Faculty Support—eLearning

Module 1

How people learn

What you need to know to succeed in AO’s
online course for Faculty.

nnin g
3–Ru ctical
iving a a pra rcise
2–G ure exe
lect

erating
ilitating 5–Modebating
4-Fac l group and d
smal ssions
discu
Faculty Support

Contents For best use…

Born to learn  4 The “How people learn” module consists of this booklet and
an online course.
The learning cycle  5
How we retain Booklet:
information  6 Designed to provide a practical guide to the learning theories and
principles that help us understand how adults learn best.
Different learning
styles  7
Online component:
How to plan learning • Knowledge check
activities  9 • Summary
The seven principles  10
In this module (and throughout the AO Faculty Learning Program)
Learning outcomes  11 you will explore how to apply the key principles of learning. This
will ensure best practice how learning programs are designed
How to structure the learning
and delivered.
experience  12
Giving and receiving
feedback  13
Next steps  14
Learning outcomes

After completion of this module, you should be able to:

• Define learning
• Demonstrate the learning cycle
• Describe how knowing about learning domains, styles,
and types of adult learners, can improve teaching
• Identify the learning experiences that will produce the
highest rates of learner retention
• Outline the 7 principles of teaching for learning in structuring
learning programs
• Write meaningful learning outcome statements
•P lan and structure a learning session
•R eflect on how feedback can be used to improve learning

There are five modules, which complement Crosslinks:

each other. Together they give a thorough
and up-to-date overview of the most relevant Booklet
refers from online exercise to booklets
aspects of teaching others.

Action plan
Module 1: How people learn

Module 2: Giving a lecture Knowledge check

Module 3: Running a practical exercise

Module 4: Facilitating small Online exercise

group discussions

Module 5: Moderating and debating

Summary

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 eLearning Module 1

LEADING TO LEARN
Teaching is a combination of leadership and art. Great teachers,
like great leaders, are capable of inspiring others into surpassing
themselves. But what is the difference between the good and the
great? It is said that “the good teacher explains”, but “the great
teacher inspires”. However, there can be no inspiration without a
polished delivery. The old adage “it’s not just what you say but also
how you say it” holds especially true for teaching.

The AO eLearning course provides AO faculty members with

the tools and know-how that can make a real difference to their
teaching. Consisting of an online self-evaluation component
together with booklets (as downloadable PDFs), the information is
conveyed in an interactive manner, allowing immediate feedback.
With the online exercises, you can assess your current level
of knowledge and test the new skills you gained. The booklets
complement the online course, providing a concise overview of the
key principles of teaching and learning.

AO eLearning should inspire you to motivate learners and

peers alike.

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Faculty Support

Born to learn

“If you hold a

cat by the tail you
learn things you
We have all learned a great deal in our
life. From the day we were born,
and even before, our brains were ready to
words, there is an experience (or more prob-
ably a series of experiences) at the heart of
the learning process.
cannot learn any capture our experiences and encode them
into a web of nerve connections. Childhood Example 1:
other way.” behavior specialists believe that we learn 80% A young girl riding a bike will be able to
of everything we will ever have absorbed by say she has learned how to ride when the
Mark Twain; the time we are five years old. Think about stabilizers come off and she can move along,
(1835–1910) this: each child moves from being unable balancing on two wheels without falling
American writer and humorist
to focus their own eyes to being the only over. She will have learned how to do a dif-
person in the household who can program ferent thing.
the VCR in just five short years! Each of us
is essentially a learning machine. Example 2:
A trauma surgeon may have learned how to
What is learning? insert a locking compression plate; mastery
So, what is this learning? There’s a simple of this new technique would save time and
and broad definition we can use: Learning vastly improve the results of the procedure.
is a change in practice as the result of an She or he will have learned how to do some-
experience. thing differently.

Let’s break this definition down… Learning with understanding

As with the examples above, knowing
For learning to have happened there must things and applying what we know is key
be a change in practice—the learner should to the ability to do things well. Gaining new
be able to do different things or do something knowledge is part of the journey, but not
differently. Learning, as we define it, cannot the destination.
Remember this...
be achieved in either of these examples by
Learning is a change simply acquiring knowledge as they both
in practice as the result
of an experience. require an opportunity to practice. In other
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 eLearning Module 1

The learning cycle

“ I have 25 years’
experience
often really means:
I have one year’s
experience, and it
is 25 years old.”

Claus Møller;
Danish business economist

In 1984, an American academic called

David Kolb published a book called
“Experiential Learning—Experience as the
Stage 1—Experience
This can be any kind of input or stimulus,
for example:
and consultant

Source of Learning and Development”. • Something that has gone wrong, such
as a surgical procedure or a small boy
In it, David Kolb describes a four-stage model falling from his bike.
of “learning by doing” that explains a full • A more formal input, such as an
range of events leading to learning: exercise, a lecture from an expert, or
information from a book or website.
• Experience
• Observation and reflection Stage 2—Observation
• Thinking and theorizing This is when we try to make sense of our
• Action, planning, and experimenting experience by reflecting upon it:
• Does this change anything?
Essentially, the cycle is continuous: there is • Are there any generalizations of
no start or end point. principles which can be drawn here?

We can break down the acquisition of a new Stage 3—Thinking

Remember this...
skill as one journey around the cycle, but This is the stage of the journey when we can
in fact we will go around the cycle repeat- logically analyze the theory and application Design learning activities or
programs to include each
edly as we seek mastery of a new skill— of what we have learned. element of the learning cycle:
continuously improving and changing our
• A n input or stimulus.
practice. Working around the learning cycle Stage 4—Action
helps to identify key elements which should This is the real action stage and involves • T ime for reflection.
go into the design and delivery of learning the learner putting in practice what they • T heory—old, new, and
programs. have learned. practical application.
•A
 ctive involvement: trying
Of course, once we have carried out our out a new technique or
planning the next step or
action, we have another experience where
“experience”.
5 we can observe what happens and the cycle
begins all over again.
Knowledge check 5
Faculty Support

How we retain
information
Learning Pyramid: developed by NTL
“The mediocre Institute for Applied Behavioral Science,
Bethel, Maine (1960s)
teacher tells. The
good teacher
explains. The
superior teacher
demonstrates.
The great teacher
inspires.”

William Arthur Ward;

(1921–1994)
American educator and
inspirational writer

Why doafterweweremember some things long

have been taught them
ported by the latest neuroscientific research
about the way the brain functions and how
and forget others almost straight away? As we remember things.
a general rule, the amount of retention will
be directly affected by the quality of the There is no single part of the brain used to
original learning process. store memories—in fact, there are five:
Simply stated, if you did not learn the informa- • Working memory (very short term)
tion well initially, you will not remember it well • Implicit memory (autopilot)
Remember this...
either. • Remote memory (data)
Provide context, triggers, and • Episodic memory (personal
active learning:
The Learning Pyramid is often used to illus- experiences)
•P
 eople need to know why trate that the more multisensory and active • Semantic memory (meanings of things,
they are learning something:
give a practical focus/
a learning activity is, the greater the reten- such as words and symbols)
relevance to their work and tion rate. There is much evidence that active
experiences. learning—discussions, practicals, teaching Context counts
• People
 have a repository others—is more effective than traditional Studies have shown that we can retrieve
of real life experiences that passive methods, such as lecturing, showing almost everything from our various memo-
should be tapped into as a videos, or giving demonstrations. (Although ries. However, the ease with which we do
resource for ongoing learning. there is some discussion about the precise this depends on the strength and processing
•P
 eople use a hands-on percentage figures used on the Learning of the initial input and/or triggers which
problem-solving approach to Pyramid.) place the learning into context.
learning.
•P
 eople want to apply Different memories Now again the importance of multisensory
new knowledge and skills
For example, you are more likely to learn and learning becomes clear. When several senses
immediately. Retention
decreases if the learning is remember the steps you need to take when are simultaneously involved and the mes-
applied only at some future repairing a dural tear by having “hands-on” sage is being received through a number of
point in time. practice and by explaining the procedure different channels, it stands a better chance
Based on Malcolm S Knowles to someone else, than just by attending a of remaining prominent—make the learning
“Theories of Adult Learning” ­lecture about it. This pattern is also sup- active, make it personal—make it episodic!
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6 Knowledge check
 eLearning Module 1

Different learning styles

Cognitive

knowledge,
facts, intellectual skills

“The key to wisdom

Psychomotor Affective is this—constant
skills, doing, coordinated attitudes, feelings, and frequent
physical activity beliefs, emotions,
mindsets, values questioning... for by
doubting we are led
to question and by
questioning we arrive
at the truth.”

Pierre Abélard;
(1079–1142)

The “Taxonomy of Educational

Objectives” published in 1956
by the American cognitive psychologist
Learning styles
As well as there being different “domains” of
learning, there are also differences between
French scholastic philosopher
and theologian

­Benjamin Bloom, identifies three domains learners.

of learning:
In terms of learning, this means that every
Cognitive (knowing) person has their own individual learning
Intellectual skills and abilities style, a preferred way of using their abilities.
Example: diagnosing a disease or develop- People will tend to learn more effectively
ing a strategy. if learning is orientated toward their own
dominant “preference”.
Psychomotor (skills, doing)
Skills that require varying levels of well- Appreciating these preferences can serve as
coordinated physical activity a guide when we design learning experi-
Example: suturing an open wound or per- ences to match (or mismatch) the learners’
forming a complex surgical procedure. styles.

Affective (attitude, feelings) Learning style models

• Dealing with feelings, emotions, There are three well used learning style
mindsets, and values models that help explain different learn-
• Nurturing desirable personal and ing preferences:
professional attitudes
Example: displaying ethical values 1. Visual, auditory, kinesthetic (VAK):
and mutual trust in working with The basic idea is that everyone has a dominant
healthcare teams. sense and this creates the preferred channel
for receiving and processing material:
We can visualize effective learning as using • Learning by seeing (visual)
each of these domains—at appropriate times­- • Learning by listening (auditory)
—to achieve “praxis” (the successful performance • Learning by doing (kinesthetic)
7 application of skill).
or

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Faculty Support

Different learning styles

Visual learner
Learns best by seeing

Auditory learner Feeling

Learns best by hearing

Kinesthetic learner
Learns best by feeling or experiencing
Doing Watching
Visual, auditory, kinesthetic (VAK) learning style

Thinking
Activist
Kolb’s learning style
Concrete experience

Pragmatist Reflector
Remember this... Testing implications of Observations
•A
 ccommodate learners’ concepts in new situations and reflections
needs and styles.
•C
 over all three learning Theorist
domains, knowledge, skill, Formation of abstract
and attitude. concepts and generalization
•P
 lan learning experiences to
Honey and Mumford learning style
include visual, auditory, and
kinesthetic elements.
•A
 ccommodate different
learning preferences
(watching, feeling, thinking, 2. Kolb’s learning styles Types of adult learners
and doing) throughout an The American educational theorist David A Personality-based learning style can also
activity or program. Kolb explained learning styles as a product be useful to ensure effective learning. The
• Adapt
 activities or teaching of two decisions: American educator and human resources
styles to the personalities • How we approach a task (we learn expert Geri E McArdle identifies 5 main
and types of adult learners.
either by watching or by doing). types of adult learners:
• How we respond emotionally (we learn
either by thinking or by feeling). Confident —wants to know the reasons why
and likes to be involved.
3. Honey and Mumford Affective —likes to be reassured of doing OK
British psychologist Peter Honey and Alan and wants to feel an emotional connection
Mumford defined four distinct learning to the trainer. Enjoys to be invited to join.
styles based on Kolb’s theory and experi- Transitional —has been promoted or moved
ential learning cycle: to a new job and wants to know how to apply
• Reflector—observes and reflects (learns new knowledge. Can be hesitant and needs
by watching and feeling) reassurance of being capable.
• Theorist—wants to understand Integrated —usually self-directed and wants
underlying reasons and concepts (learns the freedom to carry out assignments without
by watching and thinking) much guidance.
• Pragmatist—likes to “have a go” (learns Risk-taking —thrives on new skills and infor-
by doing and thinking) mation. Likes to deviate from the course
• Activist—prefers hands-on experiences curriculum if this will give more informa-
(learns by doing and feeling) tion.

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8 Knowledge check
 eLearning Module 1

How to plan
learning activities

“You don’t
understand
anything until you
learn it more than
one way.”

Marvin Minsky;
American cognitive
scientist in the field of
artificial intelligence

What learning is required? Inter-

estingly, there is often a mis-
match between an organization’s professional
Evaluating types of learning activities
Let’s consider some other questions when
evaluating types of learning experiences:
competencies and the training activities it • Are learners given a chance to do and felt
offers. This is because professional competen- as well as know?
cies are mainly skills-based whereas training • Do the planned activities cover a whole
is often knowledge-based. range of preferred learning styles?
• Is the learning program structured to
Also, much organizational training is focused allow progression?
on “low-order” skills such as “recalling facts” • Do learners only imitate (copy) new
or “understanding procedures” whereas the skills or do they progress to a level where
workplace requires more “higher-order” skills they could also demonstrate and teach
like “applying knowledge”, “assessing situ- others?
ations”, or “making decisions”.
As we have seen earlier, in order to maxi- Remember this...
Think about: Are we using lectures when more mize effective learning, activities need to Use a range of different
group discussions and practical sessions would be engaging, relevant, and memorable. They learning activities, including:
be more effective? should also incorporate theory, practice, • Lectures,
 quizzes, videos,
and reflection. and expert talks
Bloom’s taxonomy • Research,
 observations, and
A very useful tool to ensure progression interviews
within a learning program is Benjamin • Practicals and peer tutoring
Bloom’s taxonomy (see table). It shows how
• Group
 discussions and
learning can be structured brainstorming sessions
to help the learner achieve Bloom’s Taxonomy
• Role
 play and problem-
higher order skills in all three Cognitive Psychomotor Affective
Knowledge Doing/skills Attitude solving games
learning domains (cognitive,
Recall data (facts) Imitate (copy) Receive(awareness) 1 • Case-studies and debates
1= low-order skill

psychomotor, affective) and

Understand Manipulate (with Respond (react) • Technology-based

applies to skills-based as well 2
(comprehend) instructions)
learning/self-learning and
as knowledge-based compe- Apply (use) Develop (precision) Appreciate values 3
assessment
5 = high-order skills

tencies. Analyze Articulate (explain/ Personalize value

4
teach) system • Personal
 action planning
Synthesize (create/ Automatic (expert level) Internalize (change and work-transfer tasks
9 build) behavior)
5

Evaluate (assess/judge) - - 6
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Faculty Support

The seven principles

“People rise to the

challenge, when it
is their challenge.”

James A Belasco;
American author, consultant,
and professor of management

Just as there are principles for man-

aging fractures, there are also
principles of teaching. The following seven
• Every session should be meaningful. Can
the learners actually “use” the content
of the session? The content needs to be
principles should be incorporated into your relevant to problems they will encounter
programs: later, and be interesting too.
Motivating • Every session should be actively involving.
Meaningful Passive and dependent learners will lose
Actively involving interest. What can you do to make them
Outcome driven think? Ask questions, pose problems, or
Based on capacity to learn present cases or situations which require
Incorporating reflection individual solutions.
Remember this... With feedback • Every session should be outcome driven.
Maybe this has happened What should the learner be able to do
to you as well: You bought a Let’s look at these principles in detail: or know by the end of the session? By
new car and suddenly you see • Every session should be motivating . making outcomes your starting point,
the same model on the roads Motivation is a major factor in learning. you can ensure your learning strategy is
everywhere.
If you want to make sure that somebody effective.
You ask yourself “Where learns you have to communicate the goal • Every session should be based on a capacity
have they all come from?”—to
which there is a simple
and that the learner is motivated to achieve to learn. Have you pitched the session at
answer: The cars have always that goal: the correct level? If the level is too low,
been there, but now as you – Use novelty and variety learners will be bored. If the level is too
bought this very same model – Pay attention to learners’ needs— high, they will lose concentration.
you have a “reason” to see starting with their basic needs. • Every session should incorporate reflection.
them.
If people are cold or thirsty their After each learning session give the
(RAS, the reticular activating attention will not be on your subject. participants time to reflect and consider
system in our brain decides
– Give the “big picture”—where a the relevance in their own context.
what we pay attention to,
it also determines if we are session fits in with what’s gone before • Every session should incorporate feedback.
highly motivated or bored.) and what it will lead to. Feedback is the fuel that drives improved
– Plan with learners—draw out performance.
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10 Knowledge check
 eLearning Module 1

Learning outcomes

Remember this...
A learning outcome can
be many things, not
just acquiring
specific knowledge.
The learner should
be able…
…to apply
…to construct
…to design
…to empathize
…to interpret
…to recognize
…to predict
…to play
…to list

Have you ever been tempted to use

a learning activity because it’s
the one you always use, without fully con-
“Upon successful completion of this ses-
sion, you (the participant/learner) will be
able to…”
sidering what it needs to achieve in terms
of learning? Each individual learning outcome can then
be listed. It will normally be broken into
A learning outcome states what a learner is three main components:
expected to know, understand, or be able to • An action or performance verb that
do at the end of the learning activity. Having identifies the performance
good, clear learning outcomes puts the focus • A noun that specifies what will be
on learning rather than teaching. This can: demonstrated
• help students by explaining what is • Other criteria that specify the purpose
expected of them and how the activity of the performance (if appropriate) “If you don’t know
will contribute to success. where you are
• help staff to focus on exactly what they Examples of learning outcomes:
want students to achieve in terms of going, any road will
Domain Action or Noun Other
both knowledge, skills, and attitudes. performance criteria get you there.”
verb
Knowledge Explain the patient that may
Ask yourself: Have you ever been tempted to use a characteristics affect Lewis Carroll;
learning activity because it’s the one you always treatment (1832–1898)
planning
use, without fully considering what it needs to English author (Alice’s
achieve in terms of learning? Skill Classify injuries to select Adventures in Wonderland)
optimal
treatment
How to express learning outcomes Recognize the need to another
Attitude
Learning outcomes refer to observable and to refer the specialist
patient
measurable knowledge, skills, and atti-
tudes.
Learning outcomes should be written from This way learning outcomes can be used as
the point of view of the learner and should an “audit tool” to guarantee that the learning
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start by using a phrase such as: experience will generate the required result.

Knowledge check 11
Faculty Support

How to structure the

learning experience
Learning activity
1 2 3 4

“We should be as
concerned with
how we teach as we
traditionally have
been concerned
with what we
teach.” Where I am Where I want
now Outcome Outcome Outcome to be
John T Bruer; 1 2 3
author and researcher

Research shows that struc-

t u r i ng le a r n-
ing—by dividing lessons into episodes or
Dialogue
The second part of a learning session should
be structured as a series of episodes:
sections—helps to maintain pace. It is also • 3–5 major learning points only! It is
a challenge and thus enhances the learning tempting to cram in as much as possible,
experience. but learners will not be able to manage
more.
Think about dividing a learning session into three • Devide the session into 10–15-minute
elements: set, dialogue, and closure. sections! Most people cannot
Remember this... concentrate longer than this.
How you engage people at Teachers often make the mistake of neglect- • Spice the content up with relevant cases
the very start can influence ing the first and last (set and close) in favor and exciting stories.
the rest of the learning of cramming in as much content as possible.
session. An attention This actually has often the opposite effect: Closure
grabbing starter activity might
be… People learn less, not more. The third part of a learning session should
have a closing or plenary element:
…a mini-quiz
Set • Actively engage learners and encourage
…a thought-provoking The first part of a learning session should them to reflect upon and articulate their
question
set the scene: learning
…a striking image • Roles and outcomes—what are you • Fully debrief outcomes of a practical
…a video clip going to do and what do you want the exercise, discussion, or debate
…a recorded speech learner to do? • Clarify, consolidate, and extend the
…a “live” performance • Context—where does your session fit in learning and how it may be transferred
to the rest of the course? and applied
…a surprise guest
• A short interactive starter activity can • Summarize key messages and
be used to get the session off to a flying emphasize the learning outcomes that
start: engaging learners and sparking have been achieved
their interest.

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12 Knowledge check
 eLearning Module 1

Giving feedback
SELF
I ask
I know I don`t know
They know
Open Blind
OTHERS

I know I don`t know

& but
others know others do know

I tell

Hidden Unknown
I know I don`t know
but &
others don`t others don`t know
They don`t know

The Johari Window

Remember this...
When giving feedback, follow

Since early childhood, we have

all been subject to a range
of feedback that has helped to shape our
Giving Feedback
Encourage “self-review” first, so that learners
have a chance to identify their own strengths
these rules:
•M
 ake it immediate
and specific
behavior and development. Children are told and weaknesses. • Make it actionable
off when they are naughty and get positive Give positive feedback to confirm success and
• M
 ake two to three
feedback when they have done well by con- achievement. Positive reinforcement—such suggestions on
forming to adult expectations. as the recognition of a successfully completed how to improve
task—releases the neurotransmitter sero- • D
 o not incorporate
The Johari Window, named after the first tonin in the brain, which releases feelings threats or sanctions
names of its inventors, American psycholo- of well-being and provides conditions for • Involve the learner,
gists Joseph Luft and Harry Ingham, is one better thinking. peers, and others
of the most useful models describing the Using constructive feedback is better than • M
 ake feedback an essential
process of human interaction. A four-paned criticism if problems occur. Make only two part of a learning cycle
“window”, as illustrated above, divides per- to three suggestions on how to improve— • Praise, praise, praise
sonal awareness into four different types, any more than this will be difficult to retain
as represented by its four quadrants: open, and act upon.
hidden, blind, and unknown. The lines
dividing the four panes are like window Planning self-improvement
shades, which can move as an interaction Seeking feedback is also a vital part of teacher
progresses. and learner development:
Feedback from learners —first, ask the learn-
Applying the Johari window one understands ers for their opinion.
the process of personal development through Feedback from faculty members —ask a
disclosure (telling others about yourself) and trusted colleague who can spend some time
feedback (receiving information about your- observing.
self from others). Identify key areas for monitoring —do I give
enough personal attention to each learner?
As a teacher think about giving and receiv- How well do I explain things? Could I use
ing feedback as an essential feature of the more questions to deepen understanding?
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learning process.

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Faculty Support

AO Foundation
vision and mission
Our vision is excellence in the surgical management
of trauma and disorders of the musculoskeletal system.
Our mission is to foster and expand our network of
health care professionals in education, research,
development and clinical investigation to achieve more
effective patient care worldwide.

“If you want to

know the taste
of a pear, you
must eat it. If you
want to know the
revolution, you
must take part in
the revolution. All
genuine knowledge
originates in direct
experience.”

Mao Zedong;
(1893–1976)
founder of the People’s
Republic of China

Copyright © 2014 by AO Foundation

Stettbachstrasse 6, 8600 Dübendorf, Switzerland
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