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Reflections on Adaptive Expertise

top view photo of girl watching through imac

[Keynote Address at the 2021 UP Manila Orientation for New Faculty]

Chancellor Padilla, our esteemed Vice Chancellors, Deans, distinguished members of the Committee on Instruction, and my fellow faculty of UP Manila, good morning. I am honored to be given the opportunity to address you today on the opening of the 2021 orientation for new faculty. Having recently received the Metrobank Outstanding Filipino award in the Teacher category for higher education, I have since spent some time on reflection, asking myself, how did I get here and what should I do next? Perhaps as new faculty, you ask yourself these questions too. And so today, I’d like to share my reflections on adaptive expertise. What is adaptive expertise? Perhaps it’s best understood by contrasting it with routine expertise. Routine experts know how something works in a particular way. Within a particular domain, routine experts are able to perform common tasks well. Routine experts have scripts that guide them when solving familiar problems.

Adaptive expertise enables individuals to construct new solutions when faced with novel problems.

Schwartz DL, Bransford JD, Sears D. 2005. Efficiency and innovation in transfer. In Mestre JP, editor. Transfer of learning from a modern multidisciplinary perspective. Charlotte (NC): Information Age Publishing; p. 1–51.

How about adaptive experts? Adaptive experts have a deeper understanding of why solutions work. Adaptive experts are creative. They are able to construct new solutions for novel problems. Isn’t this what we expect of our students? What we teach them now may well become obsolete, but we expect them to be lifelong learners, able to adapt to whatever is thrown at them. We should then also expect it of ourselves as teachers. After all, even before the pandemic, our classrooms have always been complex, constantly changing environments with students of diverse backgrounds and varying needs. I would argue then that even before the pandemic, teachers needed adaptive expertise. But what happens when the class moves online, when the screen separates us from our students and the digital divide disrupts the learning experience? I saw someone lamenting on Twitter that he is not able to give his best as a teacher in the remote learning environment. More than ever, adaptive expertise is needed, because now the pandemic has upended our routines. As the title of the event today says, we need to expand our competencies as teachers in the new normal. Routine and adaptive expertise should not be seen as a dichotomy though, as routine experts adapt to situations as they arise and adaptive experts master routines in order to innovate.

But the difference between routine and adaptive expertise, lies in this quote from Timperley et al (2018) –

Adaptive expertise demands constant evaluation of the appropriateness of particular practices and routines, and does not assume them to be appropriate because they form part of one’s repertoire of practice.

Timperley et al (2018)

Someone asked me after I won the Metrobank award, what do you think made you win? Perhaps I can answer, adaptive expertise. I remember the first lecture I was assigned to do as faculty was on gestational diabetes. I had been involved in the writing of the clinical practice guideline for gestational diabetes. My research in fellowship was on gestational diabetes. So I felt extremely competent and really excited to give my first lecture on gestational diabetes to the second year medical students. I prepared my slide deck as I had seen others do, crammed full with content. But at that first lecture, there were some students sleeping in my class.

Systematic reflection is the catalyst for adaptive expertise.

H. Emily Hayden , Deborah Moore-Russo & Mark R. Marino (2013) One teacher’s reflective journey and the evolution of a lesson: Systematic reflection as a catalyst for adaptive expertise, Reflective Practice, 14:1, 144-156, DOI: 10.1080/14623943.2012.732950

That reflection cycle consists of noticing and then taking action. I could have shrugged off those sleeping students. After all as a medical student, I too sometimes struggled to keep awake in class. But I also remembered those professors whose lectures left us enthralled. And so, it bothered me that students were sleeping in my class. It was the critical incident that triggered a reflection. Why were they sleeping in my class? I was confident about the content. Was it my slides? Where they too crowded? Not interesting enough? So I read Presentation Zen by Garr Reynolds. Was it the way I delivered the lecture? So I read The Presentation Secrets of Steve Jobs: How to be Insanely Great in Front of Any Audience by Carmine Gallo. BUT there were still students sleeping in my class.

Novice teachers are often egocentric but later notice and feel responsible for student engagement.

H. Emily Hayden , Deborah Moore-Russo & Mark R. Marino (2013) One teacher’s reflective journey and the evolution of a lesson: Systematic reflection as a c

Apparently, this inward questioning of one’s abilities is common with novice teachers. Early career reflection is often focused on personal improvement. What can I do better? It’s egocentric. How dare they sleep in my class? I’ll make my slides look better. I’ll be a better speaker. But later as novice teachers gain experience, the focus shifts from self to their students.The question changes from, did I cover the topic adequately to, were the students engaged? From egocentric to learner-centric. We want our students to be self-directed learners. It may surprise you to know that I have no formal training in health professions education. As I look back on my 17 years of teaching, I find that I learned the lingo much later – pedagogy, andragogy, heutagogy, TPACK, the SAMR model, flipped classroom, blended learning etc. In the beginning, all I had was a desire to become a better teacher and I was willing to try new ways of doing.

A key part of adaptive expertise is about taking agency for making a difference.

– Helen Timperley

In my early years as faculty, I was also in the first batch of health informatics graduate students under Dr. Alvin Marcelo. He used Moodle for our graduate class. That was 2004 and Moodle 1.0 had just come out in 2002. It was my first encounter with a learning management system and I thought, wow, this is cool! How can I use this in my own class? How I can use technology to reach those sleeping students? Because if I do, I can teach everyone better. And so I suggested that we use Moodle for OS 215, the endocrine module for 2nd year medical students. That was in 2007 when Dr. Marcelo launched Moodle in the College of Medicine, calling it Organ Systems Integrated Resource Inventory System or OSIRIS for short. But I would joke that it was named after me, OS IRIS. I’ll never forget that typhoon Ondoy happened in the middle of the endocrinology module in 2009, and how for those students who had electricity and internet access, they were still able to access our learning materials so that we didn’t lose too much time even if classes were cancelled. My students told me to include graphics to break the monotony of content in the learning management system. I realized then that the LMS should not be a glorified Google drive. I learned to annotate our learning resources. Later, OSIRIS died and we transferred to UVLE in UP Diliman and later, to the UP Manila VLE. I flipped the class by putting my gestational diabetes slide deck on UVLE. During my assigned one hour in class, I no longer lectured but instead employed a team-based learning approach. The students first take an individual quiz then take the same quiz again, but this time with their team. This allowed them to learn from each other as they defend their individual answers, until a consensus is reached on what will be the team answer. The class was noisy as the students discussed among themselves. I didn’t mind. No one was sleeping! I had completed my first reflection cycle. I noticed sleeping students and I took action by trying the flipped classroom with team-based learning. To the new faculty, if you want to try new ways of doing, UP Manila is a good place to be. I’ve always found support from co-faculty, the deans and our Chancellor.

Solving complex problems often requires questioning and challenging one’s personal beliefs.

Timperley et al (2018)

Timperley et al (2018) also pointed out that solving the complex problems of teaching and learning requires more than doing something different. Not so much adding on, but transforming the learning experience. It often requires questioning and challenging one’s personal beliefs. And for me this was about listening to student feedback. In team-based learning, after teams discuss their answers, the class goes into a plenary with me where I call on teams with differing answers to explain their reasoning. To my surprise, a student asked for clarification on one of my quiz questions! I had asked, what’s the most important adverse reaction to metformin? The student said that my question was confusing. What did I mean by most important, did I mean the most common, in which case the answer would be gastrointestinal intolerance or did I mean the most life-threatening, in which case the answer would be lactic acidosis. It was a tense moment in this big class of 160 medical students, this was years before the pandemic. Suddenly, everyone was quiet, waiting to see how I would respond. I would never have imagined asking such a question to any of my professors when I was a medical student. But really, the student was correct and so I said, that’s a good point. I will revise that question. And I did. I also put on the UVLE, some case scenarios which the students had to go through and answer questions. It was a formative evaluation. Whenever a wrong option was chosen, the students were shown an explanation why it was incorrect. Later, students asked me to also include an explanation if an option was correct instead of the UVLE just saying, Yes, that’s the correct answer. It puzzled me. It would be more work for me and it was already added effort on my part to even include explanations. And so I asked them why. And they said, well because Ma’am sometimes, we just happen to guess the correct option but we don’t really know why it’s the correct answer! I also learned from the students never to name an image for what it was in the questions I posted on Moodle. I had put a picture of an MRI of an empty sella in one of the case scenarios, and asked what the diagnosis was. When you upload an image on Moodle, you have to give it a name. And foolishly, I named the image, empty sella. A student later told me that by right clicking the image, they can see the name of the file and therefore guess the answer. Another student also commented in the Moodle forum that the answer to one of my questions was outdated already, because the guideline had changed in the latest edition of the textbook. While these experiences challenged my own belief system on what a student should be able to say to a teacher, I learned to appreciate these feedback in the spirit that they were given – to make my teaching and their learning better.

How can we build adaptive expertise as teachers? Timperley suggests going through the inquiry spiral shown here.

The spiral of inquiry, learning and action (Timperley, Kaser & Halbert, 2014)

Such an approach ensures active learning and problem solving for teachers. It starts with scanning, that is noticing what is going on then focusing on what to change. This is followed by developing a hunch, how are we contributing to this situation? This is followed by thinking creatively about what can be done. What will we do differently? Then finally, evaluating if we had made enough of a difference in our learners’ experiences. From the adaptive expertise point of view, we not only assess students to find out what they know but also to assess the effectiveness of our teaching. Let me share some of the changes I did for my topics in the endocrinology module in the past year. SCANNING. As the students were not allowed to go to the hospital, I wanted to add the patient perspective to my topic. So I included a YouTube video of a patient discussing her experience as a patient with hypothyroidism. I also talked about my own experience as an endocrine patient. FOCUSING. I didn’t think that team-based learning would work on Zoom. I decided to use Zoom breakout rooms and have them work together on Google Jamboards to outline the patient journey, using the Youtube video of the patient with hypothyroidism. DEVELOPING A HUNCH. I was anxious because I was handling the session by myself and I couldn’t be at all the breakout rooms. I could hop around the breakout rooms but given the limited time of one hour, I didn’t think that would be feasible to be moderating the groups on rotation. I also didn’t know if they knew how to use Jamboards but I thought they would be agile enough to figure it out on their own. So I thought I would just get out of their way and see what happens. I could see the progress of their Google jam boards online anyway. And so under TAKING ACTION, that’s what I did. I let them loose to work on their jam boards and asked them to take a screenshot of their final jam board and paste them on the slide labeled with their group number on a Google slide deck accessible to all, when the time was up. And for CHECKING, I left the last ten minutes for the class to go back in Zoom plenary with me so we could process their jam boards, which I was able to summarize quickly as I was already taking notes as I watched the jamboards evolve. And yes, we achieved our learning outcomes and the students said they enjoyed and appreciated the activity!

Adaptive expertise goes beyond a mindset or a set of skills and comes to form the essence of teachers’ professional identities.

Timperley et al (2018)

I think that it speaks of our commitment to our students and their learning, and how willing we are to change the way we do things to offset the learning deficit that the pandemic is causing. Today as new faculty, you start your orientation. Take advantage of this opportunity to reflect on your educator identity, because often it will be in tension with your other identities, that of clinician and researcher. Learn from what the Committee on Instruction has prepared for you. May you be empowered to make changes in your teaching as adaptive experts!

We learn from one another. Professional conversations are absolutely essential to developing adaptive expertise.

Timperley et al (2018)

As you engage with the learning materials the Committee of Instruction has prepared for you on Canvas and the VLE, be mindful of your colleagues taking this same journey, and of others who have gone before you. Let us continue having professional conversations like these about how we teach. May we continue to learn from each other beyond the faculty orientation. Timperley believes that professional conversations are absolutely essential to developing adaptive expertise. This is the spirit of the recently launched Interactive Learning Center-Medical Education Unit Conversations on Remote Teaching & Learning in the Health Professions. We had our first session last week and it will run every other Tuesday, so the next will be Sept 28, until December 7. For an hour from 12 nn to 1 pm, Dr. Heizel Manapat-Reyes and I discuss what worked and what didn’t based on our own experiences. Last week we talked about student engagement online. The other teachers who joined us shared their own experiences too via a noisy chatbox. Next week Heizel and I will be discussing curating open educational resources. Please join us if you can. We’re trying to create a safe space for health professions educators and a community of practice.

Finally, let me end with this quote.

Teaching is the greatest act of optimism.

– Colleen Wilcox

Certainly our teaching, our optimism, has been greatly challenged by this pandemic. But as Steinert et al wrote in a commentary for a special issue of the Medical Teacher and I quote –

We also witnessed an enduring commitment to educating the next generation of health professionals and basic scientists, a collective will to adapt educational curricula to online platforms, and a profound desire to help our faculty members cope with uncertainty and change. This has been a time of deep introspection, collective learning, and a sustained willingness to adapt to the world around us.

Yvonne Steinert, David M. Irby & Diana Dolmans (2021) Reframing faculty development practice and research through the lens of adaptive expertise, Medical Teacher, 43:8, 865-867, DOI: 10.1080/0142159X.2021.1931081

Certainly, I’ve seen this and continue to see this in UP Manila. The faculty may have shed blood, sweat and tears to complete and revise course packs, record lectures, learn Zoom and dive into learning management systems be it the UP Manila VLE or Canvas. We are teachers, and we remain optimistic! Magandang umaga po.

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