1. How do we learn and how can we learn more effectively
Learning strategies
How do we learn and how can we learn more effectively

2. Aims / objectives Introduce some models of learning
To encourage you think about how you learn and to identify ways you may be able to learn more effectively in the future
Introduce some models of learning
Identify some resources from which you can learn

3. What do you need to be a good GP?

4. The VTS Learning Objectives
Have a sound, practical knowledge of clinical medicine
Understand the basic principles of health and health care for populations
Have a broad understanding of medical ethics 
Use time effectively
Are able to tolerate uncertainty
Value diversity
Are prepared for adaptation to change throughout their career 
Have good communication skills
Practise patient-centred medicine
Are able to organise an efficient and caring practice
Are able to work effectively in multidisciplinary teams
Practise preventive medicine
Practise evidence-based medicine
Regularly audit their own performance
Are able to plan their continuing education and professional development
Are able to balance the demands of personal and professional life
Apply these in context

5. What types of learning? Acquiring knowledge
Practical skills / competencies
Values

6. Miller’s pyramid
Does
Shows how
Knows how
Knows

7. Acquiring knowledge Lectures Tutorials Books Journals
Electronic info. – DTB, MeRec, Mentor, PILs, Medline, on line journals, Bandollier.
Others?

8. Skills Clinical skills Practical skills
Communication / consultation skills
Problem solving skills
Evaluating and doing research and audit
Others?
And what about values / attitudes?

9. Experiential learning
Kolb (1984) describes an experiential learning cycle:
concrete experience
observations and reflection
formation of abstract concepts and generalizations
testing implications of concepts in new situations.
So whilst learning from concrete experience forms part of the theory of experiential learning, a process reflection is also central.

10. Reflective practitioner
Schön (1983) developed the concept of the ‘Reflective Practitioner’.
The professional practitioner reflects on their knowledge whilst engaging in activity.
This enables them to adapt to the potentially unique context or problem with which they are faced.
Coles (1994) concludes that:
‘Professional education should provide people with the opportunity to reflect on their practice and to identify the theories embedded in their routine work.’

11. Feedback
Feedback from others is important in helping to learn. Who do we get feedback from?
How can you help others to give you feedback?
What sorts of feedback are effective?

12. Learning from each other
Feedback
Facilitating reflection
Sharing knowledge
Teaching skills
Different perspectives
Sharing resources

13. Adult learning Learning stuff that is important to you
Can be applied in the ‘real world’ i.e.context is important
Your responsibility to learn rather than the teachers responsibility to tell you what you need to know
Learning that is self-directed (SDL)
Learning is continuous and ongoing and must adapt to new situations (lifelong learning)
Is ‘knowledge’ only temporary?

14. Constructivism Three C’s
Construction- Knowledge builds on what is already known.
Context is important when learning and also when applying learning in practice
Collaboration – knowledge is socially negotiated, i.e varies in different contexts / cultures, collaboration helps to explore different perspectives.

15. Some tools to help learning whilst working
Write down and find out later:
Patient Unmet Needs (PUNs) – This bloke needs a hip replacement and the waiting list is 12months, is there anything I can do?
Doctor Eduactional Needs (DENs) e.g. I don’t know whether I should start this bloke on a statin.
PCA – looks at what you know you don’t know
RCA – looks at things you might think were not problems
Critical Incident Analysis – looks at things that have gone wrong, or nearly went wrong, or went well

16. Summary There is a vast amount to learn in order to be a good GP
Factual knowledge is a small, but important part of this and is perhaps relatively simple to acquire.
Learning can and should occur in lots of different ways, in different circumstances and with lots of different resources
Most of what you learn will not be from your ‘elders and betters’ but from yourselves, your peers, your patients and yourselves?
Understanding what type of learning need you are trying to address can help identify the best way to achieve it.