Australasian College of Podiatry Deans

Have you considered becoming a mentor or supervisor?

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7 min. reading time

Dr Ryan Causby is the program director at the University of South Australia. Ryan is a lecturer, researcher and practicing podiatrist with an interest in clinical biomechanics, motor control and musculoskeletal disorders. Since graduating he has worked in both rural and urban settings, once providing remote podiatry services to over 70% of South Australia. Ryan has held roles at the Royal Adelaide and Queen Elizabeth hospitals. Ryan completed a PhD investigating the role of dexterity in scalpel skill learning amongst podiatry students and is currently involved in multiple research projects, including investigating soft tissue changes in diabetes, the use of antimicrobial dressings in chronic wounds, and brain-related changes associated with diabetes. Outside of podiatry he is an avid trail runner and lover of wine.

Are you interested in stepping up and supervising students after the next pandemic? Dr Ryan Causby offers the following advice.

It is important to recognise that we cannot assess learning itself, as this is implicit to the individual, we can only evaluate performance. Performance itself can be transient and it depends on numerous extrinsic and intrinsic factors.

The recent pandemic was a reminder of how important hands-on clinical experience is for podiatry students' learning. Forced into a period to learn online, universities faced growing concern on how to overcome the deficit in hands-on exposure and ensure students continued to develop clinical skills in a timely manner when coming out of lockdown, such as motor skills.

For that outcome we rely on a pool of mentors and supervisors through internal clinics and external placements. Maybe this is something you may be interested in exploring, if you don’t already?

To support this network we try to likewise offer these people support in their roles as mentors and supervisors. We clearly know how to ‘do’, it doesn’t always mean we know how to ‘teach’ various skills; particularly motor-skills which involve a large component of implicit learning rather than explicit knowledge.

Where are you at?

It may be that you are (or want to become) a supervisor, or simply want a better understanding into how students, new graduates or even experienced clinicians better acquire new skills such as the provision of workshops.

If this applies to you, this article outlines some simple, evidence-based tips on how to provide effective learning experiences and guide students or new graduates in a manner designed to improve the learning of motor skills. Let’s get started.

Tip #1: Respect the individual

Firstly, it is important to recognise that we cannot assess learning itself, as this is implicit to the individual, we can only evaluate performance. Performance itself can be transient and it depends on numerous extrinsic and intrinsic factors.

Psychological factors that can influence performance include:

The level of ‘anxiety’ experienced
The individual’s ‘self-efficacy’ (confidence on a particular task)
The often-forgotten aspect of ‘motivation’.

Observing someone perform a particular action will activate the observer’s own sensorimotor representations (this is particularly beneficial for complex skills).

Setting up the correct environment can substantially affect these factors and ultimately influence a person’s performance. After all, how they perform at the outset may not truly reflect their ability, particularly in the ‘anxious’ student.

Tip #2: Observation and practice

Observing someone perform a particular action will activate the observer’s own sensorimotor representations (this is particularly beneficial for complex skills). And combining this observational learning with practice is even more effective than practice alone.

In other words, students will benefit by watching you treat the patient, but swapping between being the clinician and an observer can be of greater benefit. Why? Partly because observation decreases the cognitive demands and improves implicit learning and skill consolidation.

Tip #3: Autonomy can help learning

Autonomy can have a big influence on learning (we assume it’s linked to motivation). But there is a LOT of evidence to show that providing students with autonomy as to when they ‘practice’ the skill can improve learning and retention. In fact, having autonomy over elements such as if and when they receive feedback has also shown large benefits.

What does the literature tell us about this? Two interesting insights stand out.

The literature reports that such autonomy will also improve a student’s own intrinsic feedback (such as their own self-evaluation of their performance)
The literature suggests that students’ preference (and benefit) is to receive feedback after a positive performance rather than a negative performance (I know, it’s like training a puppy with treats right!).

Tip #4: Feedback is so important

The role of feedback cannot be understated. When feedback is provided it should be:

Immediate
Positive, and;
Focus on external rather than internal cues (such as the required movement of the scalpel rather than position of the hands).

Here’s why. Motor learning literature suggests that focusing on internal cues, such as body movement effect, promotes subconscious (automatic) processes rather than conscious focus (which is more likely to constrain the motor learning system).

A word of caution though, feedback should be withdrawn over time as excessive feedback can have a detrimental effect.

Focus on external rather than internal cues (such as the required movement of the scalpel rather than position of the hands).

Tip #5 When the stakes are down…

What is the best approach when students really struggle? Evidence suggests there are a couple of methods you may wish to use.

Ask students to repetitively imagine what they need to do. This has a positive learning effect (such as motor imagery which a lot of racing car drivers do before a race)
Get students to practice on models, where their anxiety is more likely to be appeased. This has been shown to have great benefit. Having high fidelity models (like 3D printed feet we use to facilitate scalpel skill learning at the University of South Australia) is great, but evidence has demonstrated that students learn just as well with low fidelity versions. It is the practice that counts.

Tip #6 Motivation matters

Finally, I can’t understate the importance of motivation. Keep communication channels open by talking through issues with a student, such as asking them what they need to create the best learning environment to ensure they are motivated. This will go a long way.

So … are you interested in stepping up and supervising students after the next pandemic?