Learning As We Go

We’re in the thick of our Washington build, and I’ve lost count of how many times the plan has had to change on a dime.

Not many major ones. But what feels like a near-constant set of pivots. Inspection corrections. New ideas. The domino effect of one decision making another no longer feasible.

And yet, we are making steady, consistent progress.

It just doesn’t look like it at first glance.

That’s why this line from James Clear stuck with me:

“In theory, consistency is about being disciplined, determined, and unwavering. In practice, consistency is about being adaptable.”

That idea has been showing up everywhere lately. Not just in construction, but in how we’re thinking about learning, especially in medical education.

Residents are already using AI. And they’re adapting quickly.

The harder question is for educators.

How do we make use of AI without losing the cognitive work that actually builds understanding?

One reframe I came across recently from Kareem Hannah shifted this for me:

Even an AI-generated note can be educational… if the learner is asked to find where it misrepresents their thinking.

That’s a bit of a nuanced change.

Instead of asking, “Is this right?” we’re asking, “Where does this not reflect your reasoning?”

To answer that, a learner has to slow down. Articulate what they were actually thinking. Notice what the AI missed and why it matters.

And learning can continue.

Frameworks like DEFT-AI, from work in JGME, give structure to this:

· D — Diagnose the AI moment (”Did you use any tools to help with this case?”)

· E — Explore the inputs (”What did you tell the AI? What does it not know about this patient?”)

· F — Feedback on reasoning (”Tell me your plan as if the AI weren’t here.”)

· T — Teach verification (”How would we check this? What if it’s wrong?”)

· AI — Advice on future use (”Next time, form your own plan first, then use AI as a double-check.”)

Not only do I love the framework, I appreciate what it represents.

We’re not preserving learning by resisting change. We’re preserving it by adapting how we teach, how we question, and how we stay connected to thinking.

Same thing with this construction project, and travel plans, workshops, and honestly, a lot of medicine right now.

I'm all about consistency. I used to say consistency was my super power.

But consistency in progress doesn’t mean consistently sticking to the original plan.

More often, it takes adjusting, refining, and recalibrating. Choosing the next best plan based on new information.

We realize new things and challenges arise we didn't anticipate.

And then the question shifts from:

How do we stick to the plan?

to:

What’s the next best step, given what we know now?

That's important in all of medicine, including how we teach and learn.

Reflection:

What situations are you facing that releasing resistance and embracing adaptability may be the best course of action?

What’s the next step?

I'd love to hear what you discover.