The ‘androgogy’ of learning
May 2003 Paul A. Raslavicus, MD
We all are familiar
with the role of steroid hormones in human physiology. But what
is the difference between androgens and androgogy? Here is a clue:
The latter term is related to brain function. No, it’s not
another steroid or a homologue of cholesterol. It is a descriptor
for the psychology of adult learning experience.
Malcolm Knowles,
an educational theorist, coined the word “androgogy”
to describe “the art and science of helping adults learn.”
He and other educators differentiated pedagogical learning as applied
to the teaching of children from the learning experiences needed
to educate adults. (I suppose professor Knowles could have called
his observations in education “homogogy,” but then it
was another time, when the male root of the word did not have chauvinistic
implications.)
So what does
this have to do with us? The time is nearing when it will no longer
suffice to list on your relicensure application or reapplication
to the medical staff only the courses you have taken or the journals
you have read. You may be required to demonstrate that you have
maintained your competence, and that may mean showing you have learned
something in the process. By 2006 the American Board of Pathology
will begin to issue 10-year limited certificates requiring re-examination
and evidence of continuous learning to maintain Board status. Some
health plans and institutions may require “voluntary”
recertification in the foreseeable future.
Other physicians
and scientists provided most of our medical education. Some of those
learning experiences were truly dull; others were great and uplifting.
Some of our mentors were gifted people whose tutoring we remember
even now. What made them so effective? What did they do intuitively
that research has now defined scientifically?
Educational
researchers have identified the learning needs of adults. They have
defined what it takes to make learning experiences effective and
efficient. They have learned that we are self-directed and intrinsically
motivated. We draw upon our own rich life experiences, and sharing
our varied experiences with other learners provides for dynamic
educational exchange. When the information presented is precisely
what is needed to address the immediate needs of my personal pathology
practice, learning is easy. The mind does not wander. Case studies,
problem-based learning, panel discussions, and skills practice sessions
are techniques educators use to ensure that education is relevant
for adult learners.
We learn best
when the educational experience is contextual and relevant. To clarify
context for adult learners, androgogy experts often begin by creating
a curriculum within which content can be organized. Curricular learning
can be to a greater depth or greater breadth. A fellowship is a
clear example of the former. In contrast, the Maintenance of Certification
learning components that have been defined for pathologists are
an example of a breadth-based curriculum. Which one is best depends
on the individual. The desired and measurable outcome is not just
the passive transfer of information but also an observed improvement
in professional skills. As Herbert Spencer, the eminent sociologist,
said, “The great aim of education is not knowledge, but action.”
Adult learning
is most effective when it is interactive. Learning objectives are
achieved when the participant is involved—the information
assimilated becomes the daily wisdom needed to be successful in
your practice setting. Opportunities for interaction make it possible
to learn from colleagues and create networks and resources for future
learning. We know from painful personal experience that past meetings
and freestanding conferences have often failed to provide that type
of learning. The aborted question-and-answer periods at the end
of sterile talks have been poor substitutes for a true meeting of
the minds. For many of us, our best learning has come when looking
into the microscope and sharing an observation with a colleague
or mentor. An outstanding example of popular and effective interactive
learning is our peer-review-based Laboratory Accreditation Program.
How much more effective is learning for both parties when interaction
is built into the education program from the start!
Learning is
best achieved, too, when the opportunity for reflection is built
into the education experience. Reflecting on what is happening as
we apply the information and after we have applied it increases
the odds that we will implement our new knowledge to the benefit
of our profession and patients. One technique for incorporating
reflection into learning is through the use of “action learning,”
whereby the learner designs part of the education experience.
I share these
thoughts and concepts with you as a prologue to what you can expect
in the future from your College. As you know, the College has a
long history of commitment to education. The education of pathologists
was explicitly included in our Constitution as one of our founding
objectives. This past year, we reasserted that commitment by adopting
a strategic plan for CAP education for the next decade. We have
backed up our plan with significant investment in staff and technologies,
and we have elevated the Committee on Education, chaired by Elizabeth
Hammond, MD, to Board committee status.
An interactive,
strategic curriculum with a focused, exciting approach to learning
will be the trademark of CAP education. We are working hard to define
and address what you think is valuable for the continuing medical
education of pathologists and for the continuing professional advancement
of all members of our laboratory team. We are committed to using
specialized tools and techniques that will make our educational
efforts innovative and memorable. New education programs are being
developed that use traditional and innovative learning methods,
including Web-based instruction, ongoing education activities in
place of education events, synchronous and asynchronous interactive
programs, and tutorials of various kinds. In the next few months,
we will release education programs on CPT coding, HIPAA, molecular
pathology, error in anatomic pathology, and virtual informatics.
In each case, our goal is to provide you with education of the highest
quality, the chief objective of which is to achieve desired learning
outcomes. To ensure that desired outcomes are realized, we will
measure the gains and impact of this learning on performance in
the practice or workplace. This feedback loop will make it possible
for us to create even better learning programs for our participants.
As we apply
all these principles of modern educational theory, we will not neglect
the past, as it, too, is a great teacher. I find all the needed
wisdom in an old Native American saying. “Tell me and I’ll
forget. Show me, and I may not remember. Involve me, and I’ll
understand.” And so it is.
For a copy of Dr. Raslavicus’ remarks to the CAP House of
Delegates in March, send your request to president@cap.org.
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