Presentation on theme: "How Adults Learn Peter J. Fabri, M.D. Professor of Surgery Associate Dean of Graduate Medical Education University of South Florida Health Sciences Center."— Presentation transcript:
How Adults Learn Peter J. Fabri, M.D. Professor of Surgery Associate Dean of Graduate Medical Education University of South Florida Health Sciences Center
Organic Chemistry 1966 I couldn’t understand it So I memorized it Every night I would rewrite my lecture notes from the beginning of the semester It went this way for 4 months One morning it made sense and from that day on I could learn
Childhood Learning Rote memory Repetition Testing as feedback Gathering building blocks Vertical and additive?
Learning Theories Many talented educators have developed theories to explain the processes of the human mind. Are they correct? Maybe in part. Then why use them? Because they provide a structure that helps us understand how to teach and glues together the episodes of learning.
Four Learning Theories Bloom’s Taxonomy Gardner’s Theory of Multiple Intelligences Gagne’s Theory of Conditions of Learning Dreyfus Process of Learning
Why is medical education different now? How much to learn? – Until recently, the amount of relevant clinical knowledge was finite and knowable. – The rate of knowledge expansion is now exponential. Where do we learn? – The traditional teaching ward provided opportunity for continuity, integration, and interaction. – The modern teaching clinic is fragmented, episodic, and discontinuous.
In the past, core knowledge could be learned in medical school. An intern or resident was an apprentice, mastering a set of skills. Once learned, the knowledge was thought to suffice for life. Today, medical education is a continuous, lifetime commitment to learning while working Why is medical education different now?
In the past, the physician was the unchallenged captain of the team. –led by authority –individual superstar with a team of helpers –learned in elite isolation Today, the physician is a senior member of a multidisciplinary team. –leads by example –one of many talented team members –learns in an integrated and interrelated system Why is medical education different now?
Learning on the Wards The Osler model Large wards; long hospitalizations All diseases are likely to be represented in all phases. Under the direction of a master, an individual is able to observe the full spectrum of a disease and its treatment.
Learning in the Clinic Fragmented and episodic Never see the whole picture Little continuity Requires an educational model to “glue” the pieces together
Modern “Tools” Competency-based education Lifelong learning Continuous improvement Evidence-based Medicine Clinical guidelines Maintenance of competence
Coaches vs. Teachers A teacher is an individual who tells the students what, when and how to learn, then tests to see if they have learned. A coach provides context, direction, motivation, and leadership, evaluating progress along the way.
Affective Domain- Attitudes Bloom’s Taxonomy paying attention participating valuing value system adopting outlook
Multiple Intelligences Learning is composed of multiple sensory and intellectual inputs --sound, sight, smell, etc. The greater the number of inputs attached to a particular idea, the greater the retention of the information. Some individuals learn better orally, some visually, some kinesthetically, some by combinations.
Gagne- Conditions of Learning There are several types or levels of learning. Each type requires a different type of instruction, and has different conditions. Five major categories of learning: – verbal, intellectual skills, cognitive strategies, motor skills, attitudes Prerequisites to learning for each level
Gagne- Principles Different instruction is required for different learning outcomes Events of learning operate on the learner in ways that constitute conditions of learning The specific operations that constitute instruction are different for each type Learning hierarchies define what intellectual skills are to be learned and a sequence of instruction
Skill Acquisition Dreyfus model (1980) novice advanced beginner competent proficient expert master é3rd year student égraduating student échief resident éboard eligible (+2years) é5-10 years practice é?
Common Misbeliefs Everyone wants to learn Everyone learns the same way Everyone learns at the same rate Once learned, knowledge is forever Memorized information can be used Everyone can integrate knowledge
Summary The “apprenticeship” model is rapidly being replaced by adult learning – Competency based – Objectives driven – Consistent evaluation methods
Summary 2 Different learners require different learning methods and assistance Learning is hierarchical and increases in complexity and interrelatedness Learning requires prerequisite knowledge and/or experience Varied learning opportunities and experiences enhance retention Something learned may not be able to be used!
Conclusion If you want to be involved in adult learning, you need to try to understand the intricacies of adult learning. The traditional notion that everyone learns at the same speed, in the same way, with the same outcome must be reassessed and methodologies modified.