Pocket Guide to Teaching for Clinical Instructors

Ian Bullock, Mike Davis, Andrew Lockey, Kevin Mackway-Jones, Ian Bullock, Mike Davis, Andrew Lockey, Kevin Mackway-Jones

• Publisher: BMJ Books
• Year: 2015
• ISBN:
  9781118860632
• Edition: 3
• Topic: Medicine
• Subtopic: Emergency Medicine & Critical Care

The Pocket Guide to Teaching for Clinical Instructors, 3rd edition, provides a concise introduction to teaching. Written by experienced medical educators from the Advanced Life Support Group and Resuscitation Council (UK), this best-selling guide gives comprehensive and practical advice on the most effective teaching methods.

Pocket Guide to Teaching for Clinical Instructors covers basic principles and practical aspects of teaching in a variety of modalities. This edition includes material which reflects current developments within instructor courses and includes new material on feedback, an awareness of non-technical skills, the teaching of teams and supporting learners.

This book is essential reading for anyone interested in teaching doctors and healthcare professionals in any context. It is aimed at the relative newcomer to the teaching role in all its variety and provides essential, practical advice as to how to get the best out of learners.

CHAPTER 1
Adult learning

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Learning outcomes

By the end of this chapter you should be able to demonstrate an understanding of

• how adults learn
• the contribution of experiential learning
• motivation

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Introduction

While adult learners differ from children and adolescents in a wide variety of ways (largely as a consequence of the voluntary character of adult learning), they retain some characteristics, particularly a perceived need to see the teacher as a fount of all knowledge and insight. In general, however, adult learners (and health professionals in particular) can be thought of as having the capacity to demonstrate different attributes (Knowles, 1973).

Knowles and the adult learner

Autonomy and self-determination

These are not always possible in formal learning but, in general, health professionals have at least the capacity to take decisions about the direction and timing of their learning. This aspect is particularly important when engaging with blended learning environments comprising virtual learning environment (VLE) and face-to-face experiences. Where decisions are taken out of their hands – for example by being sent on a course – there may be some initial resistance unless learning can be experienced as stimulating and valuable. This clearly has implications for motivation and this will be explored later in the chapter.

Life experience and knowledge

Most health professionals have had many years of formal full-time education (13 years in school, 3–6 years in higher education) and many more years in postgraduate training. No matter how receptive they may be to new ideas, there is a great deal of conservatism which needs to be overcome before learning can occur. This has been represented by Lewin (1951) in the following way:

Unfreezing – change – refreezing

Unfreezing is the point at which the learner becomes open to the idea of change (in understanding, affect, skill level); change is then incorporated and reinforced through feedback and ongoing practice both in the training environment and in the workplace.

Goal orientated

Many adults like to have an outcome or a clear product from their efforts. Learning for its own sake may have some attractions at certain times, but it is not a luxury that busy professionals can include in their working lives.

Relevance orientated

Similarly, learning has to be relevant to work-based practices if it is to be valued by learners. As well as subject matter, this also relates to level: material can fail to be relevant if it is too easy or too complex. Content needs to be constructed around the experiences of the learner. In this case, the learning is located quite explicitly within a ‘community of practice’ and this will be explored later in the chapter.

Practical

Learners get a great deal from integrating skills, knowledge and affect in complex, practical learning events, preferably related to previous experience and/or expectation of future practice. Nana Gitz Holler (Denmark), a learner on a European Provider Course, wrote

… we are not machines and this course gives room for us to think and makes the whole teaching session and the teamwork alive and interesting. It opens up for discussions and that is where you really learn something – not only from the instructors but also from the other candidates.

Esteem

Ask health professionals about negative experiences of learning and they are likely to mention humiliation. Good education acknowledges the contribution that learners can make to the learning of others including the teachers (and respects their achievements thus far).

The experiential learning cycle

There are a number of theories of adult learning that are relevant to those involved in continuing medical education, but it is beyond the scope of this book to explore them all. Relevant titles are included in the references at the end of each chapter for those who are interested in exploring some of these. However, there is one theory that is useful to explore briefly here, that of experiential learning.

This theory was based on ideas about reflection developed in the 1930s by John Dewey (1938). One of the components is the experiential learning cycle, illustrated in Figure 1.1.

Figure ...