Transcript Slide 1

Learning Theories and
Interprofessional
Education: An Overview
ESRC Seminar Series: 26th June 2009
Background
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Research evidence underpinning the drive for IPL is
still growing (Payler et al., 2007; Thistlewaite, 2008)
Descriptive, anecdotal & atheoretical? (Freeth et al., 2002; Barr et
al., 2005; Clarke, 2006)
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Few interventions identify the educational theory
underpinning the development & delivery of IPE
initiatives (Cooper et al., 2001; Freeth et al., 2002; Barr et al., 2005)
Kolb’s (1984) experiential learning cycle, adult learning
theory & psychological theories of group behaviours
and teamwork approaches (Cooper et al., 2001; Barr et al., 2005) and
learning organisations (Freeth et al., 2002)
Theory needed to guide IPE curriculum development
(Eraut, 2003; Clark, 2006)
Families of Learning Theory
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Behaviourism
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Constructivism
-cognitive
- social
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Use in IPE?
Behaviourists consider that:
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Learning outcomes are important as opposed to
the processes underpinning this learning;
All behaviour is learned and all learning involves
an observable change in behaviour;
Adopt a positivist approach;
Students’ own activity in achieving outcomes is
pivotal to learning.
(Jarvis et al., 2003; Armitage et al., 2003)
Behaviourism in IPE
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IPE curriculum developers create an outcome
based curriculum;
Interprofessional competencies (Arredondo et al., 2004;
Norris et al., 2005)
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-learning outcomes assessed and evaluated
No clear reference to IPE competencies in
curriculum design
IPE evaluations- Kirkpatrick’s (1967) model
Modified Kirkpatrick's Model of Educational Outcomes for IPE
1
Reaction
Learner's views on the learning experience and its
interprofessional nature.
2a
Modifications of
attitudes/perceptions
Changes in reciprocal attitudes or perceptions between
participant groups. Changes in perception or attitude
towards the value and/or use of team approaches to
caring for a specific patient group.
2b
Acquisition of
knowledge/skills
Including knowledge and skills linked to interprofessional
collaboration.
3
Behavioural change
Identifies individuals' transfer of interprofessional learning
to their practice setting and changed professional practice.
*Self report (Kilminister et al., 2004; Pollard et al., 2005;
Pollard and Miers, 2008)
4a
Change in
Organizational practice
4b
Benefits to patients
Wider changes in the organizational and delivery of care.
Improvements in health or well-being of patients.
(Barr et al., 2000; Freeth et al, 2002; Hammick et al., 2007)
Cognitive Constructivism
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Concerned with the process of how learners
learn;
Adult learning- self directed learning
Learning is within the learner’s control (Spencer
and Jordan, 1999; Kaufman, 2003; Wood, 2003)
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Application and use of developmental theories
(Paiget, 1973)
Clark (2006) applied Perry’s (1970) theory:
Ultimate Goal
Commitment
to relativism
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Relativism:
recognise other professions
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Dualism:
expansion of beliefs beyond own profession
Accepting of the range
of complementary
professions required to
provide holistic care;
Students recognise the
presence and nature of
other professions.
Via IPE students are
offered an opportunity to
expand beliefs beyond
own profession
IPE Curriculum Developer’s Role:
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Consider ways to develop students’ knowledge by activating and
building on existing knowledge bases- transformative learning
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Consider key assumptions underlying the constructivist origins
of adult learning theory (ALT) or androgogy (Knowles, 1990;
Kaufman, 2003)
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ALT- key mechanism for well received IPE (Hammick et al., 2007)
Teaching methods used to facilitate adult learning:
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Self-directed learning
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Problem based learning
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Discovery learning (Spencer and
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Case based learning;
Portfolio based learning;
Project based learning;
Peer evaluation;
Use of learning contracts
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(Kaufman, 2003)
(Newble, 2002; Wood, 2003);
Jordan, 1999; O’Halloran et al., 2006);
(Kolb, 1984; Brown and Atkins, 1988;
Spencer and Jordan, 1999).
Use reflective practitioner
theory (Schon, 1984; Goosey and Barr,
2002) and experiential learning
(Moon, 2004; Roberts et al., 2000).
Social Constructivism – Vygotsky (1978; 1986)
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•Learning- mediated via
socio-cultural instruments
e.g. language
•Support systems
D’Eon (2005):
Use of IPE tasks could
become progressively
more complex from, for
example simple paper
case-based scenarios with
two disciplines to very
complex cases in real life
settings with many
disciplines
Social constructivism & macro level thinking:
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•Communities of
practice (Wenger, 1998)
•Activity systems
(Engestrom, 1999; 2004).
•Expansive learning
–to
create new knowledge & practice
Used to inform evaluations
of IPE (see, for example
Robinson and Cottrell, 2005;
Payler et al., 2007);
Why has it not been used to
inform IPE curriculum
development?
-HE curriculum developersfocus on micro level of
learning (Hean, Craddock and
O’Halloran, 2009)
-Critics of activity theory
(Fuller et al., 2005; Payler et al., 2007)
Summary
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Insufficient rigorous research identifying the
theoretical underpinning of IPE initiatives;
Implications of overlooking IPE theorising;
Benefits of IPE theorising
Catholic approach to a whole range of
theoretical doctrines is needed (Meads et al, 2003).
Time for Reflection
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How can learning theory
be used to inform your
own work?
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How can you evaluate its
use in practice?
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How can we work
together to advance
knowledge in this field?
Our overview of contemporary learning
theories used in IPE:
MICRO
ADULT LEARNING
Self directed, experiential,
problem based,
discovery
interprofessional, collaborative
B-1-1
BEHAVIOURISM
interprofessional competencies
A
CONSTRUCTIVISM
B
MACRO
Expansive learning
B3
Social
Social conflict theory
Socio-cultural learning
Situated learning
Collaborative learning
Interprofessional learning
B2
Cognitive
Developmental/stage theory
Self directed, experiential,
problem based,
discovery
B-1
(Hean, Craddock and O’Halloran, 2009)