Valuing learners' experience and supporting further growth: educational models to help experienced adult learners in medicine.

Attitudes towards and expectations of careers have changed. Portfolio careers and changing needs in the medical workforce have led, for example, to increasing numbers of postgraduate entrants to medical school, greater movement between specialties, and an influx of qualified doctors from overseas. Learners with substantial previous experience and knowledge may provide a challenge to trainers to maximise their learning. Recognising the individuality of the learner is the hallmark of good teaching. We explore particular attributes of experienced adult learners and for each attribute propose an educational model that may help the trainer develop an approach to achieve maximum growth. Raised awareness of an individual’s learning needs and potential contribution, combined with greater use of these models, will promote a movement away from didactic teaching, which is characterised by an unequal status of teacher and learner, to one of coaching and partnership between learner and trainer, with additional benefit to both. To illustrate our points we have used examples taken from the real lives of postgraduate learners in medicine —people who have a substantial amount of previous experience and have changed the direction of their career. The examples illustrate some of the attributes we describe and the relevance of the educational model. As all learners have relevant previous experience and prior understandings that may pass unrecognised, the attributes and related frameworks we describe are, in practice, relevant to all adult learners.