1. Principles of Adult Learning
Applications to Clinical Teaching
Dennis Baker, Ph.D.
Assistant Dean For Faculty Development
Florida State University
College of Medicine
Welcome to this PowerPoint presentation on “Principles of Adult Learning.” Please go to the next slide for further instructions.

2. Instructions and Overview
This program consists of 12 slides about adult learning principles and the application of those principles to clinical teaching. To view the slides, think about them, and answer the quiz at the end should take about 30 minutes of effort.
As you view each slide you can read text below each in the notes section of the slide. There are two primary learning objectives to be accomplished. The last slide provides a quiz. Please consider the quiz “open book.” If you would like feedback on your answers please send them to me as an and I will give you feedback.
Please note that as you view this program there is text below each slide. You can adjust the size of this text area simply by placing your cursor on the bar just above the first line of text. When you do this the cursor changes to a small up and down arrow indicating that you can adjust the size of the text box up and down. This will permit you to view the slide and the text below it simultaneously.

3. Learning Objectives
At the end of this presentation you should be able to:
List 3 principles of adult learning.
Explain the implications these 3 principles have for you as a clinical teacher. In other words, how can you as a clinical teacher apply the 3 principles you listed?
These are the two learning objectives for this program. The quiz presented on the last slide will ask you to answer/do these two objectives.

4. Adult Learning Theory Adults ……. bring knowledge, skills, attitudes
bring experience
like to solve problems
like to apply what they learn to real situations
like to have choices
like to share in the setting learning objectives
have variety of learning styles/preferences
do best in an environment where they feel safe, accepted, and respected
want and need feedback
need to have their abilities and achievements honored
Our students are adults and the above principles have implications for teaching and learning in the clinical setting. Lets take a look at these implications.

5. Adult Learning Principles
Adults …….
bring knowledge, skills, and attitudes
bring experience
Medical students bring experience to a learning situation. That experience sometimes has a valence such as good memories, bad memories, etc., that impacts on their learning. Medical students also bring knowledge, skills, and attitudes. These are called the three domains of learning. There is always an interaction between these three domains. For example, the attitude about elderly patients a student brings with him/her to a clerkship will influence how much he/she learns about the care and management (knowledge and skills) of those patients. If a student has a negative attitude toward elderly patients, gaining new knowledge about elderly patients during the clerkship may lead to a more positive attitude about them. It is important to be aware that the attitudes modeled by the clinical teacher are often adopted by the student.
Educational research clearly indicates that a primary factor that influences the acquisition of new information is the information the student already has. This is one reason it is important to ask the student at the beginning of a clerkship to share with you his/her self-assessment of strengths and weaknesses relative to knowledge, skills, and attitudes. You also need to ask the student which clerkships he/she has completed because the knowledge and skills gained on those clerkships influences the level at which the student starts on your clerkship.

6. Adult Learning Principles
Adults …….
like to solve problems
Like to apply what they have learned to real problems
Students like to solve “real” medical problems. One implication of these two principles is that students need to be involved in patient care and to feel they are responsible, to some degree, for patient care outcomes. These principles also imply that clerkship faculty members need to actively work to help the student develop their clinical reasoning skills by asking questions of the student (e.g. what is your differential on this patient?) and then asking the student to explain that reasoning.

7. Adult Learning Principles
Adults …….
like to have choices
Like to participate in the setting of goals and objectives
I once asked a resident why she and her colleagues sat at the back of the room while a fellow resident made a case presentation. She said, “That’s the only decision we get to make.” In another situation I sat with a group of residency directors who were deciding on the monthly topics that would be presented to residents. I suggested that the residents would like to have input. Their response was, “They are residents. How would they know what they need?” Biting my tongue, I wanted to ask them, “What sort of magic happens on the night a resident falls asleep being a resident and not knowing what he/she needs and waking up the next morning as an attending, with the ability to not only know what he/she needs but to also know what the residents in training need. I can only say that it must be a very long night or at least one of magical revelation. Giving learners choices early in their medical training and involving them in the setting of learning goals and objectives is critical to the development of their ability to make good choices and to make intelligent decisions with regard to the selection of goals and objectives. One implication of the two principles above is to ask the student which objectives in the syllabus he/she finds most interesting and challenging and wants to work on. Some would argue that the student has to accomplish every clerkship objective and so making choices is not appropriate. A wise academic program director I worked with once said, “They (students) can’t learn it all and we (teachers) can’t teach it all.” I would argue that clerkship faculty and students can work together in a collaborative fashion to select which clerkship learning objectives will be attained during the clerkship.

8. Adult Learning Theory Adults …….
have a variety of learning styles/preferences
This principles implies that we do not all learn the same way. This means each student may be different and that the teacher’s learning style may be different from the student’s learning style. For example the teacher may be someone who values facts and details and therefore his/her explanations may include these. But the student may be someone who needs to be given the big picture (e.g. the overall context) before the facts and details have any meaning. Being one who likes facts and details, the teacher may value them so much that he/she feels the learner should commit them to memory. Whereas the student may be saying, “I would have a better understanding of his/her detailed explanation if I were given an overview or context first.”
The implication for clinical teachers is that a student may have a different way of learning new information than he/she does. This doesn’t mean that clinical teachers should not share with students how they learned something best and to even suggest a learning strategy they used. But it does suggest that clinical teachers need to be flexible and they need to be aware that the student’s learning style may be different from his/hers.

9. Adult Learning Theory Adults …….
do best in an environment where they feel safe, accepted, and respected
In every learning environment, learners ask themselves, “Is this environment safe? Is it safe to make a mistake or will I be punished? Am I accepted here? Am I respected here? Was I prejudged because of my student status or is this an environment where I will get the opportunity to grow?” The educational research is clear; students tend to rise to the teacher’s level of expectations. High expectations combined with a learning environment of safety, acceptance, and respect is a magic formula for teaching and learning success.

10. Adult Learning Theory Adults ……. want and need feedback
need to have their abilities and achievements honored
Feedback truly is the breakfast of champions. We know that the highest level of patient care can only be achieved if feedback is consistently integrated into the learning equation. For the clerkship faculty member, this implies that feedback should be a point discussed in the orientation at the beginning of the clerkship and that feedback should be given early and given often. The clinical teacher that looks for opportunities to give positive and specific feedback also creates an environment in which feedback is sought by the learner instead of being avoided. We all want our achievements to be recognized. This is a critical part of feeling honored as a learner. You may have seen the bumper sticker on cars stating, My kid is an honor student at such and such high school. In medical education, we need a bumper sticker like the one on the next slide.

11. Please go to the next slide to take the quiz.
Every student should be an honored student.
The End
Please go to the next slide to take the quiz.

12. Quiz 1.List 3 principles of adult learning.
2.Describe how each principle can be applied to your clinical teaching. In your descriptions please try to go beyond the examples provided in this slide program.
Click on my address and the box will pop up. The two questions are repeated in the subject line. Type in your answers and I will provide you with feedback.
Please note, in the slide above is my address. Clicking on it as directed in the slide will provide you an window to type in your answer to the two questions if you choose to do so. If you choose not to answer the questions, I still would appreciate your feedback
Thanks for your participation in this program.
Dennis Baker, Ph.D., Assistant Dean for Faculty Development.