This chapter contains an overview of some key foundational concepts in education that will help you to think about how learners might learn and how you may be most effective as a teacher. These concepts, some of which date back several years, underpin a lot of educational writing, so an understanding of them will help make sense of the sometimes conflicting and often confusing aspects of the health educational literature. They are offered here as examples of frameworks that might be useful to interrogate and make sense of your teaching, especially when things go wrong or actions bring unintended consequences, rather than as models of 'absolute truth'! We will cover some introductory elements of the psychology of learning and the importance of educational climate, constructivism and experiential learning. We will start with a discussion of the relevance of considering self-determination theory as a way of thinking about factors that motivate adult learners to learn.
This chapter is based on the understanding that education and healthcare have one essential characteristic in common: they are both values-based propositions. Values are personal principles that drive behaviour – both as healthcare professionals and teachers – and can be challenging to respond to or develop in our learners. In this chapter we will consider the example of developing healthcare professionalism. This is a concept derived from socio-cultural values that will be context specific, so must be locally defined. It can however be modelled by educators for learners, by demonstrating our professional values in action. The chapter will cover aspects of teaching that assume it might not matter what pedagogical choices we make to enhance learning about professionalism, so long as we make our expectations explicit, approach it mindfully and ensure that they are authentic to the healthcare setting.
Technology has revolutionised the way that we all live and work and is reshaping the delivery of healthcare too. What do educational supervisors or teachers need to bear in mind to help our learners safely incorporate the use of technology into patient care? This chapter will discuss some of the developments in technology with the risks and benefits that might be associated with them and the implications for healthcare professionals, trainees or students.
In this chapter we will continue our discussion, started in Chapter 7, of some of the underpinning models in education which have been applied to thinking about health professions education. Healthcare professionals are expected to be 'adult learners'; this refers not to age but to the extent to which they will be independent and self-directed. Self-directedness is not an all or nothing phenomenon and takes time to develop. We will look at factors that assist or get in the way of that development and also how teachers can support and encourage the features of adult learners as well as problems that might arise if the staged nature of this development is not recognised. The chapter concludes with some examples of how this type of learning, that emphasises personal reflection and critique of workplace-based activities, can improve practice.
In this chapter we discuss the impact on training and professional development following the introduction of new or extended roles within the healthcare setting. The variety of professional roles in 2022 is wider than ever before, and new roles and changing responsibilities bring additional training and development needs. The chapter will cover the need for clarity in roles and scope of practice, identification of learning needs, the importance of the context of learning and the need for mentorship and supervision to help support the development of a community of practice. The key aspects to be considered when supporting learning in the workplace within a changing multidisciplinary team, particularly when the supervisor or mentor is supporting learners who work within different professional roles from their own, will be addressed.
Teaching, just like clinical work, requires the appropriate knowledge, skills and attitudes. How you teach will be influenced by your own style, the subject matter and learner group. Some elements of a 'good teacher' may evolve naturally from your own interests and motivations to help others. In subsequent chapters we will look more closely at the features of healthcare teaching and the transferable skills from clinical practice. How do you plan to pursue your interest in teaching healthcare professionals? Opportunities and career choices are not always highly visible. You may not always find someone to provide the advice you need. This chapter guides you to find out more about teaching healthcare professionals and ways in which you can formalise this. Developing and refining the new knowledge, skills and attitudes is not enough. You must continually strive to improve these qualities, and must formally demonstrate such improvement. The latter part of this chapter will assist you with doing this.
All healthcare professionals are teachers. Daily interactions with patients, carers, staff and colleagues result in challenges to, and development of, knowledge, skills and beliefs. Patients expect you to explain risk and increase their understanding to maximise involvement in decision making; these are teaching skills, and to be an effective guide for learners, you will draw on many of the same skills integral to the role of healthcare providers. This chapter will look at how clarification of roles facilitates this. Political and other changes in the health sector affect the organisation and delivery of teaching. In addition learners and healthcare professionals are also citizens with a wider societal responsibility. This chapter will cover aspects of sustainability, widening participation in, and the social accountability of, healthcare training.
This chapter will help you to choose the teaching method that will most efficiently support your learning objectives. For those of you that are active researchers, this is exactly the same process as selecting a research methodology aligned with your research question. A variety of teaching methods are considered, with tips for making the best use of them, plus what to consider if they are failing to work. Increasingly, following advances in technology during the COVID-19 pandemic in particular, healthcare teaching is moving online, including using video-conferencing with online breakout groups. The pros and cons and use of digital teaching methods are discussed in Chapter 11. Simulation in teaching is covered in Chapter 13.
Health professions educational research aims both to look at teaching (its rigour, evidence base, modalities and collaborations) and learning (outcomes, achievement and assessment) in the health professions. The field is very broad. It includes selection of candidates for training, curriculum and assessment developments and underlying cultural aspects. This chapter will help guide you through the many terms, concepts and techniques in use. Many of these terms may at first appear impenetrable to the individual whose training may have been based only on a scientific (positivist) paradigm. Here, in health professions education, there is a much broader inclusion of other theoretical frameworks, from the humanities as well as the sciences.
In the past, teachers might have tended to teach subjects in isolation, without integrating that learning with the requirements of the whole healthcare system or different disciplines. Teachers may have focused on improving practice in one topic regardless of whether it was a current priority for the healthcare system or learner and duplicating learning that might be happening in other health professions. Teaching about one topic without alluding to the knock-on effects, such as the consequent lack of resources for other areas of practice, or setting a poor role model by not considering the perspectives of patients or those in other disciplines, makes it less effective. There is now more emphasis on those that work together, learning together. This chapter considers ideas for teaching some of the challenging areas of practice, including clinical governance, involving the public and patients in the planning and delivery of healthcare, putting changes into practice and involving patients in teaching.
Effective teachers recognise and realise that adult learning is facilitated by the teacher. Brookfield has debated the subject of adult learning at length, providing many examples. Grow's Staged Self-Directed Learning model builds on work by Hersey and is a helpful way to look at tensions that can arise if the learner's and teacher's levels are not matched. Some students appear to be Stage 4 self-directed learners, but turn out to be highly dependent students in a state of defiance. A group of highly resistant learners can coerce teachers into an authoritarian mode, and then frustrate them, at the same time being dependent on teachers and resentful of being taught. Work-based learning aligns with the principles of adult learning and represents the most accessible opportunities for self-directed learning during clinical work. The self-directed learner will take note of the patients they see and find out what subsequently happens during the care episode.
Chapter 17 has been written to help in the understanding of how to identify and manage doctors who run into difficulties, both in the training and career grades.
This paper reports the first stage in the development of a tool, the Six Staffordshire Teaching Styles Questionnaire, designed to raise awareness in teachers about their teaching style. Effective teachers are adaptable and flexible in providing variety in their teaching activities, aiming to match their manipulation of the teaching and learning environment to the needs of the learner, but teachers should also know what type of activities they are most effective at delivering. Just as mismatched learning styles can cause dysfunctional learning situations, one of the causes of stress in teachers can be an incongruency between the type of activities they believe are effective, or feel they are good at carrying out, and external expectations of "good teaching".
