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By Dan Limmer

Let’s Go Backwards

We like when things go in order. Students like when things go in order. Everyone is comfortable. Should learning always be comfortable or should we occasionally shake things up a bit?

I think we should. Especially when it comes to thinking.

I’ve been involved with publishing books for many years. I had the good fortune to work with many talented publishing professionals. When I first started, I was told that the proofreaders who did a final check of my books read the book backwards. If you read forward you see what you think you should be seeing.

What if we taught backwards to give our students a fresh perspective?

Reverse Learning for Contraindications

Take pharmacology or any treatment modality. We spend more time talking about indications and what the medication or modality will do. What if we gave students an exercise that focused on when they aren’t supposed to do things?

I call this reverse learning and created a dynamic learning exercise in which students focus on findings that would contraindicate a medication or modality or even cause the student to choose to exercise caution. This approach helps identify pitfalls—but not as an afterthought to when you should use that medication or modality. The comfortable way we usually teach.

Educator’s pdf: Reverse Learning Exercise

You can download the exercise here. It presents students with various medications and asks them to identify four important items for each:

  • Clinical findings that contraindicate use or suggest caution
  • Conditions that might mimic indications
  • Assessments to identify mimics
  • Consequences of improper use

The reverse learning approach has benefits in class and after class for the NREMT and in practice. Students will be better able to identify subtle clues to direct better patient care and prevent pitfalls and potential errors. There is a secondary benefit to place value on solid assessment and differential diagnosis to make good decisions.

Give it a try and let us know how it goes.

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