Adaptive teaching

Adaptive teaching is a way of teaching that addresses the needs of learners that have different levels of knowledge and backgrounds, rather than a “one size fits all” approach.

In medicine, it’s used to teach adaptive learners who learn through real-world problems - usually a clinical issue affecting a patient.

To show how this works, let’s say there’s clinical instructor named Dr. Michael who loves teaching endocrinology.

He might have learning objectives listed in his course syllabus; things like “Recognize the most common symptoms of endocrine disorders” or “Differentiate between primary and secondary endocrine disorders”.

The syllabus might list out specific “flipped classroom” segments in his course, like one in which he provides his students with his notes and PowerPoint slides so that they can review beforehand, and come prepared to discuss a case about precocious puberty.

Altogether, this makes up the declared curriculum which is basically everything that a teacher expects to teach in a course, and also what they plan to draw from in a final exam or assessment.

Often times, though, there ends up being a difference between what a teacher expects to teach and what is actually taught.

In our example, it’s totally possible that Dr. Michael’s students don’t remember normal endocrine physiology and are therefore struggling to understand the diseases.

To adapt to this situation, Dr. Michael might spontaneously include a ‘team learning’ exercise, where he breaks the students into groups to answer multiple choice questions about various hormones using audience response ‘clickers.’ The time spent on this topic might mean that the class won’t ever get a chance to discuss some of the more rare endocrine diseases, and this is where the declared and taught curriculum diverge.

Now, let’s say that Dr. Michael also likes to work with his students outside the classroom through a web-based learning platform.

He might review questions and flashcards that have been written by one student for their peers, and Dr. Michael might even add some of his own to help his students remember important information.

This process lets a teacher get insight into how the students are learning as well as where they may have gaps in their understanding.

By doing this, Dr. Michael is exploring the parallel curriculum, which is all of the learning that happens in parallel to or “outside” what a teacher teaches in the classroom.

That includes all of the supplemental materials that each student uses to help them learn. This ranges from online notes and question banks, to mobile apps to review books.

It also includes,though, all of those little side-bar conversations that students have about confusing topics, as well as a metacognitive aspect - because it's where students “think about the way they think and learn” and they make choices about how they want to study.

Additionally, some students might get private tutors, while others use educational websites - it varies quite a bit, but nearly every student uses some form of “outside” learning strategies.

Now, a few weeks into class, Dr. Michael might invite a person with diabetes into his classroom to talk about the disease.

During that interview, the students get to watch how Dr. Michael treats the person with kindness and respect - both through his words and his actions.

This sort of learning is part of the hidden curriculum which includes skills like active listening and motivational counseling, which are learned through observation and experience.

That’s not to say that these aren’t skills that can’t be discussed in class, but generally speaking they’re things that have to be experienced to be fully understood.

In the adaptive teaching model, a teacher is able to fluidly move between the taught, parallel, and hidden curriculum - meeting a student wherever they are in their educational journey.

In our scenario, Dr. Michael can establish a relationship with each of his students, and provide really specific feedback and guidance.

Also, readily available technology like responseware, video lecture capture, and web-based study platforms provide the opportunity for teachers like Dr.

Michael to mentor large groups of students. In health sciences education, adaptive teaching is most easily done through case-based learning, which is when students are learning as they work through clinical cases.

That’s because students can pick and choose elements of a case that they want to take a deep dive on, therefore personalizing the curriculum to meet their own interests and needs.

In case-based learning the goal is to embed every basic science concept in a clinical case. Medicine is practiced in cases, and therefore learning in cases prepares students for practice.

The key here, though, is to make sure that there is careful mapping to ensure that all of the material has been adequately covered and that theteaching objectives are appropriately mapped out.

Alright, as a quick recap ... Adaptive teaching is a way of teaching where teachers adapt to the shifting needs of learners by sliding between the taught, parallel, and hidden curriculum.

Case-based learning is very amenable to this approach because it facilitates adaptive learning, which is where students learn in a real-world context.