Moving Toward a Third Generation of Medical Education: Integrating Transformational Learning Principles in Health Professions Education

Introduction

The number of health professions education programs continues to increase across the United States and globally. As of 2018, the Foundation for the Advancement of International Medical Education and Research lists 37 US-based masters programs that focused on health professions education. These programs are situated in colleges of education, medical schools, and health science programs or in partnership across colleges and schools. The goal of these programs is to teach health professions educators core educational principles that provide practitioners with the knowledge necessary to integrate adult learning principles within their educational practice. The field of adult education can play a role as it investigates theoretically grounded approaches to teaching and learning and informs adult education practice. Medical education researchers have begun to look critically at the structure of health professions education and some have discussed the benefits of integrating adult educational principles in health professions education. This includes grounding medical education programs in adult education theory in order to provide a robust educational experience for students (e.g., Kaufman, 2003; Taylor & Hamdy, 2013). One theoretical approach that has been gaining prominence is transformational learning (Mezirow, 2000). The implementation of a transformative learning approach would shift the focus from didactic teaching and learning to one that is focused on critical reflection and interpersonal engagement. In addition, an emancipatory approach to transformational learning, drawn from Freire’s (1970) theory incorporates health professions education within a wider framework of equality and social justice, thus moving the focus away from a focus on more mechanistic aspects of skill development.

Transdisciplinary theory has been applied to health disparities as complex health issues require multiple lenses in order understand the problems and identify effective solutions (Gelhert, 2012). In order to successfully address health disparities, a multi-faceted approach that includes clinical, social, and structural components is needed. This requires individuals who can work effectively together across disciplines. In order to develop a cadre of people who can engage across disciplines, it is essential to design learning environments that move beyond didactic, passive learning and foster spaces where individuals can think critically about content. Embedding learning experiences within a transformative paradigm and implementing principles of transformational learning will aid in the development of practitioners and researchers who can more effectively work across disciplines by valuing alternative perspectives, research and evaluation methods. This chapter provides a deeper look at how transformational learning can be applied to health professions education programs and how it can influence individual paradigms and practice.