Skip to main content

Some Learning Theories for Medical Educators

Abstract

Perspectives on the nature of learning influence decisions about curriculum design, teaching and learning strategies, and assessment of students. Current literature on medical education suggests that medical teachers have much interest in using theories to inform their practice. This article describes the following learning theories that have been discussed to various degrees in previous literature on medical education: cognitivism, constructivism, experiential learning, adult learning, self-directed learning, community of practice and situated learning, cognitive apprenticeship, and reflective learning. Each theory is explained in sufficient detail to help readers grasp its essence. Then, medical education literature is cited to show how the theory has been used or can be used to guide practice in medical education. Finally, this article analyzes the problem-based learning approach as an example to illustrate how the theories may be reflected in practice. Throughout the introduction of the various theories, this article aims at their application in medical education and attempts to draw connections among the theories rather than represent them as unrelated or competing ideas.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Kaufman D, Mann K. Teaching and learning in medical education: how theory can inform practice. In: Swanwick T, editor. Understanding medical education: evidence, theory, and practice. Wiley Blackwell; 2010. pp.16–36.

  2. Mann K. Theoretical perspectives in medical education: past experience and future possibilities. Med Educ. 2011;45(1):60–8.

    Article  Google Scholar 

  3. Lyons K, McLaughlin J, Khanova J, Roth M. Cognitive apprenticeship in health sciences education: a qualitative review. Adv in Health Sci Educ. 2017;22(3):723–39.

    Article  Google Scholar 

  4. Van Merrienboer J, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Med Educ. 2010;44:85–93.

    Article  Google Scholar 

  5. Issa N, Mayer R, Schuller M, Wang E, Shapiro M, DaRosa D. Teaching for understanding in medical classrooms using multimedia design principles. Med Educ. 2013;47:388–96.

    Article  Google Scholar 

  6. Philips DC, Soltis JF. Perspectives on learning. 3rd ed. New York: Teachers College Press; 1998.

    Google Scholar 

  7. Gonzalez-DeHass A, Willems P. Theories in educational psychology: concise guide to meaning and practice. Lanham, Maryland: Rowman & Littlefield Education; 2013.

    Google Scholar 

  8. Ertmer P, Newby T. Behaviorism, cognitivism, constructivism: comparing critical features from an instructional design perspective. Performance Improvement Quarterly. 1993;6(4):50–72.

    Article  Google Scholar 

  9. “Cognitivism.” In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  10. McKeachie W. Implications of cognitive psychology for college teaching. New Directions for Teaching & Learning. 1980;2:85–93.

    Article  Google Scholar 

  11. McKeachie W. Improving lectures by understanding students’ information processing. New Directions for Teaching & Learning. 1980;2:25–35.

    Article  Google Scholar 

  12. Mayer RE. The promise of multimedia learning: using the same instructional design methods across different media. Learn Instr. 2003;13:125–39.

    Article  Google Scholar 

  13. Cooper J, Robinson P. Using classroom assessment and cognitive scaffolding to enhance the power of small-group learning. Journal on Excellence in College Teaching. 2014;25:149–61.

    Google Scholar 

  14. Holmes JD. Great myths of education and learning. West Sussex, UK: Wiley-Blackwell; 2016.

    Book  Google Scholar 

  15. Matheson C. The educational value and effectiveness of lectures. Clin Teach. 2008;5:218–21.

    Article  Google Scholar 

  16. DeGolia S. How to give a lecture. In: Roberts LW, editor. The academic medicine handbook: a guide to achievement and fulfillment for academic faculty. New York: Springer; 2013. p. 55–67.

    Chapter  Google Scholar 

  17. Krathwohl D. A revision of Bloom’s taxonomy: an overview. Theory Pract. 2002;41(4):212–8.

    Article  Google Scholar 

  18. Anderson LW, Krathwohl D. A taxonomy for learning, teaching and assessing: a revision of Bloom’s taxonomy of educational objectives. New York: Longman; 2001.

    Google Scholar 

  19. Bransford JD, Brown AL, Cocking RR. How people learn: brain, mind, experience, and school. Washington DC: National Academy Press; 2000.

    Google Scholar 

  20. Webster-Wright A. Reframing professional development through understanding authentic professional learning. Rev Educ Res. 2009;79(2):702–39.

    Article  Google Scholar 

  21. Fiorella L, Mayer RE. Learning as a generative activity: eight learning strategies that promote understanding. New York: Cambridge University Press; 2015.

    Book  Google Scholar 

  22. Wenger E. A social theory of learning. In: Elleris K, editor. Contemporary theories of learning: learning theorists … in their own words. London: Routledge; 2009. p. 209–18.

    Google Scholar 

  23. Ausubel DP. Educational psychology: a cognitive view. New York: Holt, Rinehart & Winston; 1968.

    Google Scholar 

  24. Norman D. What goes on in the mind of the learner. New Directions for Teaching & Learning. 1980;2:37–49.

    Article  Google Scholar 

  25. Sweller J, Van Merrienboer J, Paas F. Cognitive architecture and instructional design. Educ Psychol Rev. 1998;10:251–96.

    Article  Google Scholar 

  26. Reese A. Implications of results from cognitive science research for medical education. Med Educ Online. 1998;3(1). https://msu.edu/~dsolomon/f0000010.pdf

  27. Lauria M, Bronson M, Lanter P, Trimarco T. The 5 T’s: applying cognitive science to improve prehospital medical education. Air Med J. 2017;36:198–202.

    Article  Google Scholar 

  28. Mayer RE. Applying the science of learning to medical education. Med Educ. 2010;44:543–9.

    Article  Google Scholar 

  29. Issa N, Schuller M, Santacaterina S, Shapiro M, Wang E, Mayer RE, DaRosa D. Applying multimedia design principles enhances learning in medical education. Med Educ. 2011;45:818–26.

    Article  Google Scholar 

  30. Philips DC. How, why, what, when and where: perspectives on constructivism in psychology and education. Issues in Education. 1997;3(2):151–94.

    Google Scholar 

  31. Richardson V. Constructivist pedagogy. Teach Coll Rec. 2003;105(9):1623–40.

    Article  Google Scholar 

  32. Schmidt H, Van der Molen H, Te Winkel W, Wijnen W. Constructivist, problem-based learning does work: a meta-analysis of curricular comparisons involving a single medical school. Educ Psychol. 2009;44(4):227–49.

    Article  Google Scholar 

  33. Schmidt H. A brief history of problem-based learning. In: O’Grady G, Yew E, Goh K, Schmidt H, editors. One-day, one-problem: an approach to problem-based learning. Singapore: Springer; 2012. p. 21–40.

    Chapter  Google Scholar 

  34. Ertmer P, Newby T. Article update: behaviorism, cognitivism, and constructivism: connecting “yesterday’s” theories to today’s contexts. Performance Improvement Quarterly. 2013;26(2):65–71.

    Article  Google Scholar 

  35. Philips DC. The good, the bad, and the ugly: the many faces of constructivism. Educ Res. 1995;24(7):5–12.

    Article  Google Scholar 

  36. Bonwell C, Eison J. Active learning: creating excitement in the classroom. ASHE-ERIC Higher Education Reports. 1991. https://files.eric.ed.gov/fulltext/ED336049.pdf. Accessed 10 March, 2020.

  37. Mayer RE. Should there be a three-strikes rule against pure discovery learning? The case for guided methods of instruction. Am Psychol. 2004;59(1):14–9.

    Article  Google Scholar 

  38. Fornari A, Poznanski A. How-to guide for active learning. International Association of Medical Science Educators. 2015.

  39. McCoy L, Pettit R, Kellar C, Morgan C. Tracking active learning in the medical school curriculum: a learning-centered approach. J Med Educ Curric Dev. 2018;5. https://doi.org/10.1177/2382120518765135

  40. Walling A, Istas K, Bonaminio G, Paolo A, Fontes J, Davis N, Berardo B. Medical student perspectives of active learning: a focus group study. Teach Learn Med. 2017;29(2):173–80.

    Article  Google Scholar 

  41. Kolb DA, Boyatzis RE, Mainemelis C. Experiential learning theory: previous research and new directions. In: Sternberg RJ, Zhang LG, editors. Perspectives on thinking, learning, and cognitive styles. Mahwah, NJ: Erlbaum; 2001. p. 227–47.

    Google Scholar 

  42. Kolb DA. Experiential learning: experience as the source of learning and development. NJ: Prentice-Hall; 1984.

    Google Scholar 

  43. Kolb AY, Kolb DA. Experiential learning theory. In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  44. Yardley S, Teunissen P, Dornan T. Experiential learning: AMEE guide no. 63. Med Teach. 2012;34:e102-e115.

  45. Dornan T, Scherpbier A, Boshuizen H. Supporting medical students’ workplace learning: experience-based learning (ExBL). Clin Teach. 2009;6(3):167–71.

    Article  Google Scholar 

  46. Schultz K, McEwen L, Griffiths J. Applying Kolb’s learning cycle to competency-based residency education. Acad Med. 2016;91(2):284.

    Article  Google Scholar 

  47. Knowles MS. Introduction. In: Knowles MS & Associates, editors. Andragogy in action: applying modern principles of adult learning. San Francisco: Jossey-Bass Publishers; 1984. pp. 1–21.

  48. Norman G. The adult learner: a mythical species. Acad Med. 1999;74(8):886–9.

    Article  Google Scholar 

  49. Sharp A. Humanistic approaches to learning. In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  50. Madsen S, Wilson I. Humanistic theory of learning: Maslow. In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  51. Rogers C. The Carl Rogers reader. Boston: Houghton Mifflin Company; 1989.

    Google Scholar 

  52. Zimring F. Carl Rogers. Prospects. 1994;24:411–22.

    Article  Google Scholar 

  53. Rogers C, Freiberg H. Freedom to learn. 3rd ed. New York: Merrill Macmillan; 1994.

    Google Scholar 

  54. Misch D. Andragogy and medical education: are medical students internally motivated to learn? Adv in Health Sci Educ. 2002;7:153–60.

    Article  Google Scholar 

  55. Neufeld V, Barrows H. Preparing medical students for lifelong learning. In: Knowles MS & Associates, editors. Andragogy in action: applying modern principles of adult learning. San Francisco: Jossey-Bass Publishers; 1984. pp. 207–226.

  56. Fidishun D. Adult learning/andragogy. In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  57. Bouchard, P. Self-directed learning and learner autonomy. In: Seel NM, editor. Encyclopedia of the sciences of learning. Boston, MA: Springer; 2012.

  58. University of Southern California. Self-directed learning for physicians at the University of Southern California. In: Knowles MS & Associates, editors. Andragogy in action: applying modern principles of adult learning. San Francisco: Jossey-Bass Publishers; 1984. pp. 299–310.

  59. Hill M, Peters M, Salvaggio M, Vinnedge J, Darden A. Implementation and evaluation of a self-directed learning activity for first-year medical students. Med Educ Online. 2020;25(1). https://doi.org/10.1080/10872981.2020.1717780

  60. Sawatsky A, Ratelle J, Bonnes S, Egginton J, Beckman T. A model of self-directed learning in internal medicine residency: a qualitative study using grounded theory. BMC Med Educ. 2017;17(1). https://doi.org/10.1186/s12909-017-0869-4

  61. Miflin B, Campbell C, Price D. A conceptual framework to guide the development of self-directed, lifelong learning in problem-based medical curricula. Med Educ. 2000;34:299–306.

    Article  Google Scholar 

  62. Barrows HS, Tamblyn RM. Problem-based learning: an approach to medical education. New York: Springer Publishing Company; 1980.

    Google Scholar 

  63. Dornan T, Hadfield J, Brown M, Boshuizen H, Scherpbier A. How can medical students learn in a self-directed way in the clinical environment? Design-based research Med Educ. 2005;39(4):356–64.

    Google Scholar 

  64. Lave J, Wenger E. Situated learning: legitimate peripheral participation. Cambridge: Cambridge University Press; 1991.

    Book  Google Scholar 

  65. Barab S, Barnett M, Squire K. Developing an empirical account of a community of practice: characterizing the essential tensions. J Learn Sci. 2002;11(4):489–542.

    Article  Google Scholar 

  66. Cruess R, Cruess S, Steinert Y. Medicine as a community of practice: implications for medical education. Acad Med. 2018;93(2):185–91.

    Article  Google Scholar 

  67. Brown J, Collins A, Duguid P. Situated cognition and the culture of learning. Educ Res. 1989;18(1):32–42.

    Article  Google Scholar 

  68. Collins A, Brown J, Holum A. Cognitive apprenticeship: making thinking visible. American Educator. 1991;15(3):6–11, 38–46.

  69. Collins A. Cognitive apprenticeship. In: Sawyer RK, editor. The Cambridge handbook of the learning sciences. Cambridge University Press; 2006. pp. 47–60.

  70. Stalmeijer R, Dolmans D, Snellen-Balendong H, van Santen-Hoeufft M, Wolfhagen I, Scherpbier A. Clinical teaching based on principles of cognitive apprenticeship: views of experienced clinical teachers. Acad Med. 2013;88:861–5.

    Article  Google Scholar 

  71. Daniel M, Clyne B, Fowler R, Sutton E, Rougas S, Warrier S, Farmer K, Doshi A. Cognitive apprenticeship: a roadmap to improve clinical teaching. MedEdPORTAL. 2015; https://doi.org/10.15766/mep_2374-8265.10245. Accessed 4 March, 2020.

  72. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv in Health Sci Educ. 2009;14:595–621.

    Article  Google Scholar 

  73. Schon D. Educating the reflective practitioner: toward a new design for teaching and learning in the professions. San Francisco: Jossey-Bass Publishers; 1987.

    Google Scholar 

  74. Kaufman DM. Applying educational theory in practice. BMJ. 2003;326(7382):213–6.

    Article  Google Scholar 

  75. Gibbs G. Learning by doing: a guide to teaching and learning methods. 1988. http://gdn.glos.ac.uk/gibbs/index.htm. Accessed 10 August, 2020.

  76. Gibbs’ reflective cycle. University of Edinburgh. 2019. https://www.ed.ac.uk/reflection/reflectors-toolkit/reflecting-on-experience/gibbs-reflective-cycle. Accessed 11 February, 2020.

  77. Tawanwongsri W, Phenwan T. Reflective and feedback performances on Thai medical students’ patient history-taking skills. BMC Med Educ. 2019;19. https://doi.org/10.1186/s12909-019-1585-z

  78. Sandars J. The use of reflection in medical education: AMEE guide no. 44. Med Teach. 2009;31:685–695.

  79. Tanner K. Promoting student metacognition. CBE Life Sci Educ. 2012;11:113–20.

    Article  Google Scholar 

  80. Collins English Dictionary. Theory. In: collinsdictionary.com dictionary. https://www.collinsdictionary.com/dictionary/english/theory. Accessed 4 May, 2020.

  81. Jonassen D. Reconciling a human cognitive architecture. In: Tobias S, Duffy T, editors. Constructivist instruction: success or failure. New York: Routledge; 2009. p. 13–33.

    Google Scholar 

  82. Schwartz D, Lindgren R, Lewis S. Constructivism in an age of non-constructivist assessments. In: Tobias S, Duffy T, editors. Constructivist instruction: success or failure. New York: Routledge; 2009. p. 34–61.

    Google Scholar 

  83. Hmelo-Silver C. Problem-based learning: what and how do students learn? Educ Psychol Rev. 2004;16(3):235–66.

    Article  Google Scholar 

  84. Albanese M, Dast L. Problem-based learning: outcomes evidence from the health professions. J Excell Coll Teach. 2014;25(3–4):239–52.

    Google Scholar 

  85. Hoffman K, Hosokawa M, Blake R, Headrick L, Johnson G. Problem-based learning outcomes: ten years of experience at the University of Missouri - Columbia School of Medicine. Acad Med. 2006;81(7):617–25.

    Article  Google Scholar 

  86. Schmidt H, Rotgans J, Yew E. The process of problem-based learning: what works and why. Med Educ. 2011;45:792–806.

    Article  Google Scholar 

  87. Hmelo-Silver C, Barrows HS. Goals and strategies of a problem-based learning facilitator. Interdiscip J Probl Based Learn. 2006;1(1). https://doi.org/10.7771/1541-5015.1004

  88. Morris T. Experiential learning – a systematic review and revision of Kolb’s model. Interact Learn Environ. 2019. https://doi.org/10.1080/10494820.2019.1570279.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hongmei Dong.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dong, H., Lio, J., Sherer, R. et al. Some Learning Theories for Medical Educators. Med.Sci.Educ. 31, 1157–1172 (2021). https://doi.org/10.1007/s40670-021-01270-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-021-01270-6

Keywords

  • Learning theories
  • Learning theories for medical educators
  • Medical education
  • Medical education practice
  • Perspectives on learning
  • Theoretical approaches to learning