Competency to Mastery

How We Learn and Apply Knowledge

Donlin M. Long
Professor of Neurosurgery, Johns Hopkins Medical Institutions


2260th Meeting Abstract
Friday, November 13, 2009 at 8:15 PM

Donlin M. Long

Abstract:

Understanding how the brain works will improve education. The competent individual moves to self-directed, learning typically interspersed with episodic directed learning experiences. Practice for improvement becomes extremely important. Mastery of a field requires lifelong learning and deliberate practice.

If we are to improve the educational process then these concepts of how we acquire knowledge must be integrated into the educational system. It appears that we must first learn facts, begin to apply them through rules, modify those rules through analytical processes, and then transcend the rules through perceptual learning. There is strong evidence that it requires about 10,000 hours of application over at least 10 years to reach the expert level. This requires practice, which must be deliberate and focused.

It also appears that we learn best when we move from easy to difficult and if we progress from facts to rules to knowledge. Application of these principles in education could improve all of us but a major goal will be the production of more experts in practice in every advanced field.

Current cognitive science begins with experience, both events and information. It is then organized in the brain to be useful, and usually this is deliberate. This organization leads to the rational probabilities to be used and this form of information processing is reflected in guidelines and algorithms. The educational process could be greatly improved by incorporating the current information available about how the brain learns with modifications whenever the new data available on these processes is validated. An immediate goal can be transition from our current time-based stepwise educational process to an untimed system based upon demonstration of competencies. The ultimate goal of our educational process should be lifelong, self-directed learning which leads to mastery of the chosen field.

About the Author:

Donlin M. Long is Professor of Neurosurgery at Johns Hopkins. In 1973, he became the first director of the Department of Neurosurgery at Johns Hopkins which he founded. He remained neurosurgeon-in-chief at the Johns Hopkins Hospital and Director of the Department of Neurosurgery until 2000. His ongoing clinical research includes the evaluation of the causes of spinal pain, and development of minimally invasive procedures to diagnose and treat spinal pain without surgical intervention, and competency theory in medical education.

He received his medical degree from the University of Missouri. He served his internship in surgery at the University of Minnesota Hospitals. He then completed residency training in neurological surgery at the University of Minnesota Health Science Center and the Brigham-Children’s Hospital Medical Center of Harvard. He received a PhD in neuroanatomy from the University of Minnesota. He served as Clinical Associate at the National Institutes of Health in the Branch of Surgical Neurology while a member of the United States Public Health Service.

In 1967, he became Chief of Neurosurgery at the Minneapolis Veterans Administration Hospital and pediatric neurosurgeon at the University of Minnesota. His initial research focused upon brain edema and the introduction of steroid therapy for the treatment of brain edema and spinal cord injury. He also studied ischemia, hypoxia, and the blood brain barrier.

He was a founding member of the International Society for the Study of Pain. He chaired the study group which managed the introduction of spinal cord stimulation into clinical practice. With engineering colleagues, he developed transcutaneous electrical stimulation (TENS) as a clinical tool, designed an implantable peripheral nerve stimulator, and helped design the first implantable rechargeable nervous system stimulators and drug delivery pumps for medication infusion. He served on the Board of Directors of the American Pain Society and was a founder of the Blaustein Pain Treatment Center at Johns Hopkins. He was a founding member of the Cervical Spine Research Society, and the AANS-CNS sections of Pediatrics, Spine, and Basic Sciences.

His clinical practice has focused upon skull-base tumors, particularly acoustic neuromas. This focus includes one of the world’s largest series of operations upon acoustic neuromas, a similar large experience with meningiomas of the base of the skull, and a broad experience with all other kinds of benign tumors of the skull base.

He has published over 250 peer-reviewed articles on neurosurgical topics. He has written or edited 15 books and has participated in the production of over 100 chapters for textbooks. He was a founding editor of the Journal Spine and continues to serve as founding editor of Quarterly Neurosurgery. He has been an editor-contributor for the AMA panels for Evaluation of Permanent Impairment and serves on the editorial board or as a reviewer for 18 national and international journals.

He is a member of the principal staff of the Applied Physics Laboratory and has served on the NIH Board of Scientific Counselors. He has served as neurosurgery consultant to the Social Security Disability Panels for spine and nervous system. He has been neurosurgery representative to the Counsel of Academic Societies and served on the Administrative Board of that organization. He is on the advisory board of the Johns Hopkins Engineering Research Center and the Center for Complementary Medicine at Johns Hopkins. He is a member of the advisory board of the Agarini Foundation for Research in Neural Regeneration, a member of the Society of Industry Leaders, and a member of the Faculty of 1000. He belongs to 37 professional societies in which he has past, active or honorary membership.


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