CTCFP

Principles and Examples of Adult Learning Theory

Motivated to learn when they experience a need		» Ask what their needs and expectations are » Involve them in discovering the value and relevance for themselves » Help them identify gaps in knowledge and skills (include assessments)

Come to workshops with a task-oriented problem-solving approach to learning		» Include problem-solving activities (case studies or simulations) » Build in time for application and practice » Structure the training around tasks concerning problems or life situations

Bring life experiences into the workshop		» Use participants as resources » Create a variety of opportunities for discussion and idea-sharing » Provide a mix of different forums that encourage sharing (dyads, small groups, rotating partners)

Motivated to learn by internal and external factors		» Ask what motivates them » Recognize need for achievement and self-esteem

Need to see themselves as self-directed learners		» Include experiential activitiesq » Invite and respond to questions

Need to know why they are being asked or required to learn something		» Ask them to state the consequences of not knowing » Ask them to clarify what they will be able to do or do better – as a result of this workshop

Traditional versus Competency-Based Instructional Approaches

	Traditional Approach	Competency-Based Approach	Examples of CBI

	Experience & knowledge is EXTERNAL to learners Curriculum developer(s) distills and arranges this experience and knowledge	Learners acquire experience & knowledge in their lives Curriculum developer(s) provides an experience that will tap learners’ values & ideas	Various assessments (written & observational) may be used Instruction is individualized All learners have the opportunity to succeed

	Faculty presents experience & knowledge to learners Learners hear & see presentation	Learners experience new situations; match new experience with previous learning Learners distill new values & new knowledge Learners try out new behaviors & acquire new experiences & knowledge in both simulated & “real world” environments	Learners may take competency-based tests ("criterion checks") a number of times Learners who have problems can obtain individual help from instructors Learners receive immediate feedback on how much they have learned Learning is measured according to how well the learner performs in relation to competencies (objectives) not in relation to other learners.

	Learners try out new behaviors in “real world”; the experience begins after instruction ends	Learners continue to process experience & knowledge as basis of original knowledge & experience Learners apply new behaviors in “real world” environment	Various assessments (written & observational) may be used to monitor progress Learning outcomes can be replicated by other instructors in other locations or at a later time

One Minute Preceptor Method

Step		Examples

1. Get a Commitment		“What do you think is going on with this patient?” “How do you think we should treat this patient?” “Based on the history you obtained, what parts of the physical should we focus on?” “Based on those differential diagnoses, what testing do you think should be ordered?

2. Probe for Supporting Evidence		“What factors in the history and physical support your diagnosis?” “Why would you choose that particular medication?”

3. Reinforce What Was Done Well		“Your presentation was well organized. You had the chief complaint followed by a detailed history of present illness.” “You included appropriate medical and social history with a focused physical exam.” “Your diagnosis of `probable PID' was well supported by your history and physical. You clearly integrated the patient’s history and your physical findings in making that assessment.”

4. Give Guidance About Errors & Omissions		“In your presentation you mentioned fever during your history but did not tell me the vital signs when you began your physical exam. Following a standard pattern will help avoid omissions and improve your communication of medical information.” “I agree that, at some point, a Pap smear will be needed, but right now the patient is acutely ill and the results would not assist us in diagnosis or management.”

5. Teach a General Principle		“Deciding whether someone with PID needs to be hospitalized challenging. Fortunately there are CDC criteria that have been tested which help...” “When looking for information on what antibiotics to choose, I have found it more useful to use an up-to-date hand book or electronic resource than a textbook which may be several years out of date.”

6. Conclusion		“OK, let’s go back in the room and talk with the patient. After that, I'd like you to ask the nurse to get a STAT serum hCG and CBC. When we’ve gotten the results, let me know and we can make a final decision about the need for hospitalization and our treatment plan.”