Principles Of Adult Learning Theory Research Articles

Development and Validation of an Active Educational Resource to Address Quality Gaps Regarding Clinical Documentation

Context Athletic trainers (ATs) have self-reported inadequate documentation of patient encounters and a desire for more educational resources to inform their documentation practices. However, continuing education opportunities regarding clinical documentation are limited and not easily accessible by all ATs. Objective To develop and validate a comprehensive educational resource on clinical documentation using an established personalized learning pathway (PLP) framework. Design Multiphase development process consisting of consensus development, subject matter expert content validation, and pilot implementation. Setting Asynchronous, web-based educational resource. Participants Three subject matter experts thoroughly reviewed the educational resource for face and content validity. Ten ATs and 23 professional athletic training students participated in pilot implementation. Main Outcome Measure(s) Through a consensus process, the research team developed a comprehensive educational resource regarding clinical documentation in athletic training. The clinical documentation PLP includes 7 overarching topic areas that are necessary for a comprehensive understanding of clinical documentation. A variety of learning formats were used to help engage learners, and content was curated and delivered by members of the research team, 14 practicing ATs, and 2 content area experts. Results Subject matter experts considered the content of the Clinical Documentation PLP and the delivery mechanism of the learning resource to be excellent; minor feedback to enhance the overall face and content validity was implemented as suggested by the subject matter experts. All 10 ATs and 23 professional athletic training students completed the PLP in its entirety. Minor feedback to enhance the overall user experience was implemented as suggested by the pilot participants. Conclusions The Clinical Documentation PLP was developed based on central principles of adult learning theory and cognitive load theory to provide comprehensive knowledge and best-practice recommendations regarding clinical documentation to ATs. The PLP is relatable, cost-free, continuously available, and conveniently accessible from any location or device.

Adult learning theory tenets: A panacea to ICT skills gaps among educators in South Africa

The integration of information communication technology (ICT) in education is vital for achieving educational objectives, and South Africa has undertaken diverse efforts and initiatives to promote this integration in schools. Despite policy support and financial backing, there persists a gap in educators' ICT skills uptake. This paper adopted conceptual analysis to make sense of the principles of adult learning theory (ALT) as a veritable tool for improving ICT skills uptake among educators. The paper outlines the Department of Basic Education's efforts in promoting ICT integration in schools and discusses the associated challenges. Overall, the article advances ALT tenets in planning and implementing ICT-focused, school-based teacher professional development (SBTPD) in schools. These tenets include the need-to-know principle, self-concept or self-directedness principle, learners' experiences principle, readiness-to-learn principle, orientation-to-learning principles, and intrinsic-motivation principle as effective correlates of ICT-oriented SBTPD training. Based on the explication, the paper recommends reforming existing teacher professional development policies, promoting a decentralised approach to ICT training, and conducting comprehensive ICT needs assessments to design effective ICT-oriented needs-based SBTPD training.

Features of designing and conducting an online course in business English for adult learners

Foreign language communication skills are crucial for today’s business professionals, as they provide opportunities for advancing their career and conducting efficient communication with partners world-wide. The present article and the underlying research explore the implementation of andragogical principles in an online course for Business English. One of the most important principles entails providing conditions for comfortable learning, including, above all, the format of interaction, which ultimately affects its efficiency and organization. The relevance of distance learning is confirmed by current national laws, as well as by social studies that indicate a demand for online classes in Russia. The use of digital technology for the development of adult learners’ foreign language communication allows them to be educated in a setting that simulates their working environment. This would suggest that when organizing adult education, it is recommended to rely on the learners’ professional experience, offer practice-oriented tasks, encourage autonomy and offer authentic, problem-oriented materials in order to facilitate interaction and set off discussions. With all the advantages of the distance learning format, adult learners may, however, encounter difficulties which are to be taken into account. This article presents an online course for Business English, taking into consideration the identified principles of andragogy, specific properties of workplace interaction and particular features of the distance learning format. The research findings may be of practical value for designing and organizing a course in Business English with its methodology based on adult learning theory principles.

Drawing on Key Partner Perspectives of an Autism-Focused Professional Development Program: A Conceptual Framework for Coaching

ABSTRACT Most teachers report wanting more training and support to teach autistic students. Individual, autism-focused coaching is a promising approach for improving teacher self-efficacy and autistic student outcomes. Given the high workload demands of coaching, it must be feasible and acceptable. This study considers coaches’, teachers’, and autistic peoples’ perspectives to identify key components integral to autism-focused coaching as well as strategies that enhance the feasibility and acceptability of each component. Interviews with seven K-2nd grade teachers, ten autistic adolescents and adults, and a focus group with six coaches were qualitatively examined using an inductive approach and incorporated grounded theory practices to develop an autism-focused coaching framework. This framework consists of four contextual elements that were identified as crucial to coaching within an autism-specific context, including the use of a neurodiversity-affirming lens and coaches’ strong autism knowledge. This framework also comprises eight sequential coaching components informed by principles of adult learning theory (e.g. observation, feedback, self-reflection) that are generalizable to supporting teachers’ work with autistic and neurodivergent students. These findings offer guidance to coaches and program developers regarding key components to implement when working with teachers supporting autistic students. We highlight specific recommendations within each component to maximize the feasibility and social validity of autism-specific coaching.

Job‐embedded professional learning: Facilitating faculty implementation of UDL

AbstractThis chapter describes a locally developed model for professional learning, whose purpose is to facilitate faculty participants’ implementation of UDL. The model is grounded in attributes of long‐term, job‐embedded professional learning and principles of adult learning theory. Recommendations for scaling‐up faculty professional learning programs focused on the implementation of UDL are provided.

Improving Trainees' Confidence and Participation in Serious Illness Communication: Testing the Serious Illness Care Program With Early Learners.

Purpose: Early conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. 1 The systems-based Serious Illness Care Program (SICP) 2 helps clinicians have more, better, and earlier conversations. 3–6 Central to this approach is a clinician conversation guide for patient encounters. 2 While the SICP works for practicing clinicians, it has not been tested with medical trainees. The goal of this training is to enable future physicians to conduct effective serious illness discussions and provide goal-concordant care for patients. Approach: We adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and 156 interns and obtained anonymous quantitative and qualitative feedback. Outcomes: Eighty-six percent of students and 91% of residents rated the session as “very good” or “excellent” and > 90% of all learners would either recommend this training or intended to apply this to their practice. Post-session learner confidence increased in all communication skills. Learners said the training provided a helpful framework and useful language for these conversations. Resident documentation of serious illness conversations in the medical record increased dramatically during the year following training commencement. Discussion: Grounded in principles of adult learning theory, this training was rated highly by trainees and resulted in demonstrable practice change, with significant increases in resident-documented serious illness conversations in the electronic health record. These early learners were more flexible and willing to try this approach than practicing clinicians who tend to resist or revert to old habits. Significance: A conversation guide represents a new paradigm for teaching communication skills and is valued by early learners. Our study is the largest report of SICP training for medical trainees and the only one to demonstrate behavioral change. The SICP training is a critical step to improving clinician confidence and perceptions of inadequate training in serious illness communication. Acknowledgments: The authors wish to thank the Massachusetts General Hospital Continuum Project for its support of this teaching effort.

Assessment of surgical autonomy: in support of aspirational goals

Drawing on key principles of adult learning theory, a number of surgical autonomy assessment scales have been developed for use in resident evaluation. These assessment scales allow graded autonomy in resident surgical education, balancing patient safety with the need for achieving resident competency during training. The main scales used, the Zwisch scale and the Dreyfus scale, differ only in the inclusion of an “expert” level, and there is controversy in surgical education on whether inclusion of these types of aspirational goals is appropriate. This clinical opinion article reviews key aspects of adult learning theory that pertain to surgical skill acquisition and use of aspirational goals in education, and situates existing surgical autonomy assessment scales within this context. Existing evidence argues for the continued inclusion of aspirational goals in surgical education, but with a concomitant update to the surgical autonomy assessment scales to more closely align with the typical progression of surgical skills during residency. The current process for milestone evaluation put forth by the Accreditation Council for Graduate Medical Education provides an example of a potential framework that could be adapted for use in surgical skill assessment.

Improving Serious Illness Communication: Testing the Serious Illness Care Program with Trainees

BackgroundEarly conversations about patients’ goals and values improve care, but clinicians struggle to conduct them. The systems-based Serious Illness Care Program (SICP) helps clinicians have more, better, and earlier conversations. Central to this approach is a clinician conversation guide for patient encounters. While the SICP works for practicing clinicians, it has not been tested with medical trainees. InterventionWe adapted the SICP training to emphasize assessing prognostic awareness and responding to emotion. We developed a 2.5-hour SICP workshop for medical students and medical interns that included large- and small-group work, practice with an actor, and interdisciplinary clinician facilitators. We trained 81 students and 156 interns and obtained anonymous quantitative and qualitative feedback. OutcomesEighty-six percent of students and 91% of residents rated the session as “very good” or “excellent” and >90% of all learners would either recommend this training or intended to apply this to their practice. Post-session learner confidence increased in all communication skills. Learners said the training provided a helpful framework and useful language for these conversations. Resident documentation of serious illness conversations in the medical record increased dramatically during the year following training commencement. ConclusionsGrounded in principles of adult learning theory, this training was rated highly by trainees and resulted in demonstrable practice change. These early learners were more flexible and willing to try this approach than practicing clinicians who tend to resist or revert to old habits. A Guide represents a new paradigm for teaching communication skills and is valued by early learners.

Active learning for fellows: The hematopathology "unknown case".

The pediatric hematology/oncology fellowship program at the Children's Hospital of Philadelphia set out to create a case-based learning curriculum for common hematologic malignancies that would apply principles of adult learning theory and improve fellows' retention of information in a supportive, goal-oriented learning environment. A framework we employed in developing this curriculum is that of "flow theory," which parallels many of the tenets of adult learning theory. After implementing this curriculum, which we call "the unknown case," the percentage of fellows correctly identifying a common hematopathologic diagnosis improved from 50% to 85%.

Development of Online Professional Development for School Resource Officers: Understanding Trauma, Social-Emotional Learning, Restorative Discipline, and Cultural Diversity

School resource officers (SROs) have become increasingly common in schools; however, most states do not require that they have youth- or school-related training (Morris et al. 2017). The intent of this project is to address potential gaps in training through the creation of four online professional development modules for SROs. Each module focused on one of the following: trauma-informed care; social-emotional learning (SEL); restorative problem-solving; and cultural competence. These modules were iteratively developed by applying established paradigms of curriculum development, that included systematic and communicative approaches, adult learning theory principles, and utilization of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) Model of Systematic Instructional Design. SROs serve as law enforcers, informal counselors, and educators. It is imperative they are provided the opportunity to build their knowledge and develop applicable skills necessary for these roles and for working with students from all backgrounds.

Active learning in head and neck trauma: outcomes after an innovative educational course

Excellence in teaching and learning is fundamental to the provision of quality training for doctors and for this a sound knowledge of the principles of adult learning theory is important. We present an educational course in head and neck trauma skills for emergency medicine (EM) registrars, using the pedagogical principle of active learning. Our aim was to provide trainees with skills in the evaluation and management of hard and soft tissue injuries to the head, neck, and mouth. Active learning has been shown to provide a superior experience in classrooms, creating a ‘deep’ understanding of the material. To maximise learning, we used these principles to develop small group seminars led by a diverse range of teachers that allowed trainees to acquire hands-on skills. Questionnaires that were completed before and after the course showed an appreciable educational impact. We conclude that innovative teaching methods facilitate the sharing of knowledge that will benefit patient care.

I-PASS Mentored Implementation Handoff Curriculum: Frontline Provider Training Materials.

IntroductionThe I-PASS Handoff Program is a comprehensive handoff curriculum that has been shown to decrease rates of medical errors and adverse events during patient handoffs. Frontline providers are the key individuals participating in handoffs of patient care. It is important they receive robust handoff training.MethodsThe I-PASS Mentored Implementation Handoff Curriculum frontline provider training materials were created as part of the original I-PASS Study and adapted for the Society of Hospital Medicine (SHM) I-PASS Mentored Implementation Program. The adapted materials embrace a flipped classroom approach with an emphasis on adult learning theory principles. The training includes an overview of I-PASS handoff techniques, TeamSTEPPS team communication strategies, verbal handoff simulation scenarios, and a printed handoff document exercise.ResultsAs part of the SHM I-PASS Mentored Implementation Program, 2,735 frontline providers were trained at 32 study sites (16 adult and 16 pediatric) across North America. At the end of their training, 1,762 frontline providers completed the workshop evaluation form (64% response rate). After receiving the training, over 90% agreed/strongly agreed that they were able to distinguish a good- from a poor-quality handoff, articulate the elements of the I-PASS mnemonic, construct a high-quality patient summary, advocate for an appropriate environment for handoffs, and participate in handoff simulations. Universally, the training provided them with knowledge and skills relevant to their patient care activities.DiscussionThe I-PASS frontline training materials were rated highly by those trained and are an integral part of a successful I-PASS Handoff Program implementation.

Adult learning theory principles in knowledge exchange networks among maple syrup producers and beekeepers in Maine

ABSTRACT Purpose: Knowledge exchange networks are critical to farmer success and help reduce barriers to entry and growth for new farmers. This study explores informal and formal knowledge exchange networks among two growing industries in Maine: maple syrup production and beekeeping. We increase understanding of the mechanisms through which knowledge exchange occurs by applying adult learning theory. Design/Methodology/Approach: We conducted 46 semi-structured interviews with small- and medium-sized maple syrup producers and beekeepers in Maine. Findings: Maple producers and beekeepers relied on both informal and formal knowledge exchange facilitated by producer associations where the following adult learning theory principles flourished: (1) orientation to learning, (2) prior experience of the learner, and (3) self-concept of the learner. These maple producers and beekeepers also found great value in the community and friendships created through these networks fostering greater expansion within each industry. Practical Implications: Agricultural extension should institute instructional design that features demonstrations, experiential learning, and sharing of fellow producer experiences to help bolster adult learning theory principles. Theoretical Implications: Adult learning theory provides a useful framework in which to explore learning and knowledge exchange among distinct agricultural production practices to help inform future education and training initiatives. Originality/Value: This study is the first to comparatively and specifically examine knowledge exchange among maple producers and beekeepers with application of adult learning theory. This study provides a framework in which to evaluate knowledge exchange among other farming enterprises within an agricultural context to identify effective, meaningful learning mechanisms.

Practical Techniques to Adapt Surgical Resident Education to the COVID-19 Era.

Practical Techniques to Adapt Surgical Resident Education to the COVID-19 Era.

Incorporating Cleft Lip Simulation Into a "Bootcamp-Style" Curriculum.

The traditions of surgical education have changed little over the years. However, the increasing focus on patient safety and duty hour restrictions mandates that residents start developing complex skill sets earlier to ensure they graduate with procedural competency. Surgical training is poised to exploit high-fidelity simulation technology to mitigate these pressures. By revisiting principles of adult learning theory, the authors created a "bootcamp-style" cleft lip curriculum that sought to (1) maximize educational impact and (2) pilot a high-fidelity procedural trainer permitting resident operative autonomy as part of that curriculum. Trainees participated in small group educational sessions comprised of a standard cleft didactic lecture, augmented by instructional video. Participants immediately processed knowledge from the lecture/video by "operating" on the simulator, allowing opportunities for questions and self-reflection, completing the learning cycle. A self-assessment survey was taken before and after each component of the session, including a self-confidence survey to conclude the session. Anthropometric measures of lip/nasal symmetry were assessed. Sixteen trainees participated in the program. Little increase in self-assessed knowledge/skill was seen after the lecture, but significant increases in most aspects of cleft lip repair were seen after simulation. The greatest increase in self-assessment was seen for the program as a whole, with significant differences across all aspects of the self-assessment. Higher levels of training were associated with both higher self-assessment scores and better lip symmetry. Regardless of level of training, all participants strongly agreed that simulation helped them actively engage in learning and should be a required aspect of training, whereas 94% (n = 15) thought simulation was much more effective than standard preparation alone. This pilot curriculum illustrates a mechanism to incorporate lessons from adult learning theory into plastic surgery training using a high-fidelity simulator for deliberate practice of cleft lip repair. Further evaluation is warranted to determine whether this didactic model can accelerate the acquisition of the complex skill set required for cleft lip repair and other surgical procedures.

Sustained improvement in hospital cleaning associated with a novel education and culture change program for environmental services workers.

To sustainably improve cleaning of high-touch surfaces (HTSs) in acute-care hospitals using a multimodal approach to education, reduction of barriers to cleaning, and culture change for environmental services workers. Prospective, quasi-experimental, before-and-after intervention study. The study was conducted in 2 academic acute-care hospitals, 2 community hospitals, and an academic pediatric and women's hospital. Frontline environmental services workers. A 5-module educational program, using principles of adult learning theory, was developed and presented to environmental services workers. Audience response system (ARS), videos, demonstrations, role playing, and graphics were used to illustrate concepts of and the rationale for infection prevention strategies. Topics included hand hygiene, isolation precautions, personal protective equipment (PPE), cleaning protocols, and strategies to overcome barriers. Program evaluation included ARS questions, written evaluations, and objective assessments of occupied patient room cleaning. Changes in hospital-onset C. difficile infection (CDI) and methicillin-resistant S. aureus (MRSA) bacteremia were evaluated. On average, 357 environmental service workers participated in each module. Most (93%) rated the presentations as 'excellent' or 'very good' and agreed that they were useful (95%), reported that they were more comfortable donning/doffing PPE (91%) and performing hand hygiene (96%) and better understood the importance of disinfecting HTSs (96%) after the program. The frequency of cleaning individual HTSs in occupied rooms increased from 26% to 62% (P < .001) following the intervention. Improvement was sustained 1-year post intervention (P < .001). A significant decrease in CDI was associated with the program. A novel program that addressed environmental services workers' knowledge gaps, challenges, and barriers was well received and appeared to result in learning, behavior change, and sustained improvements in cleaning.

When Schools Change and Teachers Do Not: The Principal’s Use of Evaluation and Feedback to Impact Veteran Teacher Effectiveness

Effective principals provide teachers with feedback on the edges of their growth moving beyond compliance-driven teacher evaluations to meaningful cycles of observation and feedback. This case focuses on preparing principal candidates to address equity issues related to teacher practices that positively impact student achievement with a veteran high school teacher who is failing to respond to her school’s shifting demographics. Embedded in the case are additional challenges of leading a rural school. The principal, who is a new principal but previously taught with the teacher, now needs to provide research-based, culturally responsive, actionable feedback aligned to principles of adult learning theory and research-based instructional practices.

Education Research: Resident education through adult learning in neurology: Implementation and impact.

To enhance residency education by implementing the 6 principles of adult learning theory (ALT) in a large academic neurology residency program. We implemented a set of curricular interventions aimed at Resident Education through Adult Learning in Neurology (REAL Neurology), in a large, academic neurology residency program. Interventions included didactic reform, increasing resident-as-teacher activities, and enhancing residents' interaction. The primary outcome was the change in mean Residency In-service Training Examination (RITE) percentile between the preintervention and postintervention cohorts, adjusting for US Medical Licensing Examination step 1 and 2 score. Other analysis included evaluating the effect of the duration of intervention exposure on outcome and evaluating the intervention effect on the proportion of advanced performers. A total of 134 RITE score reports were evaluated (87 preintervention and 47 postintervention). The mean RITE score percentile postintervention was 11.7 points higher than preintervention (adjusted, longitudinal analysis: fit linear mixed model, p < 0.0001). Postgraduate year 3 learners who had 1 and 2 years of exposure scored 13.4 and 18.9 points higher than those with no exposure at all, respectively (analysis of covariance, p = 0.04). The adjusted odds of better performance with REAL Neurology was 5.77 (ordinal logistic regression, 95% confidence interval 2.37-14.07, p < 0.05). This study evaluated the efficacy and feasibility of an ALT-based curricular program in neurology education. The results show robust and sustainable benefit for residents in training without imposing a financial or logistical burden on programs. REAL Neurology could serve as a model for curricular reform in other programs across subspecialties.

Fellow as Clinical Teacher (FACT) Curriculum: Improving Fellows' Teaching Skills During Inpatient Consultation.

Multiple barriers, including time constraints, a demanding teaching environment, and lack of longitudinal relationships with residents, make it challenging for fellows and learners to engage in effective teaching during consultation. The Fellow as Clinical Teacher (FACT) curriculum was developed to overcome such barriers and improve fellow teaching in the setting of inpatient consultation. The FACT curriculum consists of two 45- to 60-minute small-group sessions designed for subspecialty fellows. The first session focuses on overcoming barriers to teaching and application of the principles of adult learning theory. The second introduces the PARTNER (partner with resident, assess the learner, reinforce positives, teaching objectives, new knowledge, execute recommendations, review) framework for teaching during consultation and uses video examples to model the application of this framework, allowing fellows to practice its implementation through role-play. Previously, the FACT curriculum was shown to improve teaching skills of rheumatology and pulmonary/critical care fellows as evaluated by objective structured teaching exercises. Here, the curriculum has been expanded to 51 internal medicine and pediatrics fellows in 15 different training programs. The curriculum improved fellow teaching skills as assessed by self-assessment surveys. It was highly rated by participants, and fellows reported being more likely to teach during consultation following this educational intervention. The FACT curriculum can be integrated into subspecialty training programs to improve the teaching skills of internal medicine and pediatrics fellows in the setting of inpatient consultation. Ultimately, improved teaching from fellows may have broad-reaching effects for residents, patients, and the fellows themselves.

Development of a patient-centered video series to improve education before kidney transplantation

BackgroundInadequate patient knowledge about transplantation can result in low patient satisfaction and contribute to poor clinical outcomes. The purpose of this patient-oriented research project was to develop an educational intervention for patients awaiting kidney transplantation. MethodsAn educational intervention was developed by patients and health care providers, experts in medication adherence, video education, motivational psychology, and cultural education. Project objectives were defined and content was guided by a series of studies conducted with stakeholders. A review process was undertaken with additional patients, external health care providers and ninth grade high school students and edits were applied accordingly. ResultsA set of six educational videos, ranging in length from 3 to 24 min, was created to describe the transplant process. The videos are patient friendly in design, and incorporate animations to explain complex information to accommodate low health literacy, and patient testimonials align the content with principles of adult learning theory. Feedback from external patient reviews [n = 8], external care providers [n = 13] and students [n = 26], indicate that the mini-series is informative and useful. ConclusionPatient involvement significantly influenced the development of a video series about kidney transplantation. Practice Implications: Patient engagement is integral for developing high quality and relevant educational interventions.