adult learning

The Principles of Adult Education

Dr. Jorge E. ValdezDean

School of Medicine and Health Sciences.

Topics• Introduction• Teaching Methods• The basis of learning• The nature of change in

medicine• The Teacher /Learner

interaction in Medicine• The learning cycle• The level of competence

• Adult learning characteristics.• The context of adult learning.

– Negotiated Education– Experiential learning– Expertise development– Expert Knowledge

• Conclusions.• Putting principles into practice.• Suggested readings.

What are the implications of adult learning for Ophthalmic Education?

• All the ophthalmic education occurs in adult population.

• Two major areas:– Ophthalmology Residency (short period)– Continues Medical Education (all professional life).– Other areas like medical students, nurses and

ophthalmic personal.

Introduction

• While most doctors regard teaching as an intrinsic part of their occupation, few have had the opportunity to study teaching techniques, much less the chance to reflect on such a ting as their teaching practice.

Teaching Methods• Historically, medicine has

been taught rather didactically with prolongation of the teacher-centered learning process, common in primary and secondary levels of education throughout university and into the years of clinical practice.

The basis of learning• Such modes of teaching tend

to be handed down from one generation to another.

• Unfortunately in the long term, authoritarian teaching tends to lead to a state of dependency on the learner´s part and is not good model for professional development.

Teacher-centeredStudent-centered

New-Innovative Curricula

Traditional Medical Curricula

Information gatheringProblem-based

Discipline-basedIntegrated

Hospital basedCommunity-based

StandardElective

Apprenticeship-basedSystematic

Continuum

The nature of change in medicine

The Teacher /Learner interaction in Medicine

The learning cycle

1. Unconscious Incompetence: The learner does not actually know all the steps that have to becarried out, but paradoxically they may feel quite capable of carrying out the procedure.

The learning cycle2. Conscious Incompetence: trying to carry out the procedure of the specific techniquethemselves and realize it is perhaps not as easy as it appeared, they become consciouslyincompetent and, providing the motivation is high enough, try to learn all the steps involved.

The learning cycle

3. Conscious Competence: Once the learners understand and can carry out the various steps of askill, they still have to think about the procedure, but given time, can carry it out satisfactory.With practice, they then enter the fourth stage.

The learning cycle

4. Unconscious Competence: after the third step is accomplished then with practice the learnerenters this step wherein, having mastery of the technique, implying that they can carry out theprocedure or the knowledge without consciously having to think about it (it becomes routine).

The level of competence

The state of knowledge is represented by point A. If no new learning occurs, there may be some increase in competence over time due to experience as suggested by the line A-B. The process is routine, the learner is unconsciously competent. At point C, a new methodology or knowledge is introduced. A decision is made either to learn or to reject; in the latter case the line continues as before to point B.

There can be a considerable gap between doing something quickly and efficiently as a master and the more laborious pace the student has to maintain during the learning process in order to get any where near an understanding or achievement of the same goal.

Adult learning characteristics

• The professionalization of medical teaching requires utilization of the basic principles of adult education in the particular context of medical practice.

Adult learning characteristics• Adult learning is purposeful.• Adults are voluntary

participants in learning.• Adults need clear goals and

objectives to be set.• Adults need feedback.• Adults need to be reflective.

The context of adult learningNegotiated Education

• Once we begin to take the individual learner’s purpose seriously, and we begin to use experiential knowledge as a learning resource, the notion of providing a standard course for a homogeneous audience becomes problematic.

• As individuals and as a group, learners will want to negotiate over the form and content of their educational experience in order to ensure the closets fit to their knowledge.

Experiential Learning

Two ways of knowingTwo ways of understanding or transforming knowledge

Tell me, and I will forget. Show me, and I may remember.

Involve me, and I will understand.- Confucius, 450 B.C.

Expertise development

Final Notes• Socialization.

Adult learners often retain traditional views of teaching and learning derived from their experience as pupils and students.

• Deference and dependency.Learner tend to be deferential towards and dependant upon “the expert” teacher. This may inhibit their learning.

• Experiential learning.Whilst recognizing the relevance of their day to day experiences for themselves, learners may be reluctant to see this as part of real learning.

Final Notes• Individualized Learning.– Because of their professional, domestic and other

commitments the effort which adults can expend on learning is variable and unpredictable.

• Provision of feedback.- Adults require feedback on their effort so that they can maintain the process of reflection and self improvement.

• The teacher role.A shift to the principles of adult learning may require just as much re-thinking on the part of the teacher as it does for the teacher.

Thank You

Jorge.valdez@itesm.mx