Adult Learning Theory: Teaching Techniques to Enhance Learning Caroline Harada, M.D. Division of Gerontology, Geriatrics, and Palliative Care University of Alabama at Birmingham

You are precepting a student. You suddenly find yourself with 15 minutes with no patient care responsibilities. You would like to teach the student something during this down time, but you haven’t planned anything specific… A scenario from real life…

Every time you get a teaching opportunity, you want it to have as big an impact as possible! How can you create high quality learning experiences with limited resources? Guerilla Geriatrics

Educational methods must be feasible We all have limited resources: – Time – Technology – Money – Space – Faculty Today’s teaching activities will be instructor- friendly: – LOW TECH! – LOW STRESS! !

Learning Theory Behaviorist theory: Learning is done TO the learner – Filling an empty vessel Constructivist theory: Learning is done BY the learner – Learner Centered Learning How People Learn. National Research Council, 1999

Learner Centered Learning New knowledge is constructed from prior knowledge – Must activate prior knowledge in order to build upon it Learners must be actively engaged – Learning is WORK! Metacognition is encouraged – Know what you know How People Learn. National Research Council, 1999

Miller GE. The assessment of clinical skills/ competence/ performance. Acad Med (1990);65:s63-s67. Miller’s Pyramid

Kolb’s model for experiential learning 2 dimensions: Perception (grasping) Processing (transformation) Multiple Learning Styles Kolb, DA. Experiential Learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall; Concrete Experience Conceptualization Active Experimentation Reflective Observation

1. Activate prior knowledge 2. Add new knowledge 3. Try out new knowledge 4. Use new knowledge Armstrong’s Curriculum Planning Framework Armstrong E, Parsa-Parsi R. Academic Medicine, July 2005 Concrete Experience Conceptualization Active Experimentation Reflective Observation

Reflective journaling Practice audits Academic detailing Concept mapping Games Exit tickets Operationalizing this Framework Armstrong E, Parsa-Parsi R. Academic Medicine, July 2005 Concrete Experience Conceptualization Active Experimentation Reflective Observation

Work Audits

An evaluation of a person, organization, system, process, enterprise, project or product What is an audit?

Geri Audit

Academic Detailing

Potentially inappropriate medications (pocket card) Pain medications (pocket card) Appropriate use of Foley catheters (pocket card) Asthma management- use of peak flow meters (patient handout) Possible applications

Concept Mapping

Concept Map A concept map is a diagram showing the relationships among concepts. It is a graphical tool for organizing and representing knowledge. We plan to use them here to: – Provide an initial conceptual frame for subsequent information and learning – Increase meaningful learning – Enhancing metacognition (thinking about what you know and what you need to learn) Wikepedia, “Concept map” Accessed Sept 4, 2009

Becomes an expert in geriatrics Example of a Concept Map Applies to FSP Accepted to FSP Comes to FSP workshop

Example Concept Map Tired person Skips exercise Eats muffins Drinks lots of coffee Gains weight Doesn’t sleep well at night

Patient: Mrs. T 75 year old woman with a history of hemorrhoids and depression admitted for blood in stools on Monday evening She is very weak and there is concern she will fall, so she is put on bedrest and a Foley is placed She is made NPO, IVF are started, she gets prepped for colonoscopy by drinking a gallon of GoLytely She has a colonoscopy on Tuesday afternoon Tuesday evening she becomes very agitated, she starts fighting caregivers, pulling out her IV and Foley She is placed in restraints She is now extremely confused

Draw a Concept Map How did Mrs. T get so confused? Blood in stools Confusion

Haldol How did this patient get so confused? Bed rest Weak, fall risk Foley Pain Restraints Anesthesia Colonoscopy GIB Depression Confused patient Preexisting Alzheimer’s Lots of meds

Taboo Health Literacy Limbo Card sorting games Role play Games

Warm ups – Pre tests – Reflective journaling Debriefing – Group discussion – Exit tickets Enhancing Metacognition

Debriefing Exit tickets – Yellow card: One thing you learned about adult learning theory – Blue card: One new teaching technique you want to try Wrap Up