Application of Adult Learning Theory to Clinical Training

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Application of Adult Learning Theory to Clinical
Training
Ann Downer, EdD Executive Director,
CHER Director, International Training and
Education Center on HIV (I-TECH) University of
Washington Seattle April 2003
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• If telling were the same as teaching, wed all
  be so smart we could hardly stand it.
• -Robert Mager

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Learning Objectives

• At the end of this session, you will be able to
• Describe how traditional principles of adult
  learning theory are applied to educational design
  and effective group facilitation
• Judge the relevance of principles in varying
  cultural contexts and educational settings and
• Adopt or adapt the principles of adult learning
  theory as needed in order to improve clinical
  training practice.

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Workshop Outline

• Before lunch participants will review the
  history of principles which underlie contemporary
  practices in adult education.
• Introductions and personal observations
• Reviewing the historical origins of adult
  learning theory
• After lunch participants will critically analyze
  principles of adult learning theory and suggest
  ways to apply these principles in order to
  improve clinical teaching.
• Identifying principles and how they manifest in
  practice
• Refining or adapting principles for different
  settings
• Improving the practice of clinical training

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Reflection Exercise

• Take a moment to remember a good teacher
  someone you knew recently or long ago.
• In your opinion, what 1 or 2 personal
  characteristics made him/her an effective teacher?

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Basic Principles of Adult Learning

• Effective adult educators
• Create a climate that is psychologically safe for
  learning.
• When threat to self is low, learning can
  proceed.
• - Carl Rogers

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Basic Principles of Adult Learning

• Effective adult educators
• Show respect for the experience and knowledge of
  learners.
• Prepare content that is relevant to the immediate
  needs of learners.
• Adults seldom learn, remember or use answers for
  which they do not already have questions.
• - Andrews, Houston, Bryant
• Adult Learners

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Basic Principles of Adult Learning

• Effective adult educators
• Use the knowledge and experience of learners as a
  major resource for teaching.
• Incorporate didactic, affective and skill-
  building methods into teaching.
• Recognize that adults have multiple
  responsibilities.
• Be sincere, be brief, and be seated.
• - Roosevelt

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Origins of Modern Learning Theory

• The values associated with modern Western
  education stem from the written works of the
  early Greeks and are closely associated with the
  study of rhetoric- the art of expression and the
  persuasive use of language.
• Logos
• Pathos
• Ethos
• These ideas resonate through the centuries and
  create the foundation for Western philosophies
  about education today.

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Origins (continued)

• Educational planning is also influenced by the
  development of psychology and ideas derived from
  research conducted in predominantly American,
  European and northern cultures. Strong
  influences include
• Cognitive
• Behavioral
• Today's cognitive psychologists tend to be
  "universalists," assuming that everyone
• perceives, thinks, and reasons in the same way.
  We will return to this issue later in the
  workshop.

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Emergence of Andragogy

• Thorndyke (Adult Learning, 1928) challenged
  long-held assumptions that people dont learn
  much after childhood and re-directed discussion
  toward how adults learn. Research on preferences
  and styles of learning (Jung, 1969) also advanced
  knowledge of adult learning.
• Perceiving information sensing and intuiting
• Decision making feeling and thinking

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Principles of Andragogy

• Research focusing on adult learning expanded
  greatly in the 1950s, 60s, and 70s with the
  infusion of insights from psychology and further
  exploration of the difference between adult and
  child cognition. Key assumptions about adult
  learning emerged from this research
• Immediacy
• Self-direction
• Experience
• Motivation
• Knowles (1998), Vella (1995), and others
  popularized these principles, resulting in broad
  dissemination and adoption into practice.

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Compare principles from Knowles and Vella with
principles from cognitive psychology

Cognitive psychology Immediacy- new information and skills to solve immediate challenges Self-direction- identify their learning needs and pace themselves Experience- reservoir of experience and insight Motivation- internally motivated to learn rather than dependent upon external motivation Knowles and Vella Need to know- training when needed for practical reasons Self-concept- recognition as independent and self-directed Life experience- accomplishments and knowledge Task-centered and practical- meeting job-related needs Internally motivated- internal rewards and not grades or parental approval
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Transition- from Principles to Practice
Andragogy greatly influences the practice of
training throughout the world today. We look
next at how these principles are put into
practice in the design, delivery, and evaluation
of training programs.
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Working Groups

1. Create a climate that is psychologically safe
   for learning. (How? What would you do/not do to
   assure a safe learning environment?)
2. Seek input on preferred content and pace of
   learning. (How/when do you ask? What
   implications does this have for control of
   content and teaching methods?)
3. Prepare content that is relevant to learners.
   (How would you know? Can you/should you adjust
   your notes or teaching plans?)
4. Use the knowledge and experience of learners as
   a major resource for teaching. (How? What are
   the advantages and disadvantages of doing this?)
5. Incorporate didactic, affective and skill-
   building methods into teaching. (How? What
   teaching methods do you/could you use for
   addressing learning objectives in each of these
   domains?)

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If time Critical Analysis
"There has long been a widespread belief among
philosophers and, later, cognitive scientists
that thinking the world over is basically the
same." -psychologist Howard Gardner, Harvard
University Although there have always been
dissenters, the prevailing wisdom holds that a
Masai hunter, a corporate raider, and a farmer
all see, remember, infer, and think in the same
way. Some researchers now question whether the
cognitive processes that are central to Western
thought are universally operational.
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If time Analysis (continued)

• "Human cognition is not everywhere the same."
• psychologist Richard E. Nisbett, University of
  Michigan, The Geography of Thought How Asians
  and Westerners Think Differently ... And Why
  (2003)
• This book compares the cognitive differences
  between people from East Asia (Korea, China and
  Japan) and Westerners (from Europe, the British
  commonwealth and North America).
• Examples of East-West differences from the book.

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Challenge assumptions about adult learning by
providing a counter argument to the rules

• Minimize lecture because it induces passivity and
  stifles critical thinking.
• Use a warm-up exercise to establish a good
  climate for learning.
• Involve learners in diagnosing their own learning
  needs.

• A respectful facilitator plays down his/her
  position of authority and treats participants as
  co-instructors.
• Sitting in a circle is an effective and
  democratic technique.

• Choose interactive teaching methods because they
  make participants feel respected and involved.

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If time Analysis (continued)

• However, at least some studies in developing
  countries (Diouf, 2000) suggest that
• while cultural norms and values strongly
  influence what adults learn when they learn why
  they learn and who provides the instruction,
• they do not affect how adults learn.
• Framing educational research and practice as
  Western or non-Western may create false
  dichotomies, but perhaps allows us to raise
  important questions about the assumptions we make
  as trainers.

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• What do you think? Consider the following
  questions in your discussion group

• In your experience, are there some universal
  principles about all people and how they learn?
• In what ways might cultural norms and values
  affect what, when, why, from whom, and even how
  people learn differently?

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The Role of Trainer
Debate the following statement with two or three
people sitting near you. Trainers are not
entertainers. They are professionals who are
tasked with providing accurate, quality
information so that learners can perform their
jobs effectively once they leave a training
program. It is learners responsibility to pay
attention, and they should not expect a trainer
to motivate them to listen and learn.
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Workshop Summary

• Now that you have completed this workshop, you
  should be able to
• Describe how traditional principles of adult
  learning theory are applied to educational design
  and effective group facilitation
• Judge the relevance of principles in varying
  cultural contexts and educational settings and
• Adopt or adapt the principles of adult learning
  theory as needed in order to improve clinical
  training practice.

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Will you do anything differently the next time
you plan and deliver training?
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Workshop Follow-up Feedback on this Workshop

• Please complete the workshop evaluation form in
  order to help us evaluate whether this workshop
  will affect the way you develop and deliver
  training programs in future.
• Thank you.