Adult Learning Theory:
Teaching Techniques to
Enhance Learning
Caroline Harada, M.D.
Division of Gerontology, Geriatrics, and
Palliative Care
University of Alabama at Birmingham
A scenario from real life…
• 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…
Guerilla Geriatrics
• 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?
Educational methods must be feasible
• We all have limited resources:
–
–
–
–
–
Time
Technology
Money
Space
Faculty
• Today’s teaching activities will be instructorfriendly:
– 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’s Pyramid
Miller GE. The assessment of clinical skills/ competence/ performance.
Acad Med (1990);65:s63-s67.
Multiple Learning Styles
• Kolb’s model for
experiential learning
2 dimensions:
Concrete
Experience
• Perception (grasping)
• Processing (transformation)
Active
Experimentation
Reflective
Observation
Conceptualization
Kolb, DA. Experiential Learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall; 1984.
Armstrong’s Curriculum Planning
Framework
1. Activate prior knowledge
2. Add new knowledge
3. Try out new knowledge
4. Use new knowledge
Concrete
Experience
4
1
Active
Experimentation
Reflective
Observation
2
3
Armstrong E, Parsa-Parsi R. Academic Medicine, July 2005
Conceptualization
Operationalizing this Framework
Reflective journaling
Practice audits
Academic detailing
Concept mapping
Games
Exit tickets
Concrete
Experience
4
1
Active
Experimentation
Reflective
Observation
2
3
Armstrong E, Parsa-Parsi R. Academic Medicine, July 2005
Conceptualization
Work Audits
What is an audit?
• An evaluation of a person, organization,
system, process, enterprise, project or
product
Geri Audit
Academic Detailing
Possible applications
•
•
•
•
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)
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
Example of a Concept Map
Applies to FSP
Accepted to
FSP
Comes to FSP
workshop
Becomes an
expert in
geriatrics
Example Concept Map
Tired person
Skips exercise
Drinks lots of
coffee
Eats muffins
Doesn’t sleep
well at night
Gains weight
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
How did this patient get so confused?
GIB
Depression
Weak, fall
risk
Colonoscopy
Anesthesia
Bed rest
Lots of meds
Haldol
Preexisting
Alzheimer’s
Confused
patient
Foley
Restraints
Pain
Games
•
•
•
•
Taboo
Health Literacy Limbo
Card sorting games
Role play
Enhancing Metacognition
• Warm ups
– Pre tests
– Reflective journaling
• Debriefing
– Group discussion
– Exit tickets
Wrap Up
• Debriefing
• Exit tickets
– Yellow card:
• One thing you learned about adult learning theory
– Blue card:
• One new teaching technique you want to try