Learning Theories and Interprofessional Education: An Overview

1. Learning Theories and Interprofessional Education: An Overview ESRC Seminar Series: 26th June 2009

2. Background • 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) • 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)

3. Families of Learning Theory • Behaviourism • Constructivism -cognitive - social • Use in IPE?

4. Behaviourists consider that: • 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)

5. Behaviourism in IPE • IPE curriculum developers create an outcome based curriculum; • Interprofessional competencies (Arredondo et al., 2004; Norris et al., 2005) -learning outcomes assessed and evaluated • No clear reference to IPE competencies in curriculum design • IPE evaluations- Kirkpatrick’s (1967) model

6. Modified Kirkpatrick's Model of Educational Outcomes for IPE (Barr et al., 2000; Freeth et al, 2002; Hammick et al., 2007)

7. Cognitive Constructivism • 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) • Application and use of developmental theories (Paiget, 1973)

8. Clark (2006) applied Perry’s (1970) theory: • 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 Ultimate Goal

9. IPE Curriculum Developer’s Role: • Consider ways to develop students’ knowledge by activating and building on existing knowledge bases- transformative learning • Consider key assumptions underlying the constructivist origins of adult learning theory (ALT) or androgogy (Knowles, 1990; Kaufman, 2003) • ALT- key mechanism for well received IPE (Hammick et al., 2007)

10. Teaching methods used to facilitate adult learning: • Self-directed learning (Kaufman, 2003) • Problem based learning (Newble, 2002; Wood, 2003); • Discovery learning (Spencer and Jordan, 1999; O’Halloran et al., 2006); • Case based learning; • Portfolio based learning; • Project based learning; • Peer evaluation; • Use of learning contracts (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).

11. Social Constructivism – Vygotsky (1978; 1986) • 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 • Learning- mediated via socio-cultural instruments e.g. language • Support systems

12. Social constructivism & macro level thinking: • 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 developers- focus on micro level of learning (Hean, Craddock and O’Halloran, 2009) -Critics of activity theory (Fuller et al., 2005; Payler et al., 2007) • Communities of practice (Wenger, 1998) • Activity systems (Engestrom, 1999; 2004). • Expansive learning –to create new knowledge & practice

13. Summary • 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).

14. Time for Reflection • How can learning theory be used to inform your own work? • How can you evaluate its use in practice? • How can we work together to advance knowledge in this field?

15. Our overview of contemporary learning theories used in IPE: MICRO BEHAVIOURISM interprofessional competencies A ADULT LEARNING Self directed, experiential, problem based, discovery interprofessional, collaborative B-1-1 CONSTRUCTIVISM B MACRO Cognitive Developmental/stage theory Self directed, experiential, problem based, discovery B-1 Social Social conflict theory Socio-cultural learning Situated learning Collaborative learning Interprofessional learning B2 Expansive learning B3 (Hean, Craddock and O’Halloran, 2009)