The Role for Contextualization

“What’s Saskatchewan famous for?”

“Potash?”

“Yes. Infamous. But what else.”

“Grain.”

“OK. But Ontario isn’t. So… Ontario is a-grain…”

“Oh! Agranulocytosis”.

And that is how we figured out why Dr. HPK asked about throat pain and infection in a patient on hyperthyroidism medication.

By now, we’ve all become somewhat accustomed to Dr. HPK’s method of teaching and can usually figure out if he’s trying to give us a hint. At the same time, I’m still amazed every time he links a real world figure or location or concept with medical knowledge. I feel like I’ve learned more about medicine and the world, from bullous pemphigoid to the Galapagos Islands, in the last week than in a month of electives. But what makes Dr. HPK’s teaching so effective?

I think there are two reasons. One, he keeps us engaged and motivated. With Dr. HPK, you never know what he’ll ask next. Perhaps he’ll ask who invented the printing press. Perhaps it’ll be the year of the First World War. Or maybe he’ll just straight up ask for the definition of fever of unknown origin. It’s never predictable but he always has a point and it keeps you interested and wanting to find out where he’s going with his questioning. At the same time, he forces you to think laterally and not with the narrow mindset often reinforced through didactic learning. Thus, he encourages us to learn by helping us maintain attention, a topic that is complicated and undergoing heavy research although its importance in learning is undisputed, both scientifically and intuitively.

The second reason I think why his methods are so effective is because it creates a solid context with which to associate the medical information. Context-based learning is a pedagogical methodology that essentially centers on the belief that setting is pivotal to education, not just the cues within the text, but everything concrete around you as well including your physical state, the room in which you study and the social interactions you engage in while learning. One classical example is an experiment by Goodwin and his team in 1969 where he showed that people who learned memory tasks while intoxicated recalled information better if they were intoxicated than if they were sober. While this is a better example of state-dependent learning, Dr. HPK’s teaching provides multiple social and intellectual cues for us to associate our medical knowledge and to “retrace our steps” in retrieving that information if we forget it.

My personal preference to learning aligns very well with Dr. HPK’s method. While I prefer Socratic to didactic teaching, I absolutely love getting “pimped”. It forces me to think and in coming up with a hypothetical answer I can either contextually reinforce or forget that particular information. Also, I learn best when there is some element of stress; I think it is also related to the social environment. Interestingly, most studies show that increased anxiety is associated with worse memory retrieval. Of course, Dr. HPK also minimizes the stress with his personality but one inevitably feels some pressure when put on the spot. I think I am just lucky that it motivates rather than discourages me. 

-DW