Consider two very different approaches to radiology continuing medical education (CME) meetings. At meeting number one, radiologists receive a program book, determine which lectures they are interested in attending, and move from room to room, witnessing a succession of instructor-generated presentations. All decisions about what is taught, how it is taught, and how learning is assessed are made by the instructors, and learners function in a largely passive role, simply listening to what the speakers have to say. The attendees are there primarily because they need to receive a certain number of CME credits each year.
At meeting number two, the curriculum, instructional methods, and assessment techniques are largely learner generated. Radiologists draw on their own clinical experiences to formulate questions or design educational projects. The instructors help participants accomplish their goals, promoting collaboration between peers. Learners attend not primarily because they want to earn CME credits but because they have specific questions, the answers to which they believe will help them do their work better. At meeting number one, only one person does all the talking, but at meeting number two, multiple people in the room share their questions and suggestions.
Andragogy
These two very different approaches to a CME meeting illustrate key differences between contrasting educational approaches often referred to as pedagogy and andragogy. Pedagogy comes from the Greek term meaning “to lead or educate children,” whereas andragogy refers to the leading or education of adults. Andragogy was widely popularized in the United States by Malcolm Knowles, an American educator who died in 1997 . Knowles advocated an approach to learning in which individuals take the initiative in identifying their own learning needs, formulating their own goals, choosing and implementing their own learning strategies, and evaluating their own learning outcomes.
One of the problems with defining andragogy as a learning approach distinct from pedagogy is the implicit suggestion that the learning of children and adults is separated by a vast and unbridgeable chasm. In fact, pedagogical and andragogic approaches should be seen along a spectrum of experience. For example, newly minted radiology residents may benefit considerably from a pedagogical curriculum that basically spells out in advance what they need to know and how they should learn it. Alternatively, adolescents with ongoing chronic illnesses may greatly benefit from directed self-learning to better understand and manage their conditions.
Need to Know
Knowles organized his approach to andragogy around six key assumptions that offer insights into the motivation to learn. The first is the idea that learners need to know why they are learning something. When the need to know is learner generated, this first challenge largely takes care of itself. To identify learning objectives, learners need but reflect on their experience and identify things that they would like to understand better. For example, a practicing radiologist might well begin to question how often the use of oral contrast material for abdominal CT scans enhances diagnostic performance, leading to a literature review and perhaps even a research project.
Self-concept
A second assumption involves what Knowles called “self-concept,” by which he meant that learners should see themselves not as passive recipients of instruction but rather as active planners and evaluators of their own education. This is important for a few reasons. First, given the opportunity, learners can often identify what they most want and need to learn, which tends to promote high-yield learning experiences. Second, encouraging learners to take responsibility for their own education inculcates good habits of lifelong learning . Finally, how we define ourselves partially dictates both our attitude toward learning and our ownership of the education process.
Experience
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Readiness
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Orientation
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Motivation
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Andragogy in CME
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Making Andragogy Work
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References
1. Knowles M., Holton E.F., Swanson R.A.: The adult learner.2015.ElsevierBurlington, MA
2. Collins J.: Education techniques for lifelong learning: principles of adult learning. Radiographics 2004; 24: pp. 1483-1489.