Adult Education Guide

There are several purposes for adult education. The most immediate purpose is to upgrade and optimize the way people perform their jobs so that the quality of the product is continually improved. Additionally, adult education should enhance the growth and development of the participants as individuals, and provide them with the knowledge and skills to proactively improve societal norms and values. In the context of the IV Admixtures program, these purposes can be described by the following desired outcomes.

The participants will perform their duties in a standardized way that improves the quality of IV
admixtures produced, resulting in fewer errors and less contamination.
The participants will have an increased appreciation for the importance and complexity of their
role, enhancing their sense of professionalism and self-worth.
The participants will be better able to provide information and leadership in their professional
organizations and communities that will lead to a higher standard of health care practice.

Characteristics of Adult Learners

Learning is the act of the student. It is the desired outcome the teacher or preceptor is attempting to achieve. There are many techniques that are based upon certain key characteristics of adult learners which may be used by the preceptor to encourage learning on the part of the adult student.

Adult learners are generally motivated to learn, particularly when they can apply the information
immediately to their present situation. This is known as functional immediacy and requires the
incorporation of examples and relevant exercises that relate the information presented directly
to their daily problems.
Adult learners will often have basic background knowledge and experience upon which learning
of new concepts can be built. This is known as the building block method of learning, and is
best accomplished with discussions and testing designed to determine the student’s levels of
existing knowledge, and to reinforce fundamentals prior to the presentation of new material.
It is intended to support the new information, while taking advantage of the student’s experience.

Characteristics of the Adult Learning Process

Characteristics of the adult learning process also suggest strategies that can be used to encourage learning on the part of adult students.

Learning is best accomplished when new skills and information build upon existing knowledge,
which is another reason pre-teaching evaluations and exercises can be valuable to the preceptor.
Adults learn best when a variety of overlapping teaching methods are used. The Aseptic
Compounding program incorporates videos to provide a visual/spoken format, and manuals to
provide a written format. By using some of the suggested techniques discussed later in this
manual, the preceptor can incorporate physical activities (such as guided practice), group
activities, and self-directed exercises to enhance the learning experience.
Adults learn both independently, and in interdependent ways. Exercises which encourage
interdependent learning are particularly useful in a situation such as an IV Admixtures program,
because students need to work cooperatively as a team in this occupation.

Transfer of Learning

Transfer of Learning is the process of incorporating learned information into daily practices.

Participants should be encouraged to identify ways new knowledge can be integrated into
changes in daily practices.
Guided practice sessions should be conducted to help participants develop the physical
proficiency required to transfer learning.
Participants should be encouraged to identify barriers to this transfer of learning and develop
strategies to overcome them.
- Participant-based barriers may be insufficient background knowledge,
  disinterest in improvement, negative social attitudes, or lack of time to
  develop required skills.
- Program-based barriers may be irrelevant, poorly-developed, or isolated
  computer-training programs, poor teaching skills and practices,
  inadequate enthusiasm or emphasis on application, insufficient follow-up,
  or unrealistic expectations.
- Organization-based barriers may include a lack of concrete organizational
  support, inadequate plans or allocation of resources for adoption of new
  processes, lack of recognition of achievements, or a reward system that
  works against change.
- Follow-up activities should be carried out to verify and reinforce change.

A Phased Approach to Facilitating Desired Learning Outcomes

Phase 1: Informing the Student

Most students want to do well and achieve the goals set for them:
- Many of us have encountered the teacher who believes that providing a
  list of concrete objectives will limit the students' learning to just those
  stated goals, and decides to keep the criteria for success a secret.
- Nothing is more frustrating, counter-productive, or destructive of the
  student-teacher relationship than creating a contest atmosphere. Such
  teachers are not adequately discharging their responsibility to facilitate
  learning.
- Well-chosen learning objectives will assure that the student acquires
  all of the knowledge and skills to achieve the desired concrete outcomes.
  They provide a road map to the student, and foster confidence that the
  teacher is there to assist them in achieving success.
The students should be informed about the learning experience so they know what the desired
outcome(s) will be.
- The concrete learning objectives for each section should be clearly defined.
  It is suggested that they be read and reviewed aloud, one at a time.
- After each objective is read the students should be queried to assure that
  they understand the objective and what will be expected of them.

Phase 2: Preparing the Student

Many of us have had the experience of watching a film more than once, and seeing new things in it each time, which were completely missed on the first viewing. In the best entertainment films, this can be a pleasurable effect. In the worst, we don't get enough during the first viewing to enjoy the film, and never watch it again. When presenting films for the purpose of education, it is imperative that the student get it on the first viewing. Evaluating the students' reaction to a film, and pacing the interval(s) of delivery are therefore important.

The Audio-Visual Viewing Guide is designed to assist the student by outlining important concepts
as they are presented.
Several strategies can be used by the preceptor to prepare the student for viewing, to maximize the
value of the experience.
- Assessment of Student Background Knowledge
  An assessment of background knowledge provides important information.
  It allows the Preceptor to fill in any gaps in assumed foundation knowledge,
  correct misinformation, and reinforce concepts that will underpin new materials
  to be presented. Care should be taken during this portion of the learning
  experience to correct any wrong information possessed by the students.
- Building Bridges
  Information collected during pre-program assessments should be organized and
  formalized in a way that will support the transition to each new concept to be
  presented. Providing the student with logical bridges from their existing knowledge
  base to the new concepts will greatly increase their interest and ability to organize
  and retain new information as they encounter it.
- A brief Preview Discussion of the film(s) is recommended to increase anticipation
  and expectations of the viewer.

Phase 3: Presenting Information

Primacy
The educational principle of Primacy is based upon the fact that what is learned the first time is usually
what is retained. This has several consequences that must be taken into account when educating adult learners.
- Participants may have to unlearn incorrect information or techniques acquired
  during previous experiences that they regard as accurate. This is usually more
  difficult than learning new information, and requires thoughtful, planned teaching
  techniques.
- Extreme care must be taken to avoid imparting incorrect information.
Intensity
The educational principle of Intensity is based upon the fact that what is learned must be intense enough
to be retained. Uninteresting, yet essential precepts must be conveyed to the adult learner with sufficient
intensity to ensure retention and use in day-to-day practice. This may be accomplished in a number of ways:
- Important concepts or ideas contained in written material should emphasized by
  use of color, highlighting, underlining, or italicizing. The use of a highlighter is
  recommended as a reading tool for important material that is otherwise indiscernible
  from its context.
- The use of humor, irony, or incongruity is beneficial in creating dynamic and memorable
  concepts, which may easily be inserted into the adult’s long-term memory. However,
  sensitivity and care should be exercised to avoid humor or anecdotes that may be
  personally offensive to some individuals. Establish limits at the socially acceptable norm.
- The use of illustrations, brief stories, and most especially artifacts (i.e., tools of the trade)
  is especially valuable in enhancing the intensity of most subject matter.
- Written materials, films, and all other instructional aides used by the preceptor should
  be evaluated for their ability to add intensity to the subject matter.
- It is important to develop reasonable styles of conversation and analysis which
  maximize intensity in the presentation of otherwise dull materials and concepts
Repetition
Knowledge is transferred from short- to long-term memory when it is repeated, which signals the brain that
the information is important. However, care must be taken to make these repetitions informational, and
prevent boredom.
- The key concepts are presented at least twice in the course materials; once
  audio-visually, and once in the written form. The instructor should then incorporate a
  method of presenting each concept in a hands-on way, such as through group
  discussion of practical application or guided practice of skills.
- In developing course materials, key concepts can also be repeated by mentioning
  their application in various settings, as frequently as is appropriate.

Phase 4: Implanting the Knowledge and Transfer of Learning

Transfer from Short-Term to Long-Term Memory
Most information resides in the short-term memory for a few minutes and then vanishes, unless strategies
are employed to transfer it to the long-term memory. Repetition is one way to accomplish this, as is
presenting information in several, overlapping and different ways (visually, verbally, written). Another excellent
way to implant new information in the long-term memory is to immediately apply it to problem solving, through
play acting.
Transfer of Learning to Daily Practice
Even when information is retained in the long-term memory, it will not necessarily be incorporated into actual
practice. The process of transforming knowledge to actions is called transfer of learning. In most cases,
this does not happen all by itself, and the job of the preceptor does not end until this concrete outcome has
occurred. It is, therefore, important to prepare for the transfer of learning while information is still fresh, and the
student’s interest is still high.

Phase 5: Closing the Loop; Assessment and Correction of Deficiencies

Formal Assessments
- A written test of factual knowledge will help the preceptor and the student
  identify concepts that were poorly understood or not effectively transferred
  to the long-term memory.
- An observed practical skills test will measure the transfer of knowledge to
  practical applications. The student should be familiarized with the process
  that will be observed, and the criteria by which performance will be assessed.
Retraining
Retraining should be based upon an assessment of the written and practical skills test. The instructor must
first identify the key concept(s) that relate to the missed questions or inadequate skills. Elicit the student’s
engagement in this process, and ask the student what aides, practice, or other information he or she feels
would be beneficial. Sometimes, it is useful to have the student try to teach the information. (The process
of teaching is often the best way to learn a subject.)
Assessment of Retraining
The written test following the retraining process should emphasize the subject area of difficulty. If the problems
were skills-based, several repetitions of the problematic processes should be performed to assure consistency.
Ongoing Assessment and Reinforcement
The ongoing assessment and reinforcement of learned skills is the most important component in achieving
desired concrete outcomes:
- The ongoing assessment should use the same criteria as the formal
  post-test of practical skills.
- Corrective observations should be presented in a supportive, not a critical, format.
- Personnel within the group should be encouraged to provide each other
  with positive reinforcement.