>>McMAHON: One of our roles as educators is creating long term retention and the change that occurs from that, and it can be really tricky to try and achieve that. Our learners are bombarded by signals and materials that often displace older existing material and ways of acting and practicing that are ultimately important. So when you want to generate long term change and improvement, instead of just focusing on knowledge, you need to drive towards incorporating knowledge into action, which is really understanding, and then associating that understanding with reflection and meaning.

Let me give you an example. I work primarily in diabetes care and there are always new diabetes medicines. And in order to really improve the quality of care delivered to my patients, I need to understand not just how those medicines work and when they're appropriate to work, but be able to see the effectiveness of those medicines. Not just on a measurement like the A1C, but on the quality of life for my patient.

So I start with learning about medicine, that's our knowledge element. When to use it, a knowledge element. How to prescribe it, that becomes a practice element and a performance element. And starting to practice using that medicine, I start to absorb and reflect on its real impact on my patients. Not just looking at numbers, which are important, but just the quality of my patients' lives as a result of being on medicines that make a difference for them.

So that's moving from knowledge to understanding to us having the opportunity to reflect on meaning. And if you can create meaning, you're really on the road to generating long-term retention and the resulting performance and improvement that results from there.