Experiential Learning Theory The WritePass Journal

Experiential Learning Theory Experiential Learning Theory IntroductionDescription of a case from my teachingLearning theory applicable to my teaching caseExperiential Learning Theory (Kolb)Principles of Experiential Learning:Four Stages of Kolb’s Learning CycleConcrete experience:Reflective observation:Abstract conceptualization:Active experimentation:Four Types of Learning Styles (Kolb, 1976)AssimilatorsConvergers   AccommodatorsDivergersRelevance of KOLB Learning theorY TO MY CASEConcrete Experience:Reflection: Abstract Conceptualisation:Active Experimentation:Some Practical Difficulties and Potential ImprovementsReferencesRelated Introduction It is difficult to define learning but I understand from my teachers that it is the acquisition of knowledge and skills from instructions or studies. The teachers have an inclination and desire to help our learners acquire, maintain or develop the knowledge, skills and attitudes that they need in the context of their everyday work (Mann 2002). According to Knowles, learning is broadly defined as the occurrence of change in a person with regards to behaviour, skills, knowledge and attitude. (Knowles 2005).    Description of a case from my teaching This was an intra-operative training for a Core Medical Trainee doctor (CT Doctor) in the reconstruction of tissue defect using a local skin flap. The trainee had never done this procedure before independently but had seen similar procedures being done and is regularly seeing the postoperative results of cases operated by me and other colleagues in the out patient follow up clinics. The aim of this teaching was a one to one surgical skill teaching of how to do a rhomboid flap, which is a transposition flap to reconstruct the defect following excision of a lesion. Though it was a teaching of an operative technique, it involved three stages namely pre-operative planning, per-operative practical procedure and post-operative documentation and reflection on the performance. The student usually is required to have preliminary prior knowledge about the skin anatomy including the components of flaps, blood circulation and different types of flap configurations based on the design (transposition, rotation and advancement flaps). The student is taught about the preparation on the operating table, draping the operation site, observing all aseptic precautions, removal of the skin lesion (this part is done me in this teaching session), planning of the flap, raising the flap, insetting the flap to fill the defect, suturing the flap and donor site, applying the dressing, documentation of operation notes, reflection on the performance and agreeing on what changes needed to improve the performance next time. Learning theory applicable to my teaching case Experiential Learning Theory (Kolb) The experiential learning theory was developed by Kolb emphasizing the importance of experience in the learning process and based his theory on the work of Dewey, Lewin and Piaget (Kolb 1984). Kolb offers a working definition of learning as â€Å"a process whereby knowledge is created through the transformation of experience† and emphasizes the importance of adaptation, as knowledge is not static but changing, as we learn and relearn through the process of ongoing experience which changes the practice. Kolb built this upon six propositions (Kolb 1984): Learning is best conceived as a process, not in terms of outcomes    Learning is a continuous process grounded in experience    The process of learning requires the resolution of conflicts between dialectically opposed modes of adaptation to the world    Learning is an holistic process of adaptation to the world    Learning results from synergistic transactions between the person and the environment    Learning is a process of creating knowledge Principles of Experiential Learning: Learning occurs best when people learn through their own experiences and from the reflections of their own experiences rather than through lectures and theories to generate knowledge and skills. In learning what the learners do is more important rather than what they know Experiential learning makes the learners’ behaviour and attitudes explicit so that they can be assessed to construct it better for the future experiences. It is not just sufficient to teach the learner what to do but they need to be actually shown how to do and also how to improve it. The cyclical learning offers the learners continuous improvement by repeating the learning wheel over and over. Continuous use of the experiential learning cycle guides individuals and groups or teams towards improved performance and high quality outcomes. Experiential learning is not just about acquiring knowledge and skills but generating experience in the learner to discover what it is like, how it made them feel and what it meant to them, which in turn is the key to generating greater skills. The new experiences not only generate new ideas but also dispose of or modify the old ones. Experiential learning gives importance to the key aspect of learning which is to achieve change in behaviour and attitude by the holistic approach of addressing cognitive, emotional and the physical aspect of the learner. Many learners feel experiential learning process gives a sense of satisfaction, reward or gift because of its value is appreciated by the learner as a vital learning tool Kolb developed a cyclical learning process consisting of four stages (abilities): Concrete experience (abilities)    â€Å"Doing something† Reflective observation (abilities)    â€Å"Observing and reflecting on the action† Abstract conceptualization (abilities) â€Å"Thinking and finding where the action fits in with theory† Active experimentation (abilities) â€Å"Planning to implement the idea to solve actual problems The learning can begin at any of the four stages (Kolb Fry 1975) but needs to go through all four stages to complete and progress further for learning to continue. Kolb and Fry developed four types of learning styles people use and they can be placed between concrete experience and abstract conceptualization; and active experimentation and reflective observation as shown below: Four Stages of Kolb’s Learning Cycle Concrete experience: The learner performs an activity and gains experience. The activity can be a demonstration, a case study or learning a skill such as assisting an operation or performing an operation under supervision. The learner links this awareness or experience with his prior knowledge or experience resulting in a new experience or knowledge and this forms a basis for future experience. Reflective observation: The learner reflects upon the performance as a self-reflection, with that of the observer who is usually the teacher or from a small group in the form of discussion or constructive criticism. This is very important for the learner to link in with his prior knowledge and experience and move forward.    Abstract conceptualization: The learner develops a concept or theory from the knowledge gained through this experience and makes some plans to alter or change his future practice. Active experimentation: At this stage the learner puts into practice of the lessons learnt from this experience to experiment the solutions to improve the new experiential cycle. Four Types of Learning Styles (Kolb, 1976) Assimilators (Abstract conceptualisation reflective observation): This group has a strong ability to learn better when provided with sound logical theories to practice and reflect. They are concerned with abstract concepts than people. Convergers   (Abstract conceptualisation active experimentation): This group learn better when exposed to practical applications of concepts and theories. They are focussed on solving specific problems by reasoning. Accommodators (Concrete experience active experimentation): Their greatest strength is doing things and learn better when given opportunity to have â€Å"hands-on† experiences. They perform well when required to react to immediate circumstances Divergers (Concrete experience reflective observation): This group is strong in imaginative ability and are good at generating ideas and seeing things from different perspectives. They are interested in people. Though there are different predominant styles of learning in each learner, there is considerable overlap and mixture of different situations that is likely to complement the learning. Kolb’s model provides an invaluable practical framework for designing experiential learning for adults. Relevance of KOLB Learning theorY TO MY CASE Concrete Experience: The CT doctor started from the stage of concrete experience when the flap procedure was planned. He has seen me doing the flap procedure before and he has also assisted me to perform this procedure before. We had discussion pre-operatively, which triggered his pre-existing knowledge about the flap and his prior knowledge of anatomy, technique of flap elevation, insetting, and suturing in place. This is followed by the operative procedure done by him and I assisted him. This practical experience imparted new level of understanding to him and assimilated with his prior knowledge. Reflection: After the completion of the operation and documentation, we had time to reflect on this new experience and consolidate the experience with the prior knowledge to form a new knowledge.   During the discussion, I have acknowledged the good points and both have agreed the importance of tissue handling, suture placements in relation to tissue planes and the need to trim off the excess bulky tissues in the flap to fill the defect better. Abstract Conceptualisation: As a result of above discussion and feedback, we have identified areas for improvement as mentioned above for the transposition flap. We have agreed that I will assist him again in another similar case when he can apply those principles during the procedure. I also introduced the concept of rotation flap and advancement flap as in some cases, after removal of lesion and creating the defect, it is not always possible to perform transposition flap. The learner has some prior theoretical knowledge about the configuration and surgical technique of rotation and advancement flaps. I gave further guidance regarding reading materials – flap books and specific articles. This fine-tuning has helped in preparing the learner for active experimentation in a new cycle. Active Experimentation: After two weeks, the learner developed further reading related to the new concepts following the above discussion and attended my skin cancer clinics. We selected two cases needing operation to remove the lesion and reconstruction using local flaps. We applied his knowledge and prior experience to formulate the new treatment plan to carry out very soon. This has prepared him for the new encounter of active experimentation stage described by Kolb. Some Practical Difficulties and Potential Improvements I have come across problems and difficulties during the flap teaching sessions and I have enumerated them with the possible solutions, which I hope will improve my future teaching and make it more beneficial to the trainee and safer to the patients. Reflection of the learners with that of teachers’ observation is an important part of this learning cycle. Problem: The operative technique teaching of the flap to cover a tissue defect is mostly done under local anaesthesia with the patient awake. It is not always easy to talk all the aspects explicitly during the procedure. How to overcome it: One of the options would be to plan the first cycle of operative learning in patient who wanted the procedure under general anaesthesia. Problem: In some instances we have missed out this session of reflection due to lack of time, busy operating list and the learner had to attend ward patients or dressing clinic patients. How to overcome it: I need to plan this teaching session when the learner has a protected time to attend my appropriate theatre session. In cases of unforeseen circumstances causing this, I instruct the learner to write down his thoughts of reflection of the session and send it by email which will enable me give my impressions to him personally at a mutually agreeable time to move forward with an agreed plan for future experiences. The other option is to hand over the further continuity of learning to another colleague. Problem: Quite often Core Trainees in Plastic Surgery do not attend the Dressing Clinic to see the post-operative results when the patient returns for the suture removal and they also miss the opportunity when the patient returns to out patient clinic subsequently for pathology results. Reviewing the patients on these two occasions is equally important to complete the learning process. How to overcome it: I have started including in the post-operative instruction to call that particular Trainee doctor (for specific cases) when the patient returns for suture removal. Another option is to book the patient into my dressing clinic session and encourage the learner to attend. I also inform the trainee that the assessment form will be completed after he has seen the patients’ post-operative result. This is an incentive for them to attend the clinic. Problem: Kolb cycle may be difficult to apply to all trainees and there are some cultural differences the way the trainees are trained, for example trainees from Indian subcontinent or from Europe. How to overcome it: I will use spiral method of learning proposed by Dewey in this type of surgical technique teaching so that the learner follows it through the spirals to modify and improve the quality of outcome performance. I would also incorporate four-stage process of teaching in theatre (Walker Peyton, 1998) as part of the Kolb cycle depending on the pre-existing experience of the learner. Stage I involves my demonstration of the normal procedure at normal speed. In stage II, I will carry out the procedure again with full explanation and trainee is encouraged to ask questions. I perform the procedure for a third time during the III stage with trainee describing the steps, being questioned on key issues and providing any necessary correction. This stage continues until I am satisfied that the trainee fully understands the procedure. Now we move on to the final stage when the trainee carries out the procedure under close supervision, describing each step before it is undertaken . Thus this drilling of four-stage surgical skill development is followed by repetition to increase the confidence and further practicing of the skills to master it to apply in different situations. I will employ flexibility as to where to start the training depending on the individual trainees’ abilities and their prior knowledge and experience. Here is a framework I plan to use for the future flap teaching sessions:       References    Mann K V. (2002) Thinking about learning: Implications for Principle-Based Professional Education, The Journal of Continuing Education in the Health Professions, 22: 69-76 Knowles M S, Holton E F, Swanson R A. (2005) What is Learning, The Adult Learner, Elsevier, Burlington, MA Kolb D A. (1984) Experiential Learning, Experience as the source of Learning and Development, Prentice Hall, Englewood Cliffs, New Jersey Kolb D A. (1976) The Learning Style Inventory: Technical Manual, Boston, Ma.: McBer. Kolb D A. (1981) Learning styles and disciplinary differences. in A. W. Chickering (ed.) The Modern American College, San Francisco: Jossey-Bass. Kolb D A, Fry R. (1975) Toward an applied theory of experiential learning;, in C. Cooper (ed.) Theories of Group Process, London: John Wiley. Walker M, Peyton R. (1998) Teaching in the Theatre, Teaching and learning in medical practice, Manticore Europe, Pages 171-180