When doctors make mistakes in practice the consequences can be very bad. When doctors make mistakes in CME the consequences can be very good. Making mistakes prepares doctors for learning by demonstrating:
a. That there is something that they should know, and
b. Their performance will improve if they learn it.
I was reminded of the educational value of mistakes by a short television interview with Jerome Groopman, author of How Doctors Think. His main point was that doctors' incorrect decisions are often caused by using "gut" reactions instead of scientific analysis based on evidence. I look forward to reading his book.
The implication of How Doctors Think for CME seems to be that doctors' knowledge is sometimes automated and applied too generally. Therefore, CME activities should highlight situations in which intuition, gut reactions, and stereotypical thinking result in impaired performance. We can then reduce medical errors by providing models of more flexible and scientific problem solving.
A similar approach was employed by the late great scientist and educator Robert Karplus. Karplus' Learning Cycle began with a hook to engage students. Typically, he'd demonstrate that what students thought they knew was inconsistent with reality. This challenge to their tacit assumptions and previous knowledge was used to motivate students and heighten their receptivity to learning.
CME is the right place to identify and correct mistakes. Let's not miss the opportunity to use mistakes constructively. As Mario Zanotti of Computer Curriculum Corporation used to say, "A mistake is an opportunity to learn."
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Another thing we need to remember as we design online learning systems is that mistakes are fast, and learning can be slow. We want to jump to perception as fast as we fall into mistakes. Speeding that learning--without just speeding data delivery to the student--is an art worth developing.
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