applies to the now and to the future: Students are likely to perform the music in concert, ability to execute and memory (develop templates to use when practicing). # # # Learning rules: Bring experiences – all different, ready and able to work – ask folks who is what, from where. Accountable for their own learning – problem needs to be relevant. When the learner realizes what they need to learn to meet their own goals and objectives.. Learn in the here and now and apply those concepts immediately. How to practice X? Learn best when integrating the learning with their lives. (the repertoire, performance) Learn best when motivated and engaged. Get them working: (In a seminar pulling the audience in as teachers and learners) 6. Bring expectations of the teacher - be collaborative. 7. What are they leaving with – what did they learn? What are they going to do differently (Hanken 2008 & 2012, Jørgensen 2008)

12 Challenging Arena Performance anxiety - emotionalCognitive challenge Teacher Cognitive differences in learners Awkward – after the class Power Feedback resistance HAYAM When Natascha first approached me about presenting and actually doing – I was “you do it.” Performance anxiety - Subject one’s self to continuous critique in public. Likely someone in the audience will know your piece, know more than you, be competing for the same chair at some point. When I get critiqued, my emotions first take over and I need to digest. A class that is harsh – it may be awkward later. What about feedback you get in class but did not get one to one? – if the expectation of feedback is in the class, then this becomes less of an issue. A bad master class is like a bad pimping – could it lead to humiliation or long term memories? Thinking back to what you remember most – the negative. We are wired this way. This format can be a challenge for the teaching – prepare on the spot and hope you know it! The learners can be various levels. Not only does the teacher have to “read” the performer, but also the audience. They also have to adjust to what may be best reviewed outside of the class. Studies have shown the student who performed in a master class are much more receptive to the learning as audience members / observers in a future master class. However, at first, people who are not performing are more likely to skip. The audience learners orientation to learning may be significantly different from the performer depending on past experience. Learner are also at different levels and the master has to teach both the performer and the audience. The audience also has to pull the learning out of the experience. In those learning rules – it is somewhat in their peer review to keep and discard the portions of the teaching that is relevant to them. In applying to medicine – patient confidentiality – the more of an audience, the more this may be an issue. Future colleagues are also future competitors for those jobs and grants. Power and respect can also be a challenge – a professor who brings in $$ in grants gives a class on how to lecture / powerpoint then asks for feedback – which no one wants to give because in the future they want this person’s support later. Back to those three parts that contribute to the master learns: self determination, cognitive load, and the learning environment. Our learning environment in medicine is often overshadowed by the performance zone. How might you overcome barriers to this kind of feedback dialogue – learning format? Expectations Environment - create safe islands - Try to avoid the perfection culture, the never make mistake culture. Recognize it, discuss it. - Practice recognizing and teaching the Hidden Curriculum Modelllng Welcoming mistakes Clarify zones? Share what you learned recently and how? Respect Training (like this one) Bring the unspoken out Learning rules: Bring experiences – all different, ready and able to work – ask folks who is what, from where. They all may have different knowledge deficits as well. What do they know about the topic in advance? Facilitators to observe and listen – what are their gaps in their own ability 2. Accountable for their own learning – problem needs to be relevant. When the learner realizes what they need to learn to meet their own goals and objectives.. Learn in the here and now and apply those concepts immediately. Look for collaborative problem solving, suggest / get learner input on how the ideas and concepts may be used for them? Learn best when integrating the learning with their lives. Learn best when motivated and engaged. Get them working: (In a seminar pulling the audience in as teachers and learners. 6. Bring expectations of the teacher - be collaborative. 7. What are they leaving with – what did they learn? What are they going to do differently (Hanken, 2012)

13 Learning Environment Environment Teacher Learners Topic / PatientNow to the environment – learners impact, teachers impact, environment impacts learner, environment impacts teacher, environment impacts topic, topic / patient impacts environment. CONSIDER image here (image removed due to permission to use). Circle) The environment should promote learning and dialogue – this could be a physical space as well as the culture in the smaller groups, clinics and overall institution – vital to build this top down and bottom up. The environment acts on the learner and the learner/experience/teacher and they act on the environment. Activities to help influence the environment (back to the learning rules) Role modeling and real learning. Real activity, real patients. Integrating the Learning into their world. Mixed messages and hidden curriculums can impact the reflection and learning. Thus experienced teachers can make explicit what is tacit – vocalize and express what is to be learned / the concepts, the tacit how to, etc.. Talking and learning about the hidden curriculum can help with favoritism and promote appropriate culture.

14 Overcoming Barriers Modeling Nurture the environment / Make it safeMake it routine / time / place Respect Training / practice Welcome mistakes Have someone read (put in handout) “The fact is that the culling of students perceived as less talented, less accomplished, or less musical is generally accepted as necessary and inevitable in conservatory life, even if this is accomplished in an unpleasant fashion.” “Proper pimping inculcates the intern with a profound and abiding respect for his attending physician while ridding the intern of needless self-esteem.” Furthermore, after being pimped, he is drained of the desire to ask new questions – questions that his attending may be unable to answer.” Davidoff 2011, Hanken 2008, (Hanken 2012)

15 Action: Ride out the J curveACTIVE LEARNER – WHAT TO DO WITH IT NOW THAT YOU GOT IT. It gets worse before it gets better. When we begin to change our happiness may immediately drop. We have high expectations. We get worse before we get better, then we feel depressed. For new skills, you almost always get worse before your get better. Are you really worse? No, you are developing an insight you did not have before. Perhaps it is not a J curve of ability but a a J curve of your perception of your ability / performance. Also remember to cultivate complexity – you are not always, and never. Correct it when you hear that kind of talk “the patient always comes first” nope. Stone 2015 Open Source – J curve, retrieved from Wikipedia, accessed May 2017

16 All opinions are not equally brilliant, but all opinions can be a vehicle to learning by those who propose or oppose them. Quote from Maria Callas (soprano) (Hanken, 2008)

17 Summary Master learner = Experiential LearningDialogue, demo, on the spot, metaphors, scaffolding, self reflection guide, break it down, observation, voice unspoken. Overcome – make it routine, experts model, discuss, process of learning HAYAM One to the aspects of Master Learner is the idea of Experiential Learning – learning in the real world. The PROCESS is the driver of learning. With experiential learning – ideas are formed and reformed, it is a continuous process, try it out and experience it, then experience it differently. Learning is grounded in experience and the tension and conflict that comes from the process – tension from ideas and feedback that may not match what we are doing, want to do. Ideas are formed and reformed through our experiences. Learning is a process not an Outcome. The continuous loop of four concepts of experiential learning was emphasized by Kolb in his paper “Experiential Learning.” Concrete experience and our abilities Self Reflection –Looking at our performance from many different perspectives. Who can’t leave your body and see how you look from the outside? YOU. This is where input from the outside comes in and helps align the self observation as we move to Abstract conceptualization – we make concepts and theories. After we reflect on the what – looking to the process of why did this happen and what could be different so it does not happen, what do I change, what ideas do I have so I can have a different outcome? Goal directed practice – break it into the parts. Experimentation – try out those concepts and the results become those experiences and we cycle through the process. Back to the “prewash.” Then rinse and repeat. The Impulse of experience gives ideas their moving force, and ideas give direction to impulse. Now the coach helps continue the cycle. These four steps / concepts of experiential learning move into learning rules. There are many iterations of these, and we are going with the more common concepts iterated in several papers as learning rules. Taylor DC et al. Adult Learning Theories Med Teach 2013 Kolb D. Experiential Learning (Taylor 2013)

18 So, How might we master class in medical education?Audience – how might they use this in medicine? Video patient encounters Presentations – did you rehearse with your peers before coming? Slide / practice, records yourself, reflect? Do you watch the intern do an exam and discuss with the patient? Open up for feedback after every grand rounds? Teaching meeting? Peer observation and feedback

19 VIDEO Master class Repeat the video – speed past the performance and note the teaching and learning techniques you see. AUDIENCE PREP: Yell out what you see happening – student and teacher. What techniques: Up buidling – confidence Confirming her skill set (who is she talking to? I think to herself; you think , etc.) Breaking it down Demonstration Metaphors Gestures Concepts vs technique – what can the class of learners related Verbalie what is unspoken – explain / sign post to the audience and learner the practice technique Feedback dialogue

20 Barber, David. A musician’s Dictionary. 1997

21 References Barber, David. A musician’s Dictionary (humor) Bradner M, Harper DV, Ryan MH, Vanderbilt AA. “Don’t play the butter notes’: jazz in medical education. Medical Education Online. 2016;21: /meo.v doi: /meo.v Davidoff F. Music lessons: What musicians can teach doctors (and other health professionals). Ann Intern Med 2011;154: Ericsson KA,Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychological Review. 1993; 100(3): Finn K, et al. How to become a better clinical teacher: A collaborative peer observation process. Medical Teacher 2011;33: Gottlieb M, Boysen-Osborn M, Chan TM, et al. Academic Primer Series: Eight Key Papers about Education Theory. Western Journal of Emergency Medicine. 2017;18(2): doi: /westjem Hanken MI. Teaching and learning music performance: The master class. FJME 2008;11 (1-2) Hanken M, Long M. Master classes – What do they offer? Norwegian Academy of Music (Seminar) 2012 Jorgenson ER. The art of teaching music. Indiana University Press. 2008:

22 Jabush HC. Setting the Stage for Self-Regulated Learning Instruction and Metacognition Instruction in Musical Practice. Front Psychol. 2016; 7: 1319 Kingsbury, H Music, Talent and Performance. A Conservatory Cultural System. Philadelphia: Temple University Press. Kolb, D.A. (1984): Experiential learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall McQueen SA, et al. Examining the barriers to meaningful assessment and feedback in medical training American Journal of Surgery. 2016:211 Reed S, et al. Applying Adult Learning Practices in Medical Education. Curr Probl Pediatr Adolescent Health Care 2014;44: Schumacher DJ, Englander R, Carraccio C. Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment. Acad Med Nov;88(11): Taylor A. Participation in a master class: experiences of older amateur pianists. Music Education Research 2010; 12(2) Taylor DC, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach Nov;35(11):e Young JQ, Van Merrienboer J, Durning S, Ten Cate O. Cognitive load theory: implications for medical education: AMEE Guide No. 86. Med Teach May;36(5): https://www.youtube.com/watch?v=n2i6UuCAw0Y Get bolded copies for seminar audience Editor First edition Publisher Info. Berlin: N. Simrock, 1896 Reprinted Great Romantic Cello Concertos (pp ) Mineola: Dover Publications, 1984. Copyright Public Domain

23 Image Credits Slide #1: Dvorak Cello Concerto, 1896, Public DomainSlide # 6: Briceno E. TED Talk. Accessed 4/2017 at https://www.ted.com/talks/eduardo_briceno_how_to_get_better_at_the_things_you_care_about Slide #10 & 19: Video - Hampson T. Master class 2012 with Leela Subramaniam, soprano and Sue Yeon Han, pianist. Manhattan School of Music. Accessed 4/2017 at https://www.youtube.com/watch?v=n2i6UuCAw0Y Slide #15: Open Source – J curve, retrieved from Wikipedia, accessed May 2017 Slide #20: Barber, David. A musician’s Dictionary. P (humor) (Others as referenced from respective articles) n2i6UuCAw0Y

24 Contacts: (Please email if questions, interest in partnering for future presentations / research)Natascha Lautenschläger, MD, MSPH Assistant Program Director, Hendersonville Family Medicine Residency Blue Ridge Health Center, Hendersonville, NC CMIO and Vice Chief of Staff, Pardee Hospital Hayam Shaker, MD Faculty and Medical Student Director, Hendersonville Family Medicine Residency, Hendersonville, NC Associate Professor, UNC Chapel Hill School of Medicine

25 Extra info

26 Audience Learning by observing – development – their ownLearning to assess performance Developing feedback skills Understanding their own level Exposure new ideas, less resistance Abstraction – applies to their situation Co-operative attitudes, modeling, environment Teacher of student in the audience – helps prepare for the class, can build on ideas presented, choose topic / repertoire. (Hanken 2008 / 2012)

27 Master / Teacher Assessments Devise lesson and adjustSafe, up-building – focus on performance Humor / rapport Repetition, teaching to all Protection of performer / Shielding (Hanken 2008/2012, Taylor 2010)

28 Please evaluate this presentation using the conference mobile appPlease evaluate this presentation using the conference mobile app! Simply click on the "clipboard" icon on the presentation page.

29 Emotional context of teaching Medical Teacher Development: Ten experienced medical teachers give input Use of feedback, mentors and co-teaching rec by many studies but rarely used. Emotional context of teaching Medical teaching learned by observing others, understanding, practicing skills “Medical teachers need time to try out new teaching techniques on the job.” HAYAM peer feedback by faculty to faculty or nsl Macdugall J, Drummond MJ. The Development of Medical Teachers: an Enquiry into the learning histories of ten experienced medical teachers. MEDICAL EDUCATION 2005; 39: 1213–1220 Strong analogy between doctor and patient and teacher and learner EMOTIONS – teachers seem less stressed than their non teaching clinical counterparts: excitement, challenge, enjoyment, frustration and anger – rarely acknowledged in medicine though a big part of teaching and learning Early on more courses to get knowledge, more experienced teachers value the reflection on teaching and discussion of teaching issues with colleagues (Macdugall 2005) 29

30 Become a better clinical teacher: A collaborative peer observation process“Co attending” to in-pt team who gives feedback, written comments, observes rounds. All had issues with timing and appropriateness of questions Wards: challenge to think of appropriate question in the moment How to engage different learner levels Jr. faculty benefited from both observing and being observed. Sr. teachers also identified new techniques. Nsl Peer obs Finn K, et al. How to become a better clinical teacher: A collaborative peer observation process. Medical Teacher 2011;33: “I’ve been teaching for 35 years and this is the first time I’ve ever been observed by a peer focused on my teaching role. Thank you. I might have been doing this wrong for thirty years, so it’s good to know I’m doing some things right along with things I can improve.” question strategies physical examination instruction, engagement of multiple learner levels, learner-focused teaching and teaching efficacy (time management) (Finn 2011) 30