Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83

Classified as probably not a substantial claim.

Using portfolios, logbooks and reflective journals as a basis for discussion makes them more effective.

“we have found that using them as a basis for discussion makes them more effective.”

May combine two claims.

Knowles popularised andragogy, but its main limitation is that it excludes context and the social mechanism of constructing meaning and knowledge.

“Knowles (1988) supported this theory by popularising the concept of ''andragogy''.Although it explains the motivation to learn, its main limitation is the exclusion of context and the social mechanism of constructing meaning and knowledge.”

• cites Knowles 1988Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Meaningful learning occurs when connections are made between new and existing information.

“Proponents of the transformative learning approach consider that meaningful learning occurs when connections are made between new and existing information (Regan-Smith et al. 1994).”

• cites Regan-Smith et al. 1994 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Elaboration links new knowledge with existing knowledge, and the linkages should be precise rather than general.

“Elaboration is linking in new knowledge with what we already know.It is important, however, that the linkages are precise rather than general (Stein et al. 1984).”

• cites Stein et al. 1984 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Self-directed learning holds that adults can plan, conduct, and evaluate their own learning.

“Self-directed learning suggests that adults can plan, conduct, and evaluate their own learning.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Premise reflection involves critically re-examining long-held presuppositions.

“Premise reflection involves the critical re-examination of long held presuppositions (Brookfield 2000).”

• cites Brookfield 2000Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Experiential learning has been criticised for focusing on individual knowledge and limiting the social context.

“Experiential learning has been criticised for focusing essentially on developing individual knowledge and limiting the social context (Hart 1992).”

• cites Hart 1992Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Expectancy valence theory incorporates both the value of success and the expectancy of success.

“The expectancy valence theory (Weiner 1992) incorporates the ''value'' of success and expectancy of success.”

• cites Weiner 1992Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Chain of Response model concerns adult participation in learning projects and identifies three interrelated internal motivating factors: self-evaluation, attitude about education, and importance of goals and expectations.

“The Chain of Response model concerns participation by adults in learning projects (Cross 1981).In this model three internal motivating factors are inter-related: self-evaluation, attitude of the learner about education and the importance of goals and expectations.”

• cites Cross 1981Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Cognitive learning theories focus on mental and psychological processes rather than behaviour, and concern perception and information processing.

“Cognitive learning theories focus learning in the mental and psychological processes of the mind, not on behaviour.They are concerned with perception and the processing of information (Piaget 1952;Bruner 1966;Ausubel 1968;Gagne et al. 1992).”

• cites Piaget 1952 sourceNot checked yet

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• cites Bruner 1966Not checked yet

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• cites Ausubel 1968Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Perspective transformation involves a disorienting dilemma, context including personal, professional, and social factors, and critical reflection.

“The process of perspective transformation includes (i) A disorienting dilemma which is the catalyst/trigger to review own views/perspectives -''knowing that you don't know'' (ii) The context, which includes personal, professional and social factors (iii) Critical reflection.”

• cites Mezirow 1990Not checked yet

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Classified as probably not a substantial claim.

Kolb's experiential learning model describes a cycle of concrete experience, reflection, abstract conceptualisation and generalisation, testing implications in new situations, and then new concrete experience.

“In Kolb's scheme, the learner has a concrete experience, upon which they reflect.Through their reflection they are able to formulate abstract concepts, and make appropriate generalisations.They then consolidate their understanding by testing the implications of their knowledge in new situations.This then provides them with a concrete experience, and the cycle continues.”

• cites Kolb 1984Not checked yet

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Probably not a substantial claim: may not pass S4 (based).

Theories of adult learning can be grouped into several overlapping categories: instrumental, humanistic, transformative, social, motivational, and reflective.

“In broad terms, theories of adult learning can be grouped into, or related to, several categories.There is quite a lot of overlap between the theories and the categories of theories, and here we give a simplified overview:”

Probably not a substantial claim: may not pass S3 (load-bearing).

Motivation to learn equals expectancy of success multiplied by value of success.

“Motivation to learn ¼ Expectancy of success  Value of success:”

• cites Weiner 1992Not checked yet

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May combine two claims.

Self-determination theory recognises intrinsic motivation and holds that autonomy, competence, and relatedness must be fulfilled to sustain it.

“The theory recognises the importance of intrinsic motivation, and considers that three basic needs must be fulfilled to sustain it: Autonomy, Competence, and a feeling of belonging -or ''Relatedness''.”

• cites Ryan & Deci 2000 sourceNot checked yet

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• cites ten Cate et al. 2011 sourceNot checked yet

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• cites Kusurkar & ten Cate 2013Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Transformative learning theory examines how critical reflection can challenge a learner's beliefs and assumptions.

“Transformative learning theory explores the way in which critical reflection can be used to challenge the learner's beliefs and assumptions (Mezirow 1978(Mezirow , 1990(Mezirow , 1995) )”

• cites Mezirow 1978 sourceNot checked yet

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• cites Mezirow 1990Not checked yet

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• cites Mezirow 1995Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The main external barriers to adult motivation are life events and transitions, opportunities, and barriers to learning or obtaining information.

“The main external barriers to motivation are life events and transitions, opportunities, and barriers to learning or obtaining information.”

• cites Cross 1981Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Reflection-change models hold that reflection leads to action and then change.

“The reflection-change models consider that reflection leads to action and then change.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Reflective learning is highly relevant to medical education and wider society.

“Reflective learning (Scho ¨n 1983(Scho ¨n , 1987) ) has important relevance to medical education, and more widely in society (Archer 2012).”

• cites Scho ¨n 1983Not checked yet

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• cites Scho ¨n 1987Not checked yet

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• cites Archer 2012 sourceNot checked yet

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May combine two claims.

A limitation of self-directed learning is that it neglects the social context and underestimates collaborative learning.

“A limitation of the concept is failure to take into consideration the social context of learning.It has also implicitly underestimated the value of other forms of learning such as collaborative learning.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

For constructivists, the learner's prior experience and knowledge, and the dissonance between these and the concrete learning experience, are important.

“Of particular importance to those who follow a broadly constructivist line (but lacking in the original model), will be the prior experience/knowledge of the individual, and the dissonance between this and the concrete experience that is provided as the learning opportunity.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Wenger emphasises communities of practice as important in guiding and encouraging learners.

“These concepts have been developed by Etienne Wenger (Lave & Wenger 1991;Wenger 1998), who emphasises the importance of ''communities of practice'' in guiding and encouraging the learner.”

• cites Lave & Wenger 1991 sourceNot checked yet

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• cites Wenger 1998 sourceNot checked yet

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Classified as probably not a substantial claim. May combine two claims.

Each adult learning theory has strengths and is incomplete without the others.

“Even this brief consideration of types of theory applicable to adult learning will lead one to realise that they each have their strengths, and are each incomplete without the others.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The process of integrating new knowledge has three main elements: elaboration, refinement, and restructuring.

“Norman & Schmidt (1992) suggest that there are three main elements to this process: elaboration, refinement and finally restructuring.”

• cites Norman & Schmidt 1992Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The dissonance phase occurs when existing knowledge is challenged and found incomplete.

“The dissonance phase exists when the learner's existing knowledge is challenged and found to be incomplete.”

Classified as probably not a substantial claim.

Both deep and surface learning can be appropriate strategies depending on what is needed.

“A moment's reflection will show that each can be an appropriate strategy.Sometimes deep understanding is needed, and sometimes it is enough to know ''the facts'' -the surface.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The feedback phase is arguably the most crucial, where the learner articulates new knowledge and tests it against peers' and teachers' beliefs.

“The feedback phase is arguably the most crucial, as it is where the learner articulates their newly acquired knowledge and tests it against what their peers and teachers believe.”

May combine two claims.

Assessment systems influence learning strategy: recall-based assessment encourages surface learning, while rewards for deep thought encourage deep learning.

“So, if an assessment system tests for recall of facts, then the successful learner will employ surface learning.If the system rewards deep thought, understanding and reasoning, then the successful learner will aim for that.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The teacher's role is to help the learner over the threshold until learning starts to make sense.

“The role of the teacher is to help the learner over the threshold, and, as discussed above, help them until it starts to make sense.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Knowing normal blood gas or electrolyte values through surface learning can trigger appropriate clinical action.

“It is important to know normal blood gas values or electrolyte levels and this surface learning triggers appropriate clinical action.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A novice stands at the threshold, not knowing what to expect and sometimes not knowing what to look at; this is liminality.

“A novice stands at the threshold, not quite knowing what to expect, and sometimes not even knowing what they are supposed to be looking at.This is a state of liminality, and the learner needs to have some threshold concepts so that they can move further (Land et al. 2008;Meyer et al. 2010).”

• cites Land et al. 2008 sourceNot checked yet

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• cites Meyer et al. 2010 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Scaffolding commonly includes providing learners with a list of intended learning outcomes and the induction they receive when entering a programme or new clinical environment.

“Most commonly, these days scaffolding includes providing learners with a list of intended learning outcomes.It is important to remember that it also includes the induction that students receive when they enter the programme or a new clinical environment.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The dissonance phase ends with the learner reflecting and determining personal learning outcomes.

“It ends with the learner reflecting and determining their personal learning outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Managing a patient with acidosis requires deeper understanding of how physiological systems interact.

“However, to sort out a patient with acidosis requires a deeper understanding of how the various physiological systems interact.”

May combine two claims.

Belenky and colleagues identified silent learners who did not recognise their own rights to question or construct knowledge, and extended the scale to being co-constructors of knowledge.

“They (Belenky et al., 1997) uncovered a group of ''silent'' learners, who did not recognise their own rights to question or construct knowledge.Belenky and colleagues also extended the scale beyond receiving and understanding knowledge, to being co-constructors of knowledge (Belenky et al. 1997).”

• cites Belenky et al. 1997Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

In the refinement phase, the learner seeks possible explanations or solutions and refines new information into concepts that are new for the learner.

“During the refinement phase, the learner seeks out a number of possible explanations or solutions to a problem (elaboration), and through completing tasks, research, reflection and discussion refines the new information into a series of concepts which are, for the learner, new.”

Classified as probably not a substantial claim.

To make sense of and use knowledge, learners must understand where things fit.

“But being able to do these things means that you have to acquire an understanding of where things fit.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In the organisation phase, the learner develops or restructures ideas to account for increased information.

“The organisation phase is where the learner develops or restructures their ideas to account for the increased information they have acquired.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Anderson's modifications indicate a belief that creating is higher than evaluating and emphasise that learners do things with knowledge.

“Anderson's modifications indicate a belief that ''creating'' is a higher attribute than ''evaluating'', but they are also important in emphasising that the learner does things with knowledge.”

• cites Anderson & Kratwohl 2001Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the consolidation phase, the learner reflects on the process, reviews the learning cycle, and identifies what was learned about both knowledge and the learning process.

“During the consolidation phase the learner reflects upon the process they have undergone, looking back over the learning cycle and identifying what they have learned from it, both in terms of increasing their knowledge base, but also in terms of the learning process itself (reflection on action).”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The elements of Bloom's and Anderson's pyramid are in reality arranged in a cycle, with evaluation leading to new ideas that are applied, analysed, evaluated, and so on.

“In reality, the elements of the pyramid are arranged in a cycle.Evaluation leads to developing a new idea which is then applied, analysed, evaluated and so on.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Restructuring is the development of new knowledge maps, or schemata, that arguably allow expertise.

“Finally, restructuring is the development of new knowledge maps (schemata) which arguably allow one to become an expert or demonstrate expertise (Norman et al. 2006).”

• cites Norman et al. 2006Not checked yet

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Probably not a substantial claim: may not pass S4 (based). May combine two claims.

All learning starts with the learner's existing knowledge, which varies in sophistication by domain.

“All learning starts with the learner's existing knowledge, which will be more or less sophisticated in any given domain (Figure 5).”

Probably not a substantial claim: may not pass S4 (based).

The entire learning process starts with what a learner already knows.

“The entire learning process starts with what a learner already knows.”

May combine two claims.

Some learners prefer deep understanding, while others prefer acquiring facts, known as surface learning.

“It does seem clear that some learners prefer to work towards a deep understanding of what they are learning; others prefer to acquire the facts, a term known as surface learning.”

Probably not a substantial claim: may not pass S3 (load-bearing).

This change in focus is accompanied by greater confidence in coping with uncertainty.

“Together with this change in focus comes a greater confidence with coping with uncertainty.”

• cites Perry 1999Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Two explanations for this paradox are that learners adopt more strategic learning styles to cope with assessment demands, or that it relates to becoming a new member of the profession.

“There are two explanations for this paradox, one is that the learners tend towards more strategic learning styles in order to cope with the demands of the assessment system; the alternative explanation is rather more complex and relates to the business of becoming a new member of the profession.”

May combine two claims.

Articulating prior knowledge helps learners anchor new knowledge in existing understanding and places them at the first stage of the learning cycle.

“This stage helps the learner anchor the new knowledge in what they already understand, and places them on the first stage of the learning cycle.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

In real life, the relevance of information is often far from apparent.

“A more challenging condition applies in real life, when the relevance of information is often far from apparent.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Feedback either reinforces the learner's schema or obliges reconsideration in light of new information.

“The feedback will either reinforce their schema, or oblige the learner to reconsider it in the light of new information.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Learning new things is not only about acquiring knowledge; it also includes making sense of it and using it.

“The process of learning new things is not just about acquiring knowledge (surface learning), it includes being able to make sense of it, and hopefully making use of it.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

The key to success as an educator is probably providing advance organisers.

“The key to success as an educator is probably providing the advance organisers.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Learning outcomes can be refined using Bloom's taxonomy, which has been revised by several authors including Anderson.

“Learning outcomes can be further refined using Bloom's taxonomy (Bloom et al. 1956), which has been revised by several authors, including Anderson (Anderson & Kratwohl 2001).”

• cites Bloom et al. 1956Not checked yet

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• cites Anderson & Kratwohl 2001Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Engagement with the dissonance phase is influenced by task nature, resources, learner motivation, developmental stage, and preferred learning style.

“There are several things that influence whether the learner will engage with the dissonance phase.These include the nature of the task, the available resources, the motivation of the learner, and the learner's stage of development and their preferred learning style.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Scaffolding includes programme-level organisers that depend on content and context, such as syllabus, lectures, planned experiential learning, and reading lists.

“Scaffolding includes programme level organisers, which are dependent on both the content and the context in which it is being learned.Programme organisers include the syllabus, lectures, planned experiential learning and reading lists.”

Classified as probably not a substantial claim.

The model can help design learning activities in one-to-one discussions, small group work, seminars, or large lectures.

“The model that we have given here shows that there are a number of ways in which applying the model can help in the design of learning activities, whether in one-to-one discussions, small group work, seminars or large lectures.”

• AssumptionRests on an assumption: The proposed model can be applied at both individual learning and curriculum planning levels.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Recognising different learning styles is important because lectures appeal more to surface learners and extended project work appeals more to deep learners.

“Recognising the different styles is important, as (most) lectures will appeal more to surface learners and extended project work will appeal more to deep learners.”

Probably not a substantial claim: may not pass S4 (based).

Educator and learner have specific responsibilities at each stage of the learning process.

“We also need to be explicit that educator and learner have specific responsibilities at each stage of the learning process.”

Classified as probably not a substantial claim. May combine two claims.

Some subject material needs to be known and rapidly recalled, while other material needs deep understanding for appropriate interventions.

“Some subject material actually needs to be known and rapidly recalled (blood gas values, electrolyte levels), while other material needs to be deeply understood to allow appropriate interventions (coping with acid base disturbances, or circulatory shock).”

Classified as probably not a substantial claim.

Learner and teacher have particular responsibilities at each stage of the model.

“The learner and the teacher will have particular responsibilities at each stage.”

Probably not a substantial claim: may not pass S2 (checkable).

The ability to be strategic about the type of learning engaged in is important.

“The ability to be strategic about the sort of learning we engage in is important.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Knowledge is the foundation of Miller's pyramid but not the pyramid itself.

“Knowledge is the foundation of the pyramid -but not the pyramid itself.”

May combine two claims.

Maudsley (2005) shows that medical students develop in how they learn, but progression is not always from duality to multiplicity.

“Some recent work by Maudsley (2005) shows that medical students develop in the way they learn, but that the progression is not always from duality to multiplicity.”

• cites Maudsley 2005Not checked yet

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Classified as probably not a substantial claim.

Scaffolding is necessary because the volume and complexity of knowledge often leaves learners in liminality rather than entering learning.

“They are necessary because the sheer volume and complexity of knowledge to be acquired often leaves the learner standing on the threshold (in a state of liminality), rather than stepping into the world of learning.”

May combine two claims.

Perry's work was based on a relatively able, affluent, homogeneous undergraduate population and was later extended to a wider cross-section.

“This work was based on a relatively able, affluent and homogenous population of undergraduates and was subsequently extended by Perry's colleagues to a wider cross section of society.”

• cites Belenky et al. 1997Not checked yet

  Not checked in the free run.

May combine two claims.

Following Wenger, the whole community has a role in leading novices over the threshold and helping them take their place in the community of practice.

“If we follow Wenger's arguments (Wenger 1998) then we will see that the whole community has a role in leading the novice over the threshold, and helping them to take their place in the community of practice, that is, in this case, the healthcare profession.”

• cites Wenger 1998 sourceNot checked yet

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May combine two claims.

Learners have different learning styles and preferences.

“Newble, Entwistle and their colleagues, in a number of studies (Newble & Clarke 1986;Newble & Entwistle 1986), have shown that there are several different learning styles, and that learners have different learning preferences.”

• cites Newble & Clarke 1986Not checked yet

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• cites Newble & Entwistle 1986Not checked yet

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May combine two claims.

Miller's pyramid is the most frequently encountered variant of Bloom's work in medical education and can guide curriculum planning and assessment.

“In medical education, the most frequently encountered is Miller's pyramid (Kolb 1984).(Miller, 1990; Figure 3), which can be used as a guide for planning and assessing within a curriculum.”

• cites Miller 1990 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The organisation phase includes reflection in action, where hypotheses are tested, and organising information into schemata that make sense to the learner.

“There are at least two elements to this: reflection in action, where the learner tests and re-tests hypotheses to makes sense of the information and the organisation of the information into schemata which (for the learner, at least) make sense.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Refinement is sifting and sorting information to retain elements that make sense.

“Refinement is the act of sifting and sorting through the information to retain those elements that make sense.”

Classified as probably not a substantial claim. May combine two claims.

Discussion between individuals increases practical knowledge, and some things remain mysterious until one talks to someone with different knowledge or understanding.

“Two things are immediately apparent from this construction -namely that discussion between individuals will increase the amount of practical knowledge, and that some things remain a mystery until we talk to someone else with a different range of knowledge or understanding.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

In a structured learning environment, new knowledge is sufficiently similar to existing knowledge for its relevance to be perceived.

“In a structured learning environment new knowledge is sufficiently similar to the existing knowledge to allow its relevance to be perceived.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Teachers can help students move into areas of unknown unknowns through careful choice of task, resources, and patients.

“There will always be ''unknown unknowns'', but teachers can help students move into those areas through a careful choice of task, resources and, of course, patients.”

May combine two claims.

Difficulties in learning are frequently due to vocabulary or language use, troublesome concepts, or becoming part of the team and assuming a new identity.

“Frequently the difficulty is in the vocabulary or the way that language is used (Bernstein 2000), but it can also be troublesome concepts (Meyer & Land 2006), or just becoming part of the ''team'' and assuming a new identity (Wenger 1998).”

• cites Bernstein 2000 sourceNot checked yet

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• cites Meyer & Land 2006Not checked yet

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• cites Wenger 1998 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable).

In any intervention, learners need the opportunity to articulate what they already know.

“In any intervention, we need to make sure that the learner has the possibility to articulate what they already know about something.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The challenge in dissonance can be internal, when a learner thinks things through, or external, provided by a teacher or patient.

“The challenge can be internal, when a learner is thinking things through, or it can be external, provided by a teacher or patient.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

To truly understand and learn, the learner needs to move through a cycle.

“Whether working with an individual learner, or planning a major programme, the educator needs to recognise that the learner needs to move through a cycle, in order to truly understand and learn.”

• AssumptionRests on an assumption: Learners must move through the proposed cycle to truly understand and learn.

Probably not a substantial claim: may not pass S2 (checkable).

The same principles apply to planning curricula at short course, module, or programme level.

“The same principles apply to planning curricula, at short course, module or programme level.”

• AssumptionRests on an assumption: The proposed model can be applied at both individual learning and curriculum planning levels.

Probably not a substantial claim: may not pass S3 (load-bearing).

In healthcare professions training, the intended outcome is a graduate who can take their place in the workforce.

“The pyramid is important, because in training students for the healthcare professions it is essential to remember that the outcome of training is intended to be a graduate who can take their place in the workforce (Action).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Educators can help learners by providing advance organisers.

“The processes of acquiring new knowledge, relating it to what is already known and developing new understanding is complicated and difficult but educators can help the learners by providing advance organisers (Ausubel 1968).”

• cites Ausubel 1968Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The success of the elaboration and refinement phase depends on the nature of the task and the provision of appropriate resources.

“Most of what happens in the elaboration and refinement phase is internal to the learner, but the success of the venture will stem from the nature of the task they were set, and the provision of appropriate resources.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The elaboration and refinement phase is the key part of problem-based learning.

“This phase is the key part of problem-based learning”

May combine two claims.

Situated cognition is an off-shoot of adult learning theories and was developed by Wenger into communities of practice.

“An off-shoot of adult learning theories is situated cognition (Wilson 1993) developed by Wenger (1998) into the theories of communities of practice.”

• cites Wilson 1993Not checked yet

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• cites Wenger 1998 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

A well thought through portfolio or log book with reflection allows the learner's progress to be documented for themselves and for the educator or assessor.

“a well thought through portfolio/log book with elements of reflection will allow for the learner's progress to be documented for themselves, and, importantly, for the educator/assessor.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The proposed model is presented as a cycle, but the learner and teacher can enter the cycle at any point.

“Although the model is presented as a cycle actually the learner and teacher can enter the cycle at any point.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Applying adult learning principles in medical education will probably require changing educators' and learners' perceptions of their roles.

“Applying adult learning principles in medical education will probably necessitate changing educators' and learners' perceptions of their roles.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The organisation phase involves fitting information into existing knowledge and constructing new information into a coherent story.

“Part of this phase is fitting the information into what the learner already knows, and part of it is in constructing the new information into a story that makes sense to the learner.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

The real test of understanding something is explaining it to other learners.

“All educators know that the real test of understanding something is explaining it to other learners.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Perry's stage of duality has attractions for both the learner and the educator.

“In the same way that surface learning has attractions for many learners, Perry's stage of duality has attractions for both the learner and the educator (Perry 1999).”

• cites Perry 1999Not checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

Clinical reasoning, hypothesis generation and testing are essential skills for good clinical practice.

“Clinical reasoning, hypothesis generation and testing are essential skills for good clinical practice.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Elaboration and the later stages of Bloom's taxonomy require increasing depth of understanding.

“Elaboration, and the later stages of Bloom's taxonomy require an increasing depth of understanding.”

• cites Atherton 2011Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Considering possible explanations helps ensure connections are made between new information and previous knowledge.

“The first is that it helps ensure that connections are made between the new information and previous knowledge, ensuring that everything is learnt in the context of what is already known.”

Classified as probably not a substantial claim.

Transformative and experiential learning theories are an important theoretical frame for learning strategies suited to attitude-related outcomes.

“Transformative and experiential learning theories constitute an important theoretical frame for learning strategies suitable for these outcomes.”

May combine two claims.

Lectures can be used to provide more than surface knowledge, though doing so is challenging.

“It is possible, but challenging, to use lectures to provide more than surface knowledge.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

Reinforcing clear thinking in both teacher and learner and considering them should improve clinical learning and even clinical outcomes.

“Reinforcing clear thinking in both teacher and learner and considering them should improve clinical learning, and even clinical outcomes.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The outcome of the elaboration and refinement phase is the generation of a working hypothesis.

“The outcome of this phase is the generation of a working hypothesis.”

Probably not a substantial claim: may not pass S3 (load-bearing).

During the organisation phase, the learner tests and retests a hypothesis against existing knowledge.

“During this phase the learner looks at a problem from all angles, testing and retesting the hypothesis against what they already know.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Too detailed scaffolding means the learner will not know until too late whether they truly understand the subject.

“It also means that the learner will not know, until too late, whether they truly understand the subject.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Elaboration without refinement leads to confusion.

“Elaboration without refinement will just lead to confusion”

Probably not a substantial claim: may not pass S3 (load-bearing).

Learning is a process through which learners weigh their knowledge against a critical examination of alternative possibilities.

“learning is a process through which they weigh their knowledge against a critical examination of alternative possibilities (Ahlquist 1992).”

• cites Ahlquist 1992Not checked yet

  Not checked in the free run.

May combine two claims.

Ethics and professional behaviours can be taught, but understanding them is demonstrated and consolidated in the clinical environment.

“Ethics and professional behaviours can be, and often are, taught but understanding them is demonstrated and consolidated within the clinical environment.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Self-directed learning transcends self-regulated learning to include motivation and the ability to determine what should be learned.

“The goal, however is self-directed learning which transcends self-regulated learning to include motivation and, crucially, the ability to determine what should be learned (Loyens et al. 2008).”

• cites Loyens et al. 2008 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Learners can develop understanding of systems through well-facilitated problem-based or case-based learning.

“Learners can also develop their understanding of systems through well-facilitated PBL or case-based learning”

Classified as probably not a substantial claim.

Too detailed scaffolding removes freedom or responsibility from the learner.

“The danger with scaffolding is that if it is too detailed it removes any freedom or responsibility from at the learner.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

An effective assessment system indicates where learners are going wrong and which areas they should focus on.

“Any effective assessment system will provide learners with an indication of where they are going wrong, and which areas they should focus on for clarification of their understanding.”

Classified as probably not a substantial claim. May combine two claims.

Self-directed and experiential learning are key strategies, but feedback is crucial for helping learners make the best use of contact time.

“Self-directed and experiential learning are key strategies, but feedback is crucial to help the learner make the best use of their contact time.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Applications of these strategies require significant institutional culture changes, active faculty development and increased learner autonomy and self-direction.

“Applications of these strategies necessitate significant institutional culture changes, active faculty development and increased learner autonomy and self-direction.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Considering possible explanations reinforces the natural tendency to be inventive and to think widely.

“The second is that it reinforces our natural tendency to be appropriately inventive and to think widely.”

May combine two claims.

Student motivation can be strongly influenced by the educational environment and the learner's frame of mind.

“Sobral's (2004) work has shown that student's motivation can be strongly influenced by the educational environment and their frame of mind towards learning.”

• cites Sobral 2004 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Encouraging discussion, debate and reflection will increase learning opportunities.

“Encouraging discussion, debate and reflection will increase learning opportunities.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Self-directed learning includes motivation and self-regulation.

“There is more to consider here, particularly the dimensions of self-directed learning (Garrison 1997), which include motivation and self-regulation (Zimmerman 2002).”

• cites Garrison 1997 sourceNot checked yet

  Not checked in the free run.

• cites Zimmerman 2002Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Assessment drives learning.

“it is widely asserted that ''assessment drives learning'' (Miller 1990)”

• cites Miller 1990 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Adult learning theories are related to several educational, social, philosophical and psychological theories.

“Adult learning theories are related to several educational, social, philosophical and psychological theories.”

Probably not a substantial claim: may not pass S4 (based).

The proposed model of adult learning shows that perception, insight, meaning-making and mental networking are interlinked and essential for good reasoning abilities.

“The model of adult learning we have illustrated (Figure 5) shows that perception, insight, meaning-making and mental networking are interlinked and essential for good reasoning abilities.”

May combine two claims.

Problem-based learning fosters self-directed learning, but publishing or giving detailed intended learning outcomes easily destroys it.

“Again, this is fostered by problem-based learning, but is easily destroyed by publishing or giving the students detailed intended learning outcomes.”

Classified as probably not a substantial claim.

Deep learning arises through discussion, research and weighing evidence.

“Deep learning comes through discussion, research and weighing up the evidence.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Feedback is best given frequently and in small doses.

“Although feedback is best given in frequent, small, doses, there are clearly times when it is crucial.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

Understanding how people learn is basic to problem-based learning and the majority of clinical practice.

“This understanding is basic to problem-based learning and the majority of clinical practice.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The first stage of making sense of new information is to consider as many possible explanations as possible.

“The first stage in this process is to consider as many of the possible explanations for the new information as possible.”