Clinical Teaching for Health Professionals

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The principles of adult education are quite different from the ideas that are commonly used to teach children in schools (Wegener). The method of teaching a child, where all the relevant knowledge are simply spoon fed to him may not appeal to any adult patient’s learning, nor provide any effective results. Adults are thought to need special considerations that are different from that of children and teens when it comes to learning (Biech). Andragogy

The concept of andragogy was introduced by Malcolm Knowles in 1968 as “a new label and a new technology” distinguishing adult learning from children’s learning or pedagogy. Knowles’ concept of andragogy “the art and science of helping adults learn … is built upon two central, defining attributes: First, a conception of learners as self directed and autonomous; and second, a concept of the role of the teacher as facilitator of learning rather than present of content” (English, 2005). As Knowles suggests “perhaps no aspect of andragogy has received so much attention and debate as the premise that adults are self-directed learners” (Knowles et al, 1998, pg. 135).There are two conceptions of self-directed learning: First, self-directed learning is seen as self-teaching, whereby learners are capable of taking control of the mechanics and techniques of teaching themselves in a particular subject; and second, self-directed learning is conceived of as personal autonomy (Knowles et al, 1998, pg. 135).

Andragogy presented six assumptions about the adult learner which provide a sound foundation for planning adult learning experiences. One assumption of andragogy states that adults need to know why they need to learn something before undertaking to learn it. Knowing why they need to learn something is the key to giving adults a sense of volition about their learning. Knowles et al found that when adults undertake to learn something on their own, they will invest considerable energy in probing into the benefits they will gain from learning it (1998). Therefore, the first task of the facilitator of learning is to help the learners become aware of the “need to know”.

Another assumption suggests that adults have a self-concept of being responsible for their own decisions; once adult learners have arrived at that self-concept; they develop a deep psychological need to be seen by others and treated by others as being capable of self-direction (Elcigil & Sari, 2006). Therefore, in adult learning situations, it is believed that sharing control over the learning strategies can make learning more effective. Engaging adults as collaborative partners for learning satisfies their “need to know” as well as appeals to their self-concept as independent learners (Knowles et al, 1998). This is further reinforced by Wong et al that there must be collaboration between the educator and patient, and the adult patient needs to be involved as a partner and active agent of care (2005).

It is also assumed that adults enter the educational activity with a greater volume and more varied experiences than do children. Adults’ experience has a very important impact on the learning process. Kolb points out that learning is a continuous process grounded in experiences, which means that all learning can be seen as relearning (1984). This is particularly true for adults who have such a large reservoir of experiences.

The next assumption suggests that adults have a readiness to learn those things that they need to know in order to cope effectively with real-life situations (Knowles et al, 1998, pg. 67). Pratt states that adults’ life situations not only affect their readiness to learn, but also their readiness for andragogical-type learning experiences (1988).

Adults generally prefer a problem solving orientation to learning, rather than subject-centered learning; they learn best when new information is presented in real-life context (Wilson & Hayes, 2000). As a result, the...
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