Abstract
Individuals have diverse characteristics that lead to different styles of learning. Teaching is an intervention designed to promote learning and accumulation of knowledge. In theory, this can be improved by matching an individual's learning style to how the individual is taught. Knowledge of learning styles can be useful for trainees for a number of reasons: improvement of their own learning techniques, participation in teaching of others or development of teaching skills in the future. This article aims to look at various models of learning styles and then discusses how teaching could be tailored to the individual to optimize the learning environment.
The GP curriculum and learning styles
Understand how adults learn Demonstrate an awareness of the differing learning styles of individuals Plan and structure a teaching episode appropriately for the learners concerned
Definition
A ‘learning style’ can be seen as the characteristics of a learner that influence the way in which that person learns. Differences between individuals shape how they learn; some prefer reflection while others need to see and practise their new skills. Understanding your preferred learning style may aid your ability to assimilate and accumulate new information.
The idea of learning styles is controversial; a systematic review by Coffield et al. (2004) discovered over 70 different styles. This article focuses on the three main learning style theories:
The first theory is based on the assumption that learners have innate or fixed traits which are tied to sensory modalities and that they learn most effectively by employing learning strategies that are linked to their preferred modality—‘modality styles’ The second uses the theory that styles are ‘flexible’ and based upon the interplay between personal characteristics and experience. This includes Kolb's learning cycle and Honey and Mumford's learning cycle/styles. The third encompasses ‘instructional’ styles and how these may be flexible depending on context and motivation
Modality styles
The modality styles theory suggests that there are four learning styles that relate to different sensory modalities. A commonly used questionnaire for discovering preferred learning style is Fleming's VARK (visual, aural, read/write, kinesthetic) which can be accessed free-of-charge via website www.vark-learn.com. The four styles are as follows:
Visual/verbal (read/write) learning style Visual/non-verbal (pictorial) learning style Tactile/kinaesthetic learning style Auditory/verbal learning style
Suitable teaching and learning approaches for each different learning style can be found in Table 1. However, it is important to remember that presenting information to learners in a variety of modalities helps all learners, no matter what their learning style preference; it allows them to integrate knowledge and assists recall by providing different representations and links to information.
Suggested learning approaches for modality learning styles
Visual/verbal learning style
Visual/verbal learners are more efficient when presented with visual information in the form of written language. They do well with the lectures that provide good slides or a suitable written outline. Textbooks and class notes are also useful. The learner will be happy to study on his or her own in a quiet room and can see information ‘in the mind's eye’ when trying to remember something. For example, this type of learner might like to learn by going to lectures and reading textbooks.
Visual/non-verbal learning style
Visual/non-verbal learners are most efficient when presented with visual information as a picture or illustration. They like visual aids, pictures and diagrams in textbooks. Often, this type of learner likes to work in a quiet room and may not like study groups. He or she frequently remembers something by mentally visualizing a picture of it. Visual/non-verbal learners often have an artistic side. An example of this type of learning might be construction of a flow chart to clarify the management steps of a particular condition in primary care.
Tactile/kinaesthetic learning style
Tactile/kinaesthetic learners are most efficient with a ‘hands-on style’. They like to get on with activities and practise what they have learnt. They also enjoy being physically active in the learning environment and benefit from practical demonstrations. Practical examples and working through scenarios will help these learners.
Auditory/verbal learning style
Auditory/verbal learners benefit from information that is presented in spoken language. They gain from lectures and enjoy group discussion or listening to audio tapes. They are able to remember information by ‘hearing’ the way that it sounds and they may like to repeat it out loud. These learners benefit from talking through examples to see how they work.
Flexible styles
David Kolb progressed the idea of learning styles in the 1980s by describing individual learning styles as ‘a differential preference for learning, which changes slightly from situation to situation. At the same time, there is some long-term stability in learning style’ (Kolb, 1984). He defined four main styles of learning:
Concrete experience—feeling—having the experience Reflective observation—watching—reviewing the experience Abstract conceptualization—thinking—concluding from the experience Active experimentation—doing—planning the next stage
Kolb's model of learning can be seen as a circle, which the learner passes through to complete the learning (Fig. 1). He hypothesized that the complete learner has the ability to pass through all the stages, but most have a preferred style. Importantly, he realized that although one method might be dominant others can be used too. He described that people would enter the circle at their preferred point and move around it according to current context. Individuals can switch between styles at different rates and may spend the majority of time in their preferred style. Kolb also produced a learning styles inventory to help learners find their preferred learning style but maintained that this should only be used a guide and to help learners achieve skills in all four types of learning.
Kolb's learning cycle.
Kolb's work was then taken forward by Peter Honey and Alan Mumford who produced a method to explore the individual's learning style that is widely used in medicine today. As seen in Fig. 2, they revised Kolb's original learning cycle to take into account general behavioural tendencies (rather than directly asking how people learn) and divided learners into four categories. These categories broadly correspond with Kolb's learning styles:
Activist (concrete experience) Reflector (reflective observation) Theorist (abstract conceptualization) Pragmatist (active experimentation)
Honey and Mumford's learning styles.
Completing the learning style questionnaire that Honey and Mumford developed may help learners tailor their learning to their preferred style. Honey and Mumford also described the strengths and weaknesses of each style (Fig. 3).
Strengths and weaknesses of Honey and Mumford's learning styles*.
It should be noted that this model was initially designed for business users and so some of the learning activities proposed are not always relevant to primary care.
Consideration of learning style may enable learners to make the most of learning opportunities. Designing a personalized plan with the method of learning tailored to the individual's preferred learning style may maximize learning gain (Fig. 4). However, because learners learn best by going around the learning style circle, it is also important for learners to understand the learning styles that they are not so good at. By developing these areas (remembering that learning styles are behaviours and that behavioural skills can be learnt), learners can enhance their learning abilities. Furthermore, sometimes learners find themselves in learning situations to which they are not well suited; by spending time developing other learning styles, learners can maximize their learning gain in all learning environments.
Learning activities and preferences for people with different learning styles.
Instructional styles
A third theory is that learners adapt their learning to suit the context. This has been demonstrated by the ASSIST tool developed by Entwistle. He describes the difference between learners' style, preferred approach to their learning/strategy and their approach to the current context. He then divides people into deep, strategic and shallow learners and discusses their ‘intrinsic’ and ‘extrinsic’ motivations for learning (Fig. 5).
Entwistle's approaches to learning.
Deep learners have more intrinsic motivations, i.e. they learn because they want to, are interested in the subject and wish to gain deeper knowledge and understanding. Shallow learners have an extrinsic motivation and learn for a purpose, for example examinations; they often employ rote learning. The middle group, or strategists, is able to move between these two extremes and will pick up whatever type of learning is required to give the best outcome.
Interestingly, very good students often start off as deep learners but as demand dictates become shallower. Surface learners employ a factual learning approach while deep learning approaches include discussion and conversation as well as problem-based learning. Strategic learners do both. Among medical students, being a strategic learner seems to correlate with success in assessments.
The contribution of learning styles to education
Both learners and teachers contribute to the learning process. Recognizing and understanding learning styles and their application can guide both parties in developing learning approaches acceptable to the student (Fig. 6). There is little concrete evidence that matching the learner's preferred learning style and the presentation of material to the learner makes a difference, but it is often useful and interesting for learners to recognize their own and others' learning styles so that they can understand why different people learn in different ways and look into developing different strategies for learning.
Contributions to the learning process.
For the educator, understanding trainees' style can help make learning relevant and help the teacher to understand why an approach will work with one trainee but not another. Knowledge of learning styles helps learners understand how they and their peers learn and in small groups, this can lead to discussion and flexibility in teaching approaches.
Knowledge of learning style can also help with individual feedback. For example, applying the Honey and Mumford learning styles, a pragmatist or activist might benefit from being shown a new skill and then practising it, while a theorist may need to understand the concepts behind it first; a reflector might wish to analyse in more depth why something went wrong, so just explaining the problem with no thought about how to improve it may not be very helpful.
However, although it might be useful to try to match learning to learning style, good learners are versatile and can adapt to different learning styles in different contexts. Furthermore, multi-dimensional teaching is useful for all learning styles. It might be useful to consider some learning scenarios to appreciate how understanding learning styles could help you learn and also teach others. Think about how people with different learning styles would approach the learning tasks in Box 1.
Learning scenarios.
Try to think how learners with different styles might approach each of these tasks:
Sarah has her Applied Knowledge Test (AKT) exam coming up and feels very shaky on her statistics Punit has a partnership interview coming up and has to give a presentation about commissioning as part of the interview Kofi has just been diagnosed with multiple sclerosis and wants to find out everything that she can about it James has recently been appointed a GP trainer. His first trainee started working in his practice last week and he is planning his first tutorial on the topic of hypertension management in primary care
Think about a new task that you have had to do recently. For example, doing a 6 weeks baby check. How did you learn to do it? How did your peers learn to do 6 weeks checks?
You have been asked to set up a teaching session for foundation doctors on polymyalgia rheumatica. Think about how you would structure and deliver a half hour teaching session that would incorporate several learning styles.
Clinical context
Patients are also individuals who will have differing learning styles. It might be worth thinking about using a variety of methods when explaining concepts to patients, for example, diagrams and leaflets may help some patients while others might prefer to reflect on what had been said vocally. Mixing modalities may help patients to understand disease processes and illness management.
Key points
Knowledge of learning styles helps learners understand how they learn and may help them develop new ways to learn more efficiently Teaching approaches can be tailored to help the individual learn more efficiently but multidimensional learning is useful for all Knowledge of others learning styles can promote harmony in a group Using a number of approaches may improve patients' understanding of disease and illness Learning styles are controversial and should be used as a guide rather than an absolute