3 The role of the learner's experience

Each adult comes into a learning environment with a wealth of life experiences. This has both positive and negative effects. The doctor can tap into some of the client's experiences to validate the need for a needed procedure. Negative effects might arise from the client's fear of change, from misinformation or from an unpleasant experience that the client may relate to the current situation. The doctor should first present the problem and then probe to ascertain the client's experience and preferred solutions. This should be followed with a discussion of the pros and cons of a recommended approach. Above all, the doctor must show respect for the client's knowledge and experience.

Application of many of the basic communication skills (empathetic statements, reflective and active listening, use of partnering statements) will help the client make the leap from their past experience to the new one.

Adults move from one stage to the next in the learning process. And they vary in the ease with which they advance to the next level. When moving from one level of knowledge to another, the client is likely to retain concepts in short snippets. First, the doctor must identify the client's current level of knowledge. Then, taking into account the client's learning and communication styles (to be discussed in the next article), begin to move the client to the next stage. After each level of learning, stop to see if the client needs clarification or time to process the information.

"Does that make sense to you?"

"Did I explain that adequately for you?"

If the client is comfortable, move on to the next level. Do not hesitate to ask the client to repeat information so you can evaluate his/her understanding.

5 Orientation to learning

Adults are practical and goal-oriented. Generally, they are not interested in knowledge for its own sake, but need to know how it is relevant to their lives. How does this recommended action affect the client's life and the patient's life? What outcomes can be expected and how will that benefit the client, the patient, the family? Instructions must make frequent references to the impact of the procedure or information on the client and patient.

"Giving these heartworm pills takes only a couple minutes each month and may prevent Fluffy from suffering a potentially fatal infection with heartworm and having to undergo a long, hard and expensive treatment."

6 Motivation

Adults respond to external motivators (better pay, promotions, bigger house) and to internal motivators (self-esteem, sense of well-being, quality of life). The well-being of a patient can fit into either or both of these categories. There may be impediments to a client's learning that may outweigh any motivating factors. These may include a negative self-image, limited resources, time constraints or personal problems such as child care or transportation difficulties.

After discussing a needed procedure, the client should be asked if there is any reason she or he may not be able to accomplish it. Impediments should be acknowledged and respected, and solutions proposed.

The concept of adult learning offers an excellent framework for building a protocol for educating clients. If you apply these concepts during your interactions with clients, they will not applaud you for knowing these six principles. But they will notice that you treated them with respect as individuals, you spoke to them in terms they understood and, most important, they learned something.

In the next article, we will discuss customizing the interaction with clients according to the client's preferred learning and communication styles.

Dr. Timmins is president of the Association for Veterinary Family Practice and director of the Center for Animals in Society at the University of California-Davis.