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 THINGS LIKE TO THINK ON YOUR FEET GET 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 ACTING LIKE TO LISTEN AND OBSERVE BEFORE MAKING YOUR MIND UP TEND 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 over You can read up on something before the activity You are given time to think about what you’ve leaned You are given time to reach a decision

THEORISTS LIKE CONCEPTS AND MODELS LIKE TO STRUCTURE AND CLEAR OBJECTIVES LIKE LOGICAL ACTIVITY DISLIKE 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 info You are involved in situations emphasising emotions and feelings You are involved in unstructured activities with no clear purpose You doubt the subject matter is methodologically sound

PRAGMATISTS LIKE PROBLEM SOLVING LIKE ROLE MODELS AND LEARNING FROM REAL LIFE SITUATIONS ARE 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

Film clip ‘whiplash’