EMS Field Instruction: Part 2--Adult Learning

The first article in this four-part series, Elements of an Effective Field Instruction Program, was written for managers who want to start or improve a field instructor (FI) program. This article addresses some leading theories about how adults learn. Recognizing different learning types will help instructors tailor their training to meet the needs of trainees.

One of the most obvious differences between child and adult education is that the teacher of children is more advanced in all areas, not just the subject being taught, which leads to a dominant/dependent relationship between teacher and pupil. Also, due to their much shorter life experience, children are more homogeneous in their views and experiences, making it easier to predict learning outcomes and to prepare a teaching curriculum.

As a teacher of adults, however, you are only considered to be more advanced in the subject that you are teaching. This makes the dynamic relationship between teacher and students more equal. Because older adults have had a larger number of life experiences, our program should be flexible and customizable to some degree.

Motivation

An adult who wants to learn has a huge edge on one who does not. In The Adult Learner, R. J. Wlodowski writes about four important elements that add up to effective motivation:

• Success: Adults want to succeed at learning.
• Volition: Adults want to feel they have choices in learning.
• Value: Adults want to learn something that is worthwhile.
• Enjoyment. Adults want to enjoy learning.¹

How can you apply these four ideas to your teaching? Involve your trainees in goal selection and choices on how to achieve those goals. Provide clear objectives so success can be clearly documented, and make it a point to have some fun along the way.

Adults need to know why they need to learn something before they begin.¹ If a student is resisting the learning process, find a way to show him the "need to know." If you can sell him on why, he will apply himself more eagerly.

Competence

The competence model is very relevant to us, as the field instruction process is largely about creating and verifying competence in all areas of EMS. The four stages of competence are presented here on a continuum from least to most desirable:

• Stage 1: Unconscious incompetence. You can't do it, don't know it, and aren't even aware that it exists.
• Stage 2: Conscious incompetence. You can't do it, don't know it, but you are aware of the fact that you can't.
• Stage 3: Conscious competence. You can do it, can know it, but you have to think about it.
• Stage 4: Unconscious competence. You can do it, can know it, and don't have to think about it.

If you have ever seen someone do something so effortlessly it left you amazed, it was Stage 4 competence. Any master EMS provider has developed it (or an expert in any field, for that matter). They know the patient needs an emergent return without thinking about it--they "just know." This ability is actually the result of a long period of learning, experience, practice and streamlining within the brain. Intuition falls into the realm of Stage 4 competence. Your brain knows something, but you're not sure how you know. You just have a feeling. To explain it, you would have to access your Stage 3 knowledge.

It has been suggested there is a fifth stage of competence that applies to those facilitating others in progressing anywhere from Stage 1 to Stage 4. Since the art of teaching is not simply the ability to express Stage 3, it requires more information than just that subject matter itself. This fifth stage is not yet commonly accepted or codified (www.businessballs.com).²