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ADULT LEARNING - BBT
September 2015
AIMS
To think about the importance of teaching and learning in our medical careers
To explore how adults learn
To identify how you learn best as an individual
To think about how you teach others effectively
COMPETENCES
communication integrated practice
standards of care
personal behaviour
management /leadership
√ √ √
‘LEARNING IS NOT PREPARATION FOR LIFE BUT PART OF LIVING’
Rogers 1986
GOOD MEDICAL PRACTICE (2006) - MAINTAINING GOOD MEDICAL PRACTICE
‘You must keep your knowledge and skills up to date throughout your working life. You should be familiar with relevant guidelines and developments that affect your work. You should regularly take part in educational activities that maintain and further develop your competence and performance’
GOOD MEDICAL PRACTICE
‘you should be willing to contribute to the education of students or colleagues and if you have responsibilities for teaching you must develop the skills, attitudes and practices of a competent teacher’
PEDAGOGY ‘THE TEACHING OF CHILDREN’
ANDROGOGY‘the teaching of
adults’ (Knowles 1998)
Pedagogy
Learner knows nothing and is passive ‘sponge’
Teacher knows everything (and is always right too!)
Information flows one way from teacher to learner
Information is subject based – this type of learning won’t change attitudes or behaviours or help you learn a skill
Boring (for both learner and teacher!)
Forgettable – knowledge is not used
Not easy to generalise or apply to real life
(finals)
Androgogy
Learner possesses their own experience
Learner is self-directed
Prefers learning relevant to their role in life
Prefers problem centred, experiential learning
Learner is self-motivated
Teacher is a facilitator rather than a font of all knowledge
But how do we know what we don’t know? (Johari)
Kolb 1998
FINE.....BUT HOW DO YOU KNOW WHAT YOU DON’T KNOW?
LEARNING CYCLES
EXPERIENTIAL LEARNING AND THE LEARNING CYCLE
CONCRETE EXPERIENCE:DOING – YOU DO SOMETHING FOR THE FIRST TIME E.G. BREAK BAD NEWS
REFLECTION: YOU THINK ABOUT WHAT YOU DID. WHAT WENT WELL, WHAT WENT BADLY, HOW YOU FELT. E.G. I FELT UNHAPPY AT THE END OF THIS CONSULTATION.
CONCEPTUALISATION: YOU MAKE SENSE OF WHAT HAPPENED. EG I REALISED I FELT BADLY BECAUSE I WAS LOST FOR WORDS DURING THE CONSULTATION. AT THIS STAGE YOU MAY THINK BACK TO PREVIOUS EXPERIENCE AND DRAW CONCLUSIONS ABOUT THE WAY YOU BREAK BAD NEWS, YOU MIGHT ASK OTHERS HOW THEY DO IT OR READ ABOUT WAYS OF HANDLING DIFFICULT CONSULTATIONS.
ACTIVE EXPERIMENTATION:YOU PLAN HOW YOU WILL DEAL WITH THIS SITUATION IN FUTURE. EG YOU MIGHT ROLE PLAY SIMILAR SITUATIONS WITH YOUR PEERS.
At the end of the process you have learned from experience and used this learning to alter future behaviour.
It is this type of learning that it is important to show in the learning log
TASK You are asked to organise some teaching for your team on handling difficult patients.
Thinking back to the principles of adult learning (kolb’s assumptions) and the learning cycle describe how you might go about this.
Group 1 – How do you decided WHAT their learning needs are
Group 2 – What methods might you use to teach them
Group 3 – How will you determine if the teaching has been effective?
LEARNING STYLES
MODEL 2: HONEY AND MUMFORD’S LEARNING CYCLE AND LEARNING STYLES
(Honey and Mumford, 1992)
ACTIVISTS LIKE TRYING NEW THINGSLIKE TO THINK ON YOUR FEETGET BORED EASILY AND HAVE TROUBLE SITTING STILL
You will learn from:
New experiences
Participation
Excitement/drama
Being in the limelight
Generating ideas
Being thrown in at the deep end
You will find learning difficult if:
You are sitting listening
You are working alone
You are asked to do something repetitive
You are given a detailed task with detailed instructions
REFLECTORS LIKE TO THINK THINGS THROUGH BEFORE ACTINGLIKE TO LISTEN AND OBSERVE BEFORE MAKING YOUR MIND UPTEND TO PROCRASTINATE AND BE INDECISIVE
Find learning difficult if:
Forced into the limelight eg role play
Have to act without planning
Pressurised by deadlines
Not given enough time to do a thorough job
Learn well if:
You are allowed to watch/think/chew things overYou can read up on something before the activityYou are given time to think about what you’ve leanedYou are given time to reach a decision
THEORISTSLIKE CONCEPTS AND MODELSLIKE TO STRUCTURE AND CLEAR OBJECTIVESLIKE LOGICAL ACTIVITYDISLIKE ANYTHING WITHOUT A CLEAR EVIDENCE BASE GET IRRITATED BY A DISORGANISED, HOTCHPOTCH APPROACH TO THINGS
Learn well if:
You are allowed to be methodical, and explore underlying theory
You are intellectually stretched
There is a clear purpose to your learning
Underlying theory is watertight and logical
Find learning difficult if:
You don’t have enough background infoYou are involved in situations emphasising emotions and feelingsYou are involved in unstructured activities with no clear purposeYou doubt the subject matter is methodologically sound
PRAGMATISTSLIKE PROBLEM SOLVINGLIKE ROLE MODELS AND LEARNING FROM REAL LIFE SITUATIONSARE QUITE PRACTICAL PEOPLE
Lear well if:
There is a strong link between what you are learning and a problem at work
You have a chance to practice what you are taught
You can focus on practical aspects / issues
Find learning difficult if:
It is not related to a need you recognise
You can’t see sufficient reward from the learning activity
The teacher is not down to earth (all theory and general principles)
TASK
You are planning a tutorial on the management of obesity in general practice for a medical student.......
How would you cater for their learning style if
Group – 1 they are an activist
Group – 2 they are a reflector
Group – 3 they are a theorist
Group – 4 they are a pragmatist
FEEDBACK
Feedback completes the ‘learning loop’ for the ‘teacher’
Without feedback you will not adapt to the needs of your learner(s)
Giving feedback is a skill
- it needs to be focused on specific examples
(what bits did work? What bits didn’t?)
-It needs to be constructive (what could be done to improve?)
-It needs to be non-judgemental
https://www.youtube.com/watch?v=mIABSdupWdI
Film clip ‘whiplash’
