Education Design: Learning Theory
Once again, lets return to the purpose of CME in general: To enhance physician performance and positively impact patient outcomes. While, learning for learning's sake is of course laudible, in the professional setting it must be transferred into use to be efficient and effective. As Sophocles notes in Oedipus Rex:
How terrible is wisdom when it brings no profit to the wise
So transfer is an old idea. More recently (1916 to be precise), John Dewey noted its importance in the relationship between educational stimuli and adjustment of behavior, and Alfred Whitehead (in 1929) cautioned that teaching "inert ideas", those not utilized and tested in combination, is not only useless but also harmless, and teaching fewer ideas in multiple contexts is more likely to achieve the goal of having those ideas used in, and adapted to, appropriate contexts.
Bransford Brown and Cocking in their seminal work echoed the idea:
Transfer is affected by the degree to which people learn with understanding rather than merely memorize sets of facts or follow a fixed set of procedures....attempts to cover too many topics too quickly may hinder learning and subsequent transfer
Yet as late as 2007, broad statistics across multiple industry settings estimate that a mere "10% of the billions of dollars invested in training is claimed to translate to job performance - some of the blame for this depressing statistic is down to design.
Transfer may be defined as the effective and continuing application of knowledge, skills, and attitudes learned/acquired from training on the job, generalization, and subsequent maintenance of these over a certain period of time (Baldwin & Ford, 1988; Broad, 1997; Ford & Weissbein, 1997; Xiao, 1996)
Dewey, John. Democracy and Education. New York: The Free Press.1996. (Fisrt published in 1916).
Wiggins, Grant, & McTighe, Jay. Understanding By Design. Upper Saddle River: Pearson/Merrill Prentice Hall. 2006.
Bransford, John, Brown, Ann L., & Cocking, Rodney R (2000). How People Learn: Brain, Mind, Experience, and School. Washington DC: National Academy Press.