Hi, my name is Katie Burlacher. I'm the Program Director at the University of Pittsburgh Medical Center, and I'm here today to talk about adult learning principles. How many of you out there know the word andragogy? If you don't, it's a word that was originally derived from the base andra, which means man, and agagos, which means leading. In modern day, andragogy has been tightly linked to the work of a man named Malcolm Knowles, who's described various characteristics and principles of adult learning. In recent years, these theories have been applied to medical education. I'd like to touch upon the basics of these theories today. But before we get started, let's talk about why this matters to you as an educator or program director. I strongly believe that if you learn and apply these principles, you will likely have a better curriculum, which means better teaching, and often leads to better learning, which hopefully results in the best patient care. So let's get started. Number five, content should be relevant and useful to the learner's real life. When I think about the application of this principle to my fellows, I think about what they need to know in various areas of training. For example, when on consults and seeing a patient with acute coronary syndrome, it's vital for my consult fellow to know the guidelines surrounding ACS management. Since she's not on her cath lab rotation, it's less vital for her to understand how to manipulate the manifold when that patient comes to the cath lab. Thus sending a link to guidelines and primary data regarding management of ACS will be more quickly learned and applied by the consult fellow than sending a link to a YouTube video about a manifold. Number four, content should be connected to experience and previous knowledge. This is important, especially for our fellows. Remember, they've had four years of medical school, typically three years of residency. They should have a solid foundation of cardiac anatomy, physiology, pathophysiology, treatment, and even management. As their educators, it's our job to build upon what they bring to the table. For example, most fellows can describe signs and symptoms of a patient presenting with constrictive pericarditis. They can list physical exam findings, EKG abnormalities, and even imaging results. But do they know which patients should have pericardial stripping? Or how the procedure is done? Or what the consequences and sequelae of that procedure are? Our job is to fill in the blanks for them. Master educators build upon their learners' prior understanding and framework to both broaden and deepen the learners' knowledge. Number three, learners should reflect about what they learn and how they learn. This principle is often forgotten, but incredibly important. And I think one of the prime examples of how children and adults are different in their learning. As a program director, we specifically take time to check in with our learners every six months after the Clinical Competency Committee meets and discusses each trainee's milestone progress. Ideally, when you meet with each fellow, she or he should also do a self-reflection on the prior six months, identifying strengths and weaknesses, as well as the process in which they have progressed. This allows for ongoing learning and advancement. Number two, learners should actively participate in their learning. This is so important, and yet unfortunately too often ignored. For decades, the medical community has used the lecture, a passive method of providing information, as its main approach to teaching in the first few years of medical school. In the past 10 to 15 years, we've come to realize that very little is actually retained or learned when sitting through a lecture. Many studies show that learners actually learn more when they actively participate in learning activities. As such, we as a community have begun to include more sessions of problem-based learning or facilitated workshops and simulation into the early years of medical school, as well as residency and even annual meetings. We as program directors should also seek out ways in which our learners can participate in conferences and lectures. Even the simple addition of having a learner answer a question during a lecture engages their mind and encourages them to participate with content. Principle number one, teaching should be learner-centered. If all you take away today is this, then you are off to a good start. This principle is overarching to many of the other principles I've mentioned. Quite simply, teaching isn't about the teaching. The timing, the method, the outcome should all be fellow-centered. When developing curriculum, teaching on rounds, or working with one individual fellow, we must keep the learner in mind. This should guide the content you discuss, the timing of teaching, and the method you use to do it. Always keep the learner as your focus. Finally, this one's a bonus. I wanted to include it as I think it is becoming more and more important in our day. Learning occurs in a context and in a community. Learning is often social. So learning and thinking are social activities and they are structured by the tools that are available and influenced by the specific setting in which learning takes place. This is incredibly important as we think about the use of technology in social media and medical education. To summarize, I have all of our top five learning principles listed for you, as well as a bonus question. So teaching should be learning-centered. Learners should actively participate in their learning. They should reflect upon what and how they learn. Conscience should be connected to experience and prior knowledge. It should be directly applicable to a learner's life. And remember that learning occurs in context and in a community. These are a few of the references and resources used today, as well as some other ones that you can use for a deeper dive. Thank you.

adult learning principles

medical education

active learner participation

self-reflection

curriculum enhancement