Alan B. Knox

Proficiency Theory of Adult Learning.

Abstract The authors theory of adult learning and teaching uses proficiency as a unifying concept to relate acquisition of knowledge, skills, and attitudes to improved performance, which motivates much adult learning. Proficiency is the capability to perform given the opportunity. An interest in enhanced proficiency encourages adults to engage and persist in learning activities. Effective adult learning is transactional and developmental, with periodic assessment of discrepancies between current and desired proficiency to assess needs, set objective, organize learning activities, and evaluate progress. Experience, learning effectiveness, sense of proficiency, and commitment to enhance proficiency affect the adults search for meaning which entails acquisition of new learnings and reorganization of old. Effective teaching-learning transactions encourage adult learners to assume major responsibility for objectives and pacing, combine an overview of content with emphasis on important aspects, and contain a sequence of activities that encourages persistence in learning activities and use of new learnings.

Designing for diversity: Are field-dependent learners less suited to distance education programs of instruction?

Some persons may be better suited than others to the correspondence mode of instruction. The characteristics associated with the cognitive style of field-independence are similar to those which are assumed to be important for correspondence study. The present study investigated whether students who register for correspondence study tend more toward field-independence. In addition, the study investigated whether field-dependent students were more likely to drop out of their correspondence courses than field-independent students and whether field-dependent students evaluate their correspondence study experience less positively than field-independent students. The results confirmed that participation in correspondence study is associated with the cognitive style of field-independence. No significant differences were found in either persistence behavior or student evaluations of correspondence study between the field-dependent and the field-independent subjects. The absence of such differences was attributed to the finding that the subjects in the study tended more toward the cognitive style of field-independence than normative groups. The study concluded that the cognitive style of field-dependence/independence may have significant implications for the design and delivery of distance education programs of instruction, such as correspondence study.

Adult Education and Adult Life Cycle

life as being highly interrelated. Raising the question &dquo;why do people participate in adult education programs&dquo; necessitates not only an analytic framework but requires a conceptualization of the problem within the total range of activities in which individuals participate. A conceptual framework with utility for research on participation by adults in educative activity should not only provide a basis for dealing with the major elements related to this domain, but also be adequate to deal

Organization development strategies for continuing medical education

Background: The purpose of this study was to identify organizational strategies for improving staff performance in primary care practices. The study rationale was based on theory, research, and practice regarding educational interventions that help people help themselves. Analysis of qualitative and quantitative data produced both plausible explanations of organizational change and implications for future efforts. Methods: The Health Education and Research Trial (HEART) Project was an experimental study designed to improve prevention services for cardiovascular disease. Primary care clinics were randomized into four experimental treatments. Two representative practices from each treatment arm were chosen for an in‐depth cross‐case analysis. Extensive data from each selected practice included patient medical record reviews and questionnaires, interviews and questionnaires from physicians and clinic staff, project records, and follow‐up interviews. After detailed case descriptions were created for each practice, a cross‐case analysis was performed. Results: Each practice improved cardiovascular prevention services somewhat. However, there was a great range of impact, likely reflecting both experimental intervention and local contingencies. Eight positive influences were identified: effective leadership, priority setting, joint planning, cooperation and teamwork, acquisition of resources, increased support and ownership, accomplishment of improvements, and personal changes. Major influences that hindered improvement included patient load, turmoil related to reorganization, lack of widespread routines, hospital‐affiliated practice, poor communication, and fragmentation within a clinic. Findings: Continuing medical education providers can enhance preventive services to improve patient health status by promoting organizational change. Suggested strategies supported by this study include selecting able leaders, focusing on accomplishments, obtaining agreement on prevention priorities, addressing local contingencies, increasing teamwork, engaging in joint planning, emphasizing quality improvement, acquiring resources, encouraging persistence, and reducing hindrances.

Organizational Dynamics in University Continuing Professional Education

A recent national study analyzed university based continuing professional education efforts in five fields — medicine, pharmacy, social work, education, and law. Persons who coordinate such efforts were interviewed. The sample of institutions was a small but somewhat representative selection of major universities that contain most or all of the five professional schools, at least one of which was perceived as having an outstanding con tinuing professional education effort. Case descriptions for each effort were analyzed within and across fields. The efforts varied greatly in their vitality, as reflected in program expansion and innovativeness. Three major characteristics associated with vitality were educational leadership, obtaining support, and involvement of practitioners.

Motivation to Participate and Learn in Adult Education

to participate in educative activities, the adult educator could be more effective in attracting the people who can benefit most from his program, with happy results in terms of holding power, satisfaction and word-ofmouth promotion. Another example relates to the orientation of faculty who will be teaching adults for the first time. With a better understanding of the psychological and social influences on adults that result in greater

Achievement and Withdrawal in University Adult Education Classes

million adults enrolled in college and university classes for adults will probably more than double in the next fifteen years. Johnstone23 in projections based on a national NORC study, estimated that in 1962 there were 3,440,000 registrations in all college and university adult education programs. Frandson18 estimated a doubling of enrollment within fifteen years. Paralleling this increase in university adult education class participants, the projections of enrollments by full time college students are equally dramatic. These enrollment pres-

Persistence in University Adult Education Classes

persistence of others. Failure to reenroll may indicate that the adult has achieved his objective when he has completed the first adult education course, or it may be that the first experience discouraged him from further educational efforts. Similarly, persistence through several adult education courses may indicate commendable progress towards a long-term educational objective, or it could mean that the adult student has failed

Reflections on CME Congress 2012

This commentary reflects my impressions of CME Congress 2012, a provocative international conference on professional development and quality improvement in the health professions that took place in Toronto, Ontario, last spring. I attended all of the plenary general sessions and one of the 4 to 10 concurrent sessions offered in each time slot, and had read recent articles by many of the other concurrent session presenters. Because I had no major obligations beyond being an attendee, I enjoyed the luxury of mainly listening and reflecting. The sessions I attended and conversations I had with other attendees were interpreted through the lens of my many years as a scholar and practitioner in adult education as well as my experience and beliefs regarding what the scope of professional development for the health occupations should be. I believe that promoting health and well-being requires that stakeholders understand and act at multiple levels, including the societal (policies, standards, resources), organizational (health care, teamwork, educational), and interpersonal (practitioners, patients, caregivers). Progress in continuing professional development depends on cooperation among a broad scope of stakeholders, including policy makers, administrators, funders, coordinators, instructors, participants/practitioners, and patients. The practitioners and scholars who took part in Congress 2012 did much to broaden our understanding of these connections and contribute to our shared goal of learning how to improve health. The comments I offer in this commentary are intended for anyone in any stakeholder role interested in promoting

Creativity and Learning

This article explores personal, organisational and societal perspectives on creativity, arts, and adult education. Attention to creativity in the United States has increased during the past century. Fifty years ago, scholars and practitioners interested in the arts and sciences were focused on extraordinary creative achievements. Since then the scope of such interest has expanded from innovative and useful outcomes such as paintings and inventions, to include characteristics of very creative people, their ways of working, and various influences. The scope has also broadened from a few outstanding examples to increasingly include all people and their lifelong learning in a society in which change and learning have become widespread. This article demonstrates how creative adult education can help enhance the creativity of all people in all aspects of their life. I combine my parallel experience in art and adult education to explore the beneficiaries of art; characteristics of artists; venues where creative activity takes place; and how appreciation is shown for creative endeavours. I also use artistic metaphors and combine a review of trends regarding major writings about creativity, with personal reflections about future directions to strengthen attention to creativity in adult education.