1. Principles of Adult Learning Theory: A Beacon in the Night Jennifer Kesselheim, MD, MEd Hematology Course Directors American Society of Hematology December 5, 2010

2. Disclosure Slide There are no relevant conflicts of interest to disclose

3. Objectives Describe several essential educational theories relevant to the teaching of adult students –Knowles concept of androgogy –Self-directed learning –Self-efficacy –David Kolb’s cycle of experiential learning –Reflective practice –Millennial learner Identify classroom strategies to apply each theory Explore methods for ongoing inspiration in medical education –Faculty development –Educational research Kaufman DM. Applying educational theory in practice. BMJ. 2003 January 25; 236(7382): 213-6.

4. Malcolm Knowles 1980 text: Modern Practice of Adult Education Androgogy –Art and practice of teaching adult learners –Distinct from learning in childhood Pedagogy Knowles MS. Modern practice of adult education: from pedagogy to androgogy. Englewood, NJ: Cambridge Book Company, 1988

5. Androgogy vs. Pedagogy Pedagogy –Formal –Learners are dependent and directed by teacher –Evaluation is external (teachers, tests) –Learners extrinsically motivated (grades) Androgogy –Informal and cooperative –Learners are independent and self-directed –Evaluation through self- assessment –Learners intrinsically motivated

6. Androgogy vs. Pedagogy Pedagogy –Learners inexperienced –Value learning that is put upon them –Learning centers on a particular subject Androgogy –Learners have own rich experience, used as a resource –Value learning that is relevant to every day life –Learning centers on a particular problem

7. Creating the Optimal Learning Environment* Create and environment where the learner is truly at the center –Why is the learner here? –What motivates her? –What problems does she want to solve? –What are her goals? –How will she measure success in meeting those goals? –What experiences will she bring to the process?

8. Creating the Optimal Learning Environment* Get to know your learner, shows respect Three questions –What are you hoping to learn? –Where will your future career likely take you? –How can this course serve you in that future? Knowing your learner and his/her goals keeps the learning environment: –Relevant –Sparks internal motivation

9. Self-Directed Learning: a related concept Adult learners are autonomous and goal- oriented –Come to educational experience with goals already in mind –Teachers facilitate the meeting of those goals Strategy gives learner feeling of control, empowerment Learner accepts responsibility for learning Candy PC. Self direction for lifelong learning: a comprehensive guide to theory and practice. San Francisco: Jossey-Bass, 1991.

10. Optimizing Self-Direction* Allow learners time to ask questions Provide opportunity for building of theories and hypotheses Encourage critical appraisal of new information Force learners to identify gaps in their own knowledge and make plan for addressing those gaps Presentations and literature reviews

11. Self-Efficacy Learners make decisions about how much effort to give, how hard to work, in part due to their perceived likelihood of success –Previous performance –Observations of others –Verbal persuasion Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, 1986.

12. Set Them Up to Succeed* Set clear goals and expectations Model what you would like learners to do Allow learners to practice and receive feedback Promote reflection on learning process

13. Experiential Learning Concrete Experience Reflection Abstract Conceptualization Reflection Experimentation David A. Kolb. Experiential Learning: Experience as the source of learning and development (1984)

14. Missed Steps Optimal learning requires time for all four steps Rushed learners often skip reflection and abstract conceptualization Oscillation between experience and experimentation is far less effective Reflection Experimentation Concrete Experience

15. Reflective Practice Formal theories inherent to training a professional tend not to apply to the messy reality of practice Learners reflect in these messy moments to compare or contrast theory and practice –Reflection in action Learners also reflect after the fact to determine how to “do better” next time –Reflection on action Through this reflection, learners develop “wisdom” and experience that enhances their performance Schon DA. Educating the reflective practitioner: toward a new design for teaching and learning in the professions. San Francisco: Jossey- Bass, 1987.

16. Opportunities for Reflection* Reflection as a group –Good-spirited challenging of theories –Debriefing Reflection as an individual –Asking questions –Practicing in safe environment –Receiving feedback

17. Attend to the Millennial Learner Accustomed to group work Prefers active learning Multi-tasks with ease Expert in technology Requires structure Goal oriented http://www.baker.edu/departments/etl/resources/Teaching%20across%20Generations%20with%2 0notesv3.ppt

18. Attend to the Millennial Learner* Use the most updated references and keep technology current Allow for use of computer and other resources during learning Allow for small group learning and build structure –Assign small group roles initially –Rotate roles –Require 100% participation –Set clear expectations of each individual

19. Keeping it Fresh Teaching the same course can get monotonous –Adherent to old methods –If it’s not broken, don’t fix it Strategies for continual inspiration

20. Faculty Development Teach the teachers! –Adult learning theory –Assessment and feedback –Small group dynamics –Simulate small group sessions –Observed teaching with feedback from peers –Share course and teacher evaluation data

21. Education Research New focus on measuring outcomes creates new opportunities for research –Internal, QI –Publish Which methods lead us to the outcomes we desire? Will achieving the outcome lead to meaningful improvement in learner’s experience?

22. Research Questions Will an electronic image bank allow students to perform better on the hematopathology portions of the exam? Will more small group sessions increase students’ ratings of our course? Will more exposure to hematology research increase medical students’ interest in scholarly pursuits with our faculty?

23. Share Your Innovations Curricula Evaluation instruments Use of technology to enhance learning Plan to collect data as you make improvements in your teaching

24. Share Your Innovations Hematology literature Pediatrics and internal medicine journals Medical education –Academic Medicine –Medical Education –Journal of Graduate Medical Education Med Ed Portal –www.aamc.org/mededportal

25. Conclusion Adult learners are… –Millennial –Self-directed –Experienced –Reflective –Self-assessed –Problem-centered –Self-motivated

26. Also…. Adult learners are all of the people in this room! While you are brought here because you are teachers, don’t forget that you are also adult learners. Directing your course is a learning opportunity that will be most successful when seen through the lens of adult learning theory. Notecard