ANDRAGOGY AND MEDICINE NOW

Humankind stands for its unique way of accumulating and generating knowledge and how this knowledge is transmitted through generations. As other animals do, humans learn by watching and by their own experience. But it is clear that teaching, an ever-evolving discipline, is a specialty on its own.

Pedagogy is generally the term to refer to the method and practice of teaching. Yet, back in 1833, the term andragogy was introduced by the German teacher Alexander Kapp to separately deal with adult education. Since then, several andragogists have contributed to this discipline, where Malcolm Knowles, more than a century after Alexander Kapp’s contribution, was acknowledged as the father of andragogy in the United States .

The Hippocratic Oath is perhaps the most widely known text upholding some

professional ethical standards oriented to the teaching, learning, and practice of medicine. It also binds the student to his teacher and the greater community of physicians, marking the early stages of medical training . So all physicians, as professionals, are adults trained by other adults. And, one way or another, they will further teach the science and practice of medicine to other adult colleagues or colleagues to be.

Adults are in a situation of freedom in their learning processes and they surely learn in a different way than children do. Andragogy is a term commonly used to address these differences, although it is not the only one. As with other disciplines, different orientations may be found. Some authors, especially European, make more emphasis on the social role. Others, like Malcolm Knowles representing the American approach, focus on individual development, and have a more practical orientation .

Among the principles of adult learning, self-direction could be the most distinctive one. It encompasses other principles like internal motivation, experience, usefulness, immediate applicability, and problemcentricity. According to Knowles, selfdirected learning describes a process in which the initiative is held by individuals on what, when, and how, they need to know including the way learning outcomes should be evaluated .

So, andragogy concepts have been integrated into a broader scope of selfregulated learning (SRL) environments. Online education is the area where SRL models are mostly considered. eLearning medical and non-medical programs are well embedded in adult learning theories . Of course, eLearning is not the ultimate solution. It is now more and more attractive and practical in some instances. Especially in situations where mobility is cumbersome or time-consuming. And it may save costs too. But barriers exist. A literature review on known barriers and solutions of online programs in medical education identified such issues and possible counteracting measures. Four listed hurdles, four intuitive yet supported solutions, plus the coveted online content development and delivery.

Unfortunately, many college courses continue creating curricula based on pedagogical principles. Classroom interactions and assessments should be designed to harness student experiences and self-directedness as the primary pathway to learning . Every day more, medical education is being enriched by instrumental, humanistic, transformative, and social learning theories using motivational and reflective models . So medical students and teachers can benefit from SRL techniques better serving the purpose of excellence in the medical practice.

Dealing with kids or grownups, all in all, learning processes are, and will always be an unavoidable challenge and hopefully progressing discipline for all people involved.

Castillo Silva, F. (2018). Andragogía, andragogos y sus aportaciones. Voces de la Educación, 3(6), 64-76. Andragogy and Adult Learners. https://thelearner101. wordpress.com/2019/03/11/eds-131-module-1andragogy-and-adult-learners/ Greek Medicine - The Hippocratic Oath. https://www. nlm.nih.gov/hmd/greek/greek_oath.html Svein Loeng (2017) Alexander Kapp – the first known user of the andragogy concept, International Journal of Lifelong Education, 36:6, 629-643, DOI: 10.1080/02601370.2017.1363826 Bordeianu, Otilia & Morosan-Danila, Lucia. (2014). Steps toward Lifelong Learning and Knowledge. Adult Learning Theories Archives. eLearning Industry https://elearningindustry.com/tags/adult-learningtheories 6 Reasons Why eLearning Development Costs Less Than Traditional Training - https://elearningindustry.com/ elearning-development-costs-less-than-traditionaltraining-6-reasons O’Doherty, D., Dromey, M., Lougheed, J. et al. Barriers and solutions to online learning in medical education –an integrative review. BMC Med Educ 18, 130 (2018). https:// doi.org/10.1186/s12909-018-1240-0 Conaway, Wendy & Zorn Arnold, Barbara. (2015). The Keys to Online Learning for Adults: The Six Principles of Andragogy. Distance Learning. 12. 37. David C. M. Taylor & Hossam Hamdy (2013) Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83, Medical Teacher, 35:11, e1561-e1572, DOI: 10.3109/0142159X.2013.828153

Thor Nissen

Doctor, graduate in Clinical Pharmacology and MBA in Quality Management. He has managed to collaborate for the development of medicines in world leading pharmaceutical companies both in medical matters and in clinical research in new drugs, regulation, marketing and sales departments.