Skip to main content

Learning Differences and Medical Education

  • Chapter
  • First Online:
Remediation in Medical Education

Abstract

Learning disabilities are the most common type of disability among medical students and may first present as a problem during medical school or later impairing achievement and clinical performance. In this chapter, the author provides a conceptual framework and vocabulary for understanding and describing the wide range of normal variations in cognitive abilities of all students, including medical students. He describes how learning challenges can be viewed through two lenses, each with their own therapeutic implications. When a medical trainee has a diagnosed learning disability, defined as a discrepancy between intellectual capacity and actual performance, the Americans with Disabilities Act (ADA) requires the educational institution to provide the student with reasonable accommodations. Further recent understanding of neurocognitive function and plasticity has provided a new lens through which to view relative learning weaknesses. In this view, individuals have a neurocognitive profile, which in certain educational contexts may produce learning challenges. Based on his extensive experience working with professional students who struggle with learning, the author provides advice on identifying effective strategies to assist these students in becoming excellent physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hafferty FW, Gibson GG. Learning disabilities and the meaning of medical education. Acad Med. 2001;76:1027–31.

    Article  PubMed  CAS  Google Scholar 

  2. Butterworth B, Kovas Y. Understanding neurocognitive developmental disorders can improve education for all. Science. 2013;340(6130):300–5. doi:10.1126/science.1231022.

    Article  PubMed  CAS  Google Scholar 

  3. Dweck CS. Mindset: the new psychology of success. New York: Random House; 2006. p. 276.

    Google Scholar 

  4. Francis DJ, Fletcher JM, Stuebing KK, Lyon GR, Shaywitz BA, Shaywitz SE. Psychometric approaches to the identification of LD: IQ and achievement scores are not sufficient. J Learn Disabil. 2005;38(2):98–108. PubMed PMID: 15813593.

    Article  PubMed  Google Scholar 

  5. Kavale KA, Forness SR. What definitions of learning disability say and don’t say: a critical analysis. J Learn Disabil. 2000;33(3):239–56. doi:10.1177/002221940003300303.

    Article  PubMed  CAS  Google Scholar 

  6. Rose DH, Meyer A, Strangman N, Rappolt G. Teaching every student in the digital age: universal design for learning. Alexandria, VA: Association For Supervision and Curriculum Design (ASCD); 2002. p. 216.

    Google Scholar 

  7. Levine MD. Developmental variation and learning disorders. 2nd ed. Cambridge, MA: Educators Publishing Service; 2001. p. 671.

    Google Scholar 

  8. Sack W, Gale J, Gulati S, Gunther M, Nesheim R, Stoddard F, St. John R. Requesting accommodation for a disability: a telephone survey of American medical schools. J Postsecond Educ Disabil. 2008;20(2):93–9.

    Google Scholar 

  9. Griffin E, Pollack D. Student experiences of neurodiversity in higher education: insights from the BRAINHE project. Dyslexia. 2009;15(1):23–41. doi:10.1002/dys.383.

    Article  PubMed  Google Scholar 

  10. Hall CW, Webster RE. Metacognitive and affective factors of college students with and without learning disabilities. J Postsecond Educ Disabil. 2008;21(1):32–41.

    Google Scholar 

  11. Aaron PG, Joshi RM, Gooden R, Bentum KE. Diagnosis and treatment of reading disabilities based on the component model of reading: an alternative to the discrepancy model of LD. J Learn Disabil. 2008;41:67–84. doi:10.1177/0022219407310838.

    Article  PubMed  CAS  Google Scholar 

  12. Americans With Disabilities Act (ADA) of 1990, 42 U.S.C Annotated, Sect. 12101 et seq.

    Google Scholar 

  13. 154 Cong Rec. S.8840-01 (daily ed. Sep 16, 2008) (Statement of Managers-S 3460).

    Google Scholar 

  14. Ansari D, De Smedt B, Grabner RH. Neuroeducation—a critical overview of an emerging field. Neuroethics. 2012;5:105–17. doi:10.1007/s12152-011-9119-3.

    Article  Google Scholar 

  15. Dehaene S. Reading in the brain. New York: Penguin Group; 2009. p. 388.

    Google Scholar 

  16. Dehaene S, Pegado F, Braga LW, Ventura P, Nunes Filho G, Jobert A, Dehaene-Lambertz G, Kolinsky R, Morais J, Cohen L. How learning to read changes the cortical networks for vision and language. Science. 2010;330(6009):1359–64. doi:10.1126/science.1194140.

    Article  PubMed  CAS  Google Scholar 

  17. Kirchoff BA, Buckner RL. Functional-anatomic correlates of individual differences in memory. Neuron. 2006;51(2):263–74. PubMed PMID: 16846860.

    Article  Google Scholar 

  18. Heim S, Tschierse J, Amunts K, Wilms M, Vossel S, Willmes K, Grabowska A, Huber W. Cognitive subtypes of dyslexia. Acta Neurobiol Exp. 2008;68(1):73–82.

    Google Scholar 

  19. Shaywitz BA, Shaywitz SE, Blachman BA, Pugh KR, Fulbright RK, Skudlarski P, Mencl WE, Constable RT, Holahan JM, Marchione KE, Fletcher JM, Lyon GR, Gore JC. Development of left occipitotemporal systems for skilled reading in children after a phonologically-based intervention. Biol Psychiatry. 2004;55(9):926–33. PubMed PMID: 15110736.

    Article  PubMed  Google Scholar 

  20. Rose DH, Dalton B. Learning to read in the digital age. Mind Brain Educ. 2009;3(2):74–83. doi:10.1111/j.1751-228X.2009.01057.x.

    Article  Google Scholar 

  21. Cooke M, Irby DM, O’Brien BC. Educating physicians: a call for reform of medical school and residency. Hoboken, NJ: Wiley; 2010. p. 323.

    Google Scholar 

  22. Fischer KW. Mind, brain and education: building a scientific groundwork for learning and teaching. Mind Brain Educ. 2009;3(1):3–16. doi:10.1111/j.1751-228x.2008.01048.x.

    Article  Google Scholar 

  23. Fischer KW, Daniel DB. Need for infrastructure to connect research with practice in education. Mind Brain Educ. 2009;3(1):1–2. doi:10.1111/j.1751-228X.2008.01054.x.

    Article  Google Scholar 

  24. Fischer KW, Goswami U, Geake J, Task Force on the Future of Educational Neuroscience. The future of educational neuroscience. Mind Brain Educ. 2010;4:68–80.

    Article  Google Scholar 

  25. Ronstadt K, Yellin PB. Linking MBE to clinical practice: a proposal for transdisciplinary collaboration. Mind Brain Educ. 2010;4(3):95–101.

    Article  Google Scholar 

  26. Fan J, McCandliss BD, Sommer T, Raz A, Posner MI. Testing the efficiency and independence of attentional networks. J Cogn Neurosci. 2002;14(3):340–7. PubMed PMID: 11970796.

    Article  PubMed  Google Scholar 

  27. Waszak F, Li SC, Hommel B. The development of attentional networks: cross-sectional findings from a life span sample. Dev Psychol. 2010;46(2):337–49. doi:10.1037/a0018541.

    Article  PubMed  Google Scholar 

  28. Immordino-Yang MH. The stories of Nico and Brooke revisited: toward a cross-disciplinary dialogue about teaching and learning. Mind Brain Educ. 2008;2(2):49–51.

    Article  Google Scholar 

  29. MacWhinney B, Snow C. The child language data exchange system: an update. J Child Lang. 1990;17(2):457–72. PubMed PMID: 2380278.

    Article  PubMed  CAS  Google Scholar 

  30. Ackerman PL, Beier ME, Boyle MO. Working memory and intelligence: the same or different? Psychol Bull. 2005;131(1):30–60.

    Article  PubMed  Google Scholar 

  31. Butler AC. Repeated testing produces superior transfer of learning relative to repeated studying. J Exp Psychol Learn Mem Cogn. 2010;36(5):1118–33. doi:10.1037/a0019902.

    Article  PubMed  Google Scholar 

  32. Ecker UK, Lewandowsky S, Oberauer K, Chee AE. The components of working memory updating: an experimental decomposition and individual differences. J Exp Psychol Learn Mem Cogn. 2010;36(1):170–89. doi:10.1037/a0017891.

    Article  PubMed  Google Scholar 

  33. Regehr G, Norman GR. Issues in cognitive psychology: implications for professional education. Acad Med. 1996;71(9):988–1001. PubMed PMID: 9125988.

    Article  PubMed  CAS  Google Scholar 

  34. Creel SC, Dahan D. The effect of temporal structure of spoken words on paired-associate learning. J Exp Psychol Learn Mem Cogn. 2010;36(1):110–22. doi:10.1037/a0017527.

    Article  PubMed  Google Scholar 

  35. Dominey PF. A shared system for learning serial and temporal structure of sensori-motor sequences? Evidence from simulation and human experiments. Cogn Brain Res. 1998;6(3):163–72. doi:10.1016/j.bbr.2011.03.031.

    Article  CAS  Google Scholar 

  36. Schneps MH, Rose LT, Fischer KW. Visual learning and the brain: implications for dyslexia. Mind Brain Educ. 2007;1(3):128–39.

    Article  Google Scholar 

  37. Stull AT, Hegarty M, Mayer RE. Getting a handle on learning anatomy with interactive three-dimensional graphics. J Educ Psychol. 2009;101:803–16.

    Article  Google Scholar 

  38. Cole MW, Yarkoni T, Anticevic A, Braver T. Global connectivity of prefrontal cortex predicts cognitive control and intelligence. J Neurosci. 2012;32(26):8988–99. doi:10.1523/JNEUROSCI.0536-12.2012.

    Article  PubMed  CAS  Google Scholar 

  39. Stein Z, Dawson T, Fischer KW. Redesigning testing: operationalizing the new science of learning, Chap. 10. In: Khine MS, Saleh IM, editors. New science of learning-cognition, computers, and collaboration in education. New York: Springer; 2010.

    Google Scholar 

  40. West DC, Pomeroy JF, Park JK, Gerstenberger EA, Sandoval J. Critical thinking in graduate medical education: a role for concept mapping assessment? JAMA. 2000;284(9):1105–10. PubMed PMID: 10974689.

    Article  PubMed  CAS  Google Scholar 

  41. Liston C, McEwen BS, Casey BJ. Psychosocial stress reversibly disrupts prefrontal processing and attention control. Proc Natl Acad Sci U S A. 2009;106(3):912–7. doi:10.1073/pnas.0807041106.

    Article  PubMed  CAS  Google Scholar 

  42. Brown TE, Reichel PC, Quinlan DM. Executive function impairments in high IQ adults with ADHD. J Atten Disord. 2009;13(2):161–7. doi:10.1177/1087054708326113.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paul B. Yellin M.D., F.A.A.P. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Yellin, P.B. (2014). Learning Differences and Medical Education. In: Kalet, A., Chou, C. (eds) Remediation in Medical Education. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9025-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-9025-8_9

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-9024-1

  • Online ISBN: 978-1-4614-9025-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics