J Oral Maxillofac
Surg
49:1323-1330.1991
Learning Style Analysis Among Oral and Maxillofacial Surgeons MORTON B. ROSENBERG,
DMD*
Learning style analysis provides a conceptual framework to aid both teachers and students in determining their optimal learning millieu. The four stages of the learning cycle apply to every learning situation, including the training and continuing education of oral and maxillofacial surgeons. Determination of learning style type may correlate with individual success in a particular program or specialty and aid in staff/student interaction and professional growth.
Oral and maxillofacial surgeons involved in the education of dental students and residents soon realize that each individual in a program learns by different methods. There is no universally correct way to learn, nor is there a preferred method of teaching that works for everyone. A knowledge of some of the elements of modern learning theory may aid in understanding and evaluating different learning styles of students and instructors. Learning style analysis provides a conceptual framework for an understanding of resident educational behavior and serves as a tool for individuals to optimize their self-study and continuing education. A useful technique to determine learning style analysis has been presented as part of D.A. Kolb’s experimental approach to organizational psychology.’ Instructors in oral and maxillofacial surgery can improve their clinical teaching effectiveness by discovering their own personal learning styles and identifying the favored learning styles of their residents. The use of Kolb’s Learning Style Inventory (LSI) and an understanding of his experimental learning model may aid in predicting resident performance,’ serve as a valuable tool in designing a curriculum unique to specific programs and individuals,3 and demonstrate to teacher and student alike
* Associate Professor of Anesthesia, Tufts University School of Medicine; Associate Professor of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine. Address correspondence and reprint requests to Dr Rosenberg: Department of Anesthesiology, New England Medical Center, 750 Washington St, Box 298, Boston, MA 02111. 0 1991 American geons
Association
0278-2391/91/4912-0013$3.00/0
of Oral and Maxillofacial
Sur-
that learning styles are as individual as the people involved.3 The Experimental Learning Model Educators have long appreciated that there exists a variety of both learning and teaching styles. D.A. Kolb’s experimental learning model is conceived as a four-stage cycle. It postulates that everyone has 1) immediate concrete experiences (CE) that are reviewed and evaluated during 2) reflective observation (RO). This leads to the process of 3) abstract conceptualization (AC), during which new ideas and theories are formed. These conceptualizations then serve as a guide and are tested by 4) active experimentation (AE), and the cycle continues (Fig 1). These four stages of the learning cycle can be defined as follows: Concrete experiences (CE). This is the sensory portion of the learning cycle. The individuals learn from feeling, hearing, and seeing themselves performing the skill. It is the experience-based approach to learning and forms the basis for observation and reflection. Rejlective observation (RO). This is the watching and remembering portion of learning. It is based on observation. By viewing the experience from many perspectives the individual can think of ways to do it better or modifying the strategy. This is an impartial approach to learning. Abstract conceptualization (AC). This is where the individual learns by thinking. It is a conceptually based, analytic approach to learning. Through this learning mode, the individual can keep the best parts of the first experience, and form a new plan to improve on the next. 1328
MORTON
1329
B. ROSENBERG
FIGURE
I.
The experiential model of learning theory.
Active experimentation (AE). This learning mode uses an active approach to learning. The individual uses theories to make decisions and solve problems, and then learns by actually performing the skill. Every individual relies on all four modes, but to a different extent. Four adaptive learning styles are delineated by these basic parameters (Fig 2). Each of the four dominant learning style types has its own learning preferences and behavioral traits. Individuals tend to make characteristic choices between the polar opposites of each dimension. The four learning style types are as follows. Accommodator. This is the person who learns well through clinical experience. The accommodator’s strength is the ability to get things done. They are able to adapt to changing circumstances and are at ease with people. The accommodator perceives or takes in new information concretely and processes it actively. Assimilator. This individual excels at research and writing. Assimilators are good at creating models and theories. They are systematic planners and tend to set goals. Assimilators tend to be less focused on people and more focused on abstract ideas and concepts. The assimilator takes in information abstractly and processes it reflectively. Diverger. The diverger is usually an excellent lecturer. Divergers are generally attentive and interesting conversationalists. The diverger is interested in people and tends to be a “feeling oriented” Concrete Diverger (Lecturer)
Accomodator (Clinician) t
Abstract
Active
Reflective
l
FIGURE
w 2.
Learning
style types grid.
person. Their strengths lie in their imaginative ability. They are sensitive to people’s feelings and values. They are excellent at gathering information. The diverger takes in information concretely and processes it reflectively. Converger. The converger is the test taker of the group. This person excels at applying difficult concepts, on multiple choice examinations, and working with mechanical equipment. The converger prefers to deal with technical problems rather than people. Their strengths are in creating new ways of thinking. They are experts at executing formally structured plans. The converger takes in information abstractly and processes it actively. LSI The LSI is a simple, easily administered, selfdescription test, based on experimental learning theory, that measures the relative emphasis on the four learning modes. The test instrument consists of ranking in order of importance four words pertaining to personal learning habits. Nine such sets are then scored in a precise fashion by simple arithmetic and the resulting six numbers are plotted on two graphs. This test identifies the four different learning modes and measures the amount of reliance an individual places on each mode to define learning style type.4 Effective learning uses all four modes of the learning cycle and each mode occurs over and over again in the learning process. Methods
The LSI was completed by 20 staff oral and maxillofacial surgeons and 45 residents in seven randomly selected oral and maxillofacial teaching programs. In addition, a resident evaluation form was completed by appropriate staff for each resident. Results
The results are shown in Figure 3. Although these data are too limited to warrant statistical validation, this study demonstrated a trend among oral and maxillofacial surgical residents towards being accommodators and convergers. Staff oral and maxillofacial surgeons, on the other hand, were more evenly distributed through all four learning style types. Strong emphasis appears to be placed at the resident level on test taking (converger) in the resident selection process and on learning through clinical experience (accommodator). On the other hand, more emphasis is placed on lecture presentation (diverger) and research (assimilator) on the staff level. The personal assessments of individual residents
1330
LEARNING
Accomodators
Divergers
4 Attending 18 Resident
6 Attending 5 Resident
22 Total
11 Total
Convergers
Assimilators
4 Attending 20 Resident
6 Attending 2 Resident
24 Total
8 Total
FIGURE 3.
Results of LSI test.
by staff within the study group were consistent with the data derived from the LSI. The accommodator attending staff scored the accommodator residents higher than other residents in clinical ability. Likewise, the diverger attending staff scored the diverger residents higher than other residents in teachability. This trend continued through the other learning types. Discussion Learning style analysis has been investigated in many areas of medicine. It has been suggested to play a role in medical career choice.5V6 Other medical specialties, such as anesthesiology, internal medicine, and family practice, also have been studied to determine what type of learners are attracted to the specialty,3’7’s as well which individual learning style is the most successful as determined by staff evaluation.2 Oral and maxillofacial surgery is a unique specialty with overlap in many medical areas (anesthesiology, medicine, pathology) so that there probably is no one preferred learning style leading to success. On the other hand, specific oral and maxillofacial surgery programs probably do encourage and reward specific learning styles depending on staff composition. It is a reasonable assumption from the results of the resident evaluation that the degree of overlap of individual learning style profiles between staff and resident could be a predictor of the ease or difficulty in interpersonal communication. Individuals with little similarity in learning style profiles can expect to experience difficulty in achieving educational rapport. lo Some studies have indicated that any given residency program and/or medical specialty has a leaming style distribution characteristic of that program
STYLE ANALYSIS
AMONG OMS
or specialty.2*7,8 This may have profound implications for a resident entering a particular training program or specialty. Because of the correlation often associated between personality and learning style type, it is possible for staff selecting resident candidates to be more inclined to accept applicants with personalities similar to their own. This only serves to perpetuate the learning style distribution of a particular specialty or institution.’ Perhaps best use of the theory of learning style analysis is to realize that each of us learns best by different methods. “Concrete” individuals tend to avoid theoretical reading and rely more on personal feedback. “Abstract” individuals learn best from case reports, theoretical reading, and thinking alone. They do not find exercises, simulations, and talks by experts helpful. “Active experimenters” learn best from projects, homework, and small group discussions, but not from lectures. “Reflective observers” find that lectures facilitate their learning.4 The theory of learning style analysis proves that each of us, teachers and students, learn by styles as individual as the persons involved. Many of the learning difficulties encountered in training programs can be directly attributed to this fact. Learning style compatibility between resident and training program, between resident and staff, and between resident and his or her perception of the specialty as a whole, may turn out to be important in determining performance and success. By detinition, the health professional is a student for life. The earlier one realizes the type of learning style most adaptable to one’s personality, the more successful one will be in his or her chosen specialty. References 1. Kolb DA, Rubin IM, McIntyre JM: Organizational Psychology: An Experimental Approach. Englewood Cliffs, NJ, Prentice-Hall, 1979 2. Baker JD, Wallace CT, Cooke JE, et al: Success in residency as a function of learning style. Anesthesiology 65:A472, 1896 3. Baker JD, Marks WE: Learning style analysis in anesthesia education. Anesth Rev 8:31, 1981 4. Kolb DA: Learning Style Inventory Technical Manual. Boston, MA, McBer & Co, 1976 5. Wunderlich R, Gjerde CL: Another look at learning style inventory and medical career choice. J Med Educ 53:45, 1978 6. Plovnick MS: Primary care career choices and medical student learning styles. J Med Educ 50:849, 1975 7. Whitney MA, Caplan RM: Learning styles and instructional preferences of family practice physicians. J Med Educ 53:684, 1978 8. Leonard A, Harris I: Learning style in a primary care internal medicine residency program. Arch Intern Med 139:872, 1979 9. Eisenkraft JB, Reed AP, Eisenkraft MA, et al: Learning styles among anesthesiologists. Anesth 63:A495, 1985 10. Sadler GR, Plovnick M, Snope FC: Learning styles and teaching implications. J Med Educ 53:847, 1978
Surg
49:1323-1330.1991
Learning Style Analysis Among Oral and Maxillofacial Surgeons MORTON B. ROSENBERG,
DMD*
Learning style analysis provides a conceptual framework to aid both teachers and students in determining their optimal learning millieu. The four stages of the learning cycle apply to every learning situation, including the training and continuing education of oral and maxillofacial surgeons. Determination of learning style type may correlate with individual success in a particular program or specialty and aid in staff/student interaction and professional growth.
Oral and maxillofacial surgeons involved in the education of dental students and residents soon realize that each individual in a program learns by different methods. There is no universally correct way to learn, nor is there a preferred method of teaching that works for everyone. A knowledge of some of the elements of modern learning theory may aid in understanding and evaluating different learning styles of students and instructors. Learning style analysis provides a conceptual framework for an understanding of resident educational behavior and serves as a tool for individuals to optimize their self-study and continuing education. A useful technique to determine learning style analysis has been presented as part of D.A. Kolb’s experimental approach to organizational psychology.’ Instructors in oral and maxillofacial surgery can improve their clinical teaching effectiveness by discovering their own personal learning styles and identifying the favored learning styles of their residents. The use of Kolb’s Learning Style Inventory (LSI) and an understanding of his experimental learning model may aid in predicting resident performance,’ serve as a valuable tool in designing a curriculum unique to specific programs and individuals,3 and demonstrate to teacher and student alike
* Associate Professor of Anesthesia, Tufts University School of Medicine; Associate Professor of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine. Address correspondence and reprint requests to Dr Rosenberg: Department of Anesthesiology, New England Medical Center, 750 Washington St, Box 298, Boston, MA 02111. 0 1991 American geons
Association
0278-2391/91/4912-0013$3.00/0
of Oral and Maxillofacial
Sur-
that learning styles are as individual as the people involved.3 The Experimental Learning Model Educators have long appreciated that there exists a variety of both learning and teaching styles. D.A. Kolb’s experimental learning model is conceived as a four-stage cycle. It postulates that everyone has 1) immediate concrete experiences (CE) that are reviewed and evaluated during 2) reflective observation (RO). This leads to the process of 3) abstract conceptualization (AC), during which new ideas and theories are formed. These conceptualizations then serve as a guide and are tested by 4) active experimentation (AE), and the cycle continues (Fig 1). These four stages of the learning cycle can be defined as follows: Concrete experiences (CE). This is the sensory portion of the learning cycle. The individuals learn from feeling, hearing, and seeing themselves performing the skill. It is the experience-based approach to learning and forms the basis for observation and reflection. Rejlective observation (RO). This is the watching and remembering portion of learning. It is based on observation. By viewing the experience from many perspectives the individual can think of ways to do it better or modifying the strategy. This is an impartial approach to learning. Abstract conceptualization (AC). This is where the individual learns by thinking. It is a conceptually based, analytic approach to learning. Through this learning mode, the individual can keep the best parts of the first experience, and form a new plan to improve on the next. 1328
MORTON
1329
B. ROSENBERG
FIGURE
I.
The experiential model of learning theory.
Active experimentation (AE). This learning mode uses an active approach to learning. The individual uses theories to make decisions and solve problems, and then learns by actually performing the skill. Every individual relies on all four modes, but to a different extent. Four adaptive learning styles are delineated by these basic parameters (Fig 2). Each of the four dominant learning style types has its own learning preferences and behavioral traits. Individuals tend to make characteristic choices between the polar opposites of each dimension. The four learning style types are as follows. Accommodator. This is the person who learns well through clinical experience. The accommodator’s strength is the ability to get things done. They are able to adapt to changing circumstances and are at ease with people. The accommodator perceives or takes in new information concretely and processes it actively. Assimilator. This individual excels at research and writing. Assimilators are good at creating models and theories. They are systematic planners and tend to set goals. Assimilators tend to be less focused on people and more focused on abstract ideas and concepts. The assimilator takes in information abstractly and processes it reflectively. Diverger. The diverger is usually an excellent lecturer. Divergers are generally attentive and interesting conversationalists. The diverger is interested in people and tends to be a “feeling oriented” Concrete Diverger (Lecturer)
Accomodator (Clinician) t
Abstract
Active
Reflective
l
FIGURE
w 2.
Learning
style types grid.
person. Their strengths lie in their imaginative ability. They are sensitive to people’s feelings and values. They are excellent at gathering information. The diverger takes in information concretely and processes it reflectively. Converger. The converger is the test taker of the group. This person excels at applying difficult concepts, on multiple choice examinations, and working with mechanical equipment. The converger prefers to deal with technical problems rather than people. Their strengths are in creating new ways of thinking. They are experts at executing formally structured plans. The converger takes in information abstractly and processes it actively. LSI The LSI is a simple, easily administered, selfdescription test, based on experimental learning theory, that measures the relative emphasis on the four learning modes. The test instrument consists of ranking in order of importance four words pertaining to personal learning habits. Nine such sets are then scored in a precise fashion by simple arithmetic and the resulting six numbers are plotted on two graphs. This test identifies the four different learning modes and measures the amount of reliance an individual places on each mode to define learning style type.4 Effective learning uses all four modes of the learning cycle and each mode occurs over and over again in the learning process. Methods
The LSI was completed by 20 staff oral and maxillofacial surgeons and 45 residents in seven randomly selected oral and maxillofacial teaching programs. In addition, a resident evaluation form was completed by appropriate staff for each resident. Results
The results are shown in Figure 3. Although these data are too limited to warrant statistical validation, this study demonstrated a trend among oral and maxillofacial surgical residents towards being accommodators and convergers. Staff oral and maxillofacial surgeons, on the other hand, were more evenly distributed through all four learning style types. Strong emphasis appears to be placed at the resident level on test taking (converger) in the resident selection process and on learning through clinical experience (accommodator). On the other hand, more emphasis is placed on lecture presentation (diverger) and research (assimilator) on the staff level. The personal assessments of individual residents
1330
LEARNING
Accomodators
Divergers
4 Attending 18 Resident
6 Attending 5 Resident
22 Total
11 Total
Convergers
Assimilators
4 Attending 20 Resident
6 Attending 2 Resident
24 Total
8 Total
FIGURE 3.
Results of LSI test.
by staff within the study group were consistent with the data derived from the LSI. The accommodator attending staff scored the accommodator residents higher than other residents in clinical ability. Likewise, the diverger attending staff scored the diverger residents higher than other residents in teachability. This trend continued through the other learning types. Discussion Learning style analysis has been investigated in many areas of medicine. It has been suggested to play a role in medical career choice.5V6 Other medical specialties, such as anesthesiology, internal medicine, and family practice, also have been studied to determine what type of learners are attracted to the specialty,3’7’s as well which individual learning style is the most successful as determined by staff evaluation.2 Oral and maxillofacial surgery is a unique specialty with overlap in many medical areas (anesthesiology, medicine, pathology) so that there probably is no one preferred learning style leading to success. On the other hand, specific oral and maxillofacial surgery programs probably do encourage and reward specific learning styles depending on staff composition. It is a reasonable assumption from the results of the resident evaluation that the degree of overlap of individual learning style profiles between staff and resident could be a predictor of the ease or difficulty in interpersonal communication. Individuals with little similarity in learning style profiles can expect to experience difficulty in achieving educational rapport. lo Some studies have indicated that any given residency program and/or medical specialty has a leaming style distribution characteristic of that program
STYLE ANALYSIS
AMONG OMS
or specialty.2*7,8 This may have profound implications for a resident entering a particular training program or specialty. Because of the correlation often associated between personality and learning style type, it is possible for staff selecting resident candidates to be more inclined to accept applicants with personalities similar to their own. This only serves to perpetuate the learning style distribution of a particular specialty or institution.’ Perhaps best use of the theory of learning style analysis is to realize that each of us learns best by different methods. “Concrete” individuals tend to avoid theoretical reading and rely more on personal feedback. “Abstract” individuals learn best from case reports, theoretical reading, and thinking alone. They do not find exercises, simulations, and talks by experts helpful. “Active experimenters” learn best from projects, homework, and small group discussions, but not from lectures. “Reflective observers” find that lectures facilitate their learning.4 The theory of learning style analysis proves that each of us, teachers and students, learn by styles as individual as the persons involved. Many of the learning difficulties encountered in training programs can be directly attributed to this fact. Learning style compatibility between resident and training program, between resident and staff, and between resident and his or her perception of the specialty as a whole, may turn out to be important in determining performance and success. By detinition, the health professional is a student for life. The earlier one realizes the type of learning style most adaptable to one’s personality, the more successful one will be in his or her chosen specialty. References 1. Kolb DA, Rubin IM, McIntyre JM: Organizational Psychology: An Experimental Approach. Englewood Cliffs, NJ, Prentice-Hall, 1979 2. Baker JD, Wallace CT, Cooke JE, et al: Success in residency as a function of learning style. Anesthesiology 65:A472, 1896 3. Baker JD, Marks WE: Learning style analysis in anesthesia education. Anesth Rev 8:31, 1981 4. Kolb DA: Learning Style Inventory Technical Manual. Boston, MA, McBer & Co, 1976 5. Wunderlich R, Gjerde CL: Another look at learning style inventory and medical career choice. J Med Educ 53:45, 1978 6. Plovnick MS: Primary care career choices and medical student learning styles. J Med Educ 50:849, 1975 7. Whitney MA, Caplan RM: Learning styles and instructional preferences of family practice physicians. J Med Educ 53:684, 1978 8. Leonard A, Harris I: Learning style in a primary care internal medicine residency program. Arch Intern Med 139:872, 1979 9. Eisenkraft JB, Reed AP, Eisenkraft MA, et al: Learning styles among anesthesiologists. Anesth 63:A495, 1985 10. Sadler GR, Plovnick M, Snope FC: Learning styles and teaching implications. J Med Educ 53:847, 1978
