How We Learn

Adult learning can be simply described as a process of self directed enquiry. There are several key principles that can help enhance learning for adults (and GP Speciality Registrars) and include the following:

Autonomy – They are autonomous and self-directed.

Adults need to be free to direct their own learning which necessitates that GP Speciality Registrars must be actively involved in the learning process. Acting as facilitators, educators are there to guide participants towards their own knowledge rather than supplying them with all of the facts. This enables registrars to take responsibility for their learning and engage in discussions, presentations and group-based tasks.

Prior knowledge and experience – They bring knowledge and experience to each learning activity.

Adults accrue a wealth of skills and knowledge throughout their lives. Linking new material to pre-existing knowledge can create a powerful learning experience. It is recognised that drawing upon the prior experience gained by GP Speciality Registrars can play an important role in the delivery of our education sessions.

Relevancy – They need learning to be relevant and practical.

The brain is constantly analysing and sorting multiple sources of information. It arranges this into what it deems to be relevant and important. Relevancy increases the likelihood of information being retained. By allowing GP Speciality Registrars to lead on the content and delivery of the course, we can ensure it is relevant to their educational needs.

Goal orientated – They are goal-oriented.

Adults primarily participate in learning programmes to achieve a particular goal. For many GP Speciality Registrars, this will include passing a number of assessments during training, e.g. Applied Knowledge Test (AKT), Clinical Skills Assessment (CSA) and the Work Place Based Assessment (WPBA).

Problem orientated – They are problem-oriented and want to apply what they’ve learned.

Adult learners want to be able to apply their learning immediately to their work or personal life. Utilising clinical cases from practice helps ‘connect’ learning to practice, together with the problem-solving approach which is relevant to some of the case discussions.

Motivation – They are motivated by intrinsic and extrinsic factors.

Learning is driven by participant motivation – the more motivated someone is to participate in training, the more he or she is likely to learn and retain information. Adults are motivated by both internal and external factors. Some of these factors can also be de-motivating and can have an adverse impact on the learning experience. All facilitators at the teaching sessions are aware of this – if there is anything that may be impacting on your learning then please let one of us know.

Time and Pacing of learning – They have time pressures.

In the modern world, we all have to deal with pressures from our jobs, families, and other commitments. Even if they are highly motivated to learn, the pressures of life often limit the time many adults can invest in learning. Adult learning, when self-directed, allows some space for self-pacing of learning, providing a degree of flexibility in how we handle the process.

The word ‘curriculum’ is derived from the Latin ‘currere’, which means ‘to run’. Its associated noun has also been translated as ‘a course’. This collective term has been used to describe a course of study, relating not only to the content of the teaching programme, but the learning situation as whole.

Cole and Grant (1985) described a ‘descriptive curriculum model’ in which the interrelationships of the curricula ‘on paper’, ‘in action’, and ‘students experience’ are compared.

The aim should be to make each of the curricula synonymous, so that students find the framework for learning appropriate to their learning needs. In theory, each of the above circles should overlap as much as possible. Nevertheless, this may be impossible to achieve, but still worth aiming for! At the Half Day Release Course with each group of registrars, every individual brings their own skills and experiences with them. Ensuring that these overlap with the curriculum formulated by each registrar is a difficult task. The best way to achieve this is to focus on the registrars’ curricula, using the group itself as a resource.

• Brookfield S.D. (1986) Understanding and facilitating adult learning. Open University Press. Milton Keynes.
• Coles C.R. & Grant J.G. (1985) Curriculum evaluation in medical and healthcare education, Medical Education, 22, 148-147.
• Knowles, M. (1990) The adult learner. A neglected species. Houston: Gulf Publishing
• Kolb D.A. (1984) Experiential Learning: Experience as the source of learning and development. Prentice Hall. Englewood Cliffs, New Jersey.