Why Won't They Learn? Part 1

Why Won't They Learn? Part 1

By Rommie L. Duckworth, LP Jul 28, 2011

This is the first in a 3-part series by EMS educator Rommie Duckworth. Rommie is a featured speaker at EMS World Expo in Las Vegas, NV, August 31-September 2, and will speak on this topic on August 31 and on managing the first five minutes of an MCI on September 1.

"What's the normal range for blood glucose?" Students with blank faces stare back at you. You think to yourself, "They went over this in the last class. I know it was taught. I just taught it!"

You may be looking for improved test scores, better QA results, fewer meetings with the medical director or EMS Olympics gold. Any way you slice it, it can be tremendously frustrating when, as an educator, you put your heart and soul into learning programs but don't get the expected results.

What happens when you believe you've done all you can do, but the students still don't seem to learn? In this article, we'll examine how course content and student attitudes and abilities affect performance outcomes. More importantly, we'll look at instructors as the channel through which learners connect with the material. As educators, it doesn't matter whether we are teaching a long form course like EMT or a one-off equipment in-service class. It doesn't matter whether we are standing in front of a single student, a large group or developing e-learning content. What matters is that we are the medium through which knowledge will be acquired.

From Medium to Well-Done

So how can we make sure that we're an excellent medium, not just a medium medium? It's not just the textbook material or PowerPoint outline that the students will be taught; course content will be filtered through our own knowledge and experience about the subject. The downside of having this knowledge is the difficulty that we can have in remembering what it's like to be a beginner; what it's like to "not know." This is what psychologists call "The Curse of Knowledge,"1 a phrase that describes the struggle our minds have in imagining what it's like for someone to not know something that we know. Anyone who's ever asked a lawyer a question and felt like they needed at least two years of law school to understand the answer will know what this is like.

Once you've gained knowledge, it's extremely difficult to remember what it's like to have not known it. As an educator, you've passed the point of "know return." Because of the Curse of Knowledge, you may find yourself teaching a topic in which you have experience without realizing that you are leaving out the contextual information your students need to process this information.2

So how does a good educator avoid the Curse of Knowledge? It can take work, especially when teaching students with little background knowledge in emergency services. A great educator begins by reviewing the curriculum and seeking out the connections between what he/she is teaching and what the student already knows. How can you find and make these connections? As with anything else, you have to start at the beginning.

In the Beginning

For emergency services education, the beginning is the 1970s with Dr. Malcolm Knowles. Dr. Knowles pioneered the concepts of "andragogy" and "adult learning" that are the foundation of emergency services programs taught today. 3 As an educator, you've likely studied Dr. Knowles' theories in your instructor courses.4 Take time now to look at the curriculum you're teaching through the lens of Knowles' six core andragogical concepts. 5

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  • Adults are self-directed: In what way are your students able to direct their own learning in your program? What is the level of flexibility in the program? What is the level of interactivity?
  • Adults have experience: In what way do you connect the material you need to teach with what the students already know, either through previous learning sessions or through their own experiences?
  • Adults are goal-oriented: How clear have you made what the goal of your class or course is? Do your students or attendees know what they're trying to solve or accomplish?
  • Adults need relevance: How have you shown your students the value of what you are teaching? At what point in the program does this become clear?
  • Adults are practical: Are the practical applications of the learning content clear to all of your students?
  • Adults need respect: In what ways do you recognize your students as adults who bring their own knowledge and experiences to contribute to the classroom environment?

While it may take time and resources to review your curriculum in light of these core concepts, your payback will be well worth it. If you are having difficulty with a particular student, you may want to look at the student in light of these concepts and think, "How can I better connect with this person?" or "How can I better connect this person with the material I'm trying to teach?" The answers often become obvious once you look at the problem or question in the right way.

Next month, we will discuss how to find out why your students are in class and how to prep for specific lessons.


1. Camerer C, Loewenstein G, Weber M. The Curse of Knowledge in Economic Settings: An Experimental Analysis. The Journal of Political Economy 97(5)1232–1254, 1989.

2. Heath C, Heath D. Made to Stick: Why Some Ideas Survive and Others Die. Random House, 2007.

3. Knowles MS. The Modern Practice of Adult Education: Andragogy Versus Pedagogy. Association Press.

4. Barwell CAP. Teaching EMS: An Educator's Guide to Improved EMS Instruction. Mosby, 1995.

5. Knowles MS, Holton EF, Swanson RA. The Adult Learner, Sixth Edition: The Definitive Classic in Adult Education and Human Resource Development. Butterworth-Heinemann, 2005.

An emergency responder for more than 20 years with career and volunteer fire departments, public and private emergency medical services and hospital-based healthcare, Rom Duckworth is an internationally recognized subject matter expert, fire officer, paramedic and educator. He is currently a career fire lieutenant, EMS coordinator and an American Heart Association national faculty member.


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