Adult learning; see also andragogy Describes a set of principles, originally described by Knowles in 1984, that differentiate how adult learners differ from children. They include the experience the adult has accumulated, motivation, and self-direction, and the interest in solving problems that are relevant to their everyday lives.

Andragogy; see also adult learning An educational concept developed by Knowles, which asserts that education of adults needs to take account of their specific ways of learning, which differ from those of children. Child-orientated education is described by the more commonly used term ‘pedagogy’.

Approaches to learning; see also deep learning and surface learning These describe how students approach learning tasks. Surface and deep learning represent two different approaches. A surface approach is characterised by accepting new facts and ideas uncritically and attempting to store them as isolated, unconnected, items (rote learning). Deep learning is characterised by examining new facts and ideas critically, tying them into existing cognitive structures, and making numerous links between ideas.

Assessment The process of gathering and discussing information from multiple and diverse sources in order to develop a deep understanding of what students know and can do as the result of their educational experiences; the process culminates when assessment results are used to improve subsequent learning.

Assessment; formal That which occurs intentionally when someone comes to a view about someone's (possibly that person's own) learning, irrespective of what use (formative or summative) is to be made of that assessment.

Assessment; formative Assessment designed to help individuals develop by giving them information on their performance, usually in a non-judgemental and low-stakes environment (has no consequences in terms of the learner's progress). Often termed ‘assessment for learning’ or simply feedback.

Assessment; informal That which occurs naturally and often unrecognised when someone, somehow, comes to a view about someone's (possibly that person's own) learning, irrespective of what use (formative or summative) is to be made of that assessment.

Autonomy; see also conditional autonomy and principled autonomy The ability to live one's own life, according to one's own motives and reason.

Behaviourism Focuses on overt behaviour and the measurement of that behaviour. The assumptions of behavioural theorists about the nature of learning focus on the role of an individual's environment in both stimulating and shaping behaviour. What happens within individuals is of less interest as it is unobservable. From a behaviourist perspective, learning equates to changes in behavioural responses to environmental stimuli. Behaviourism is based on a causal and mechanistic model of human learning.

Codified knowledge Academic knowledge in the form of textbooks, protocols, records, manuals, etc.

Cognitive dissonance A psychological concept developed by Festinger, which describes a state of inconsistency or disequilibrium when an individual perceives a situation, experience, or thought that is incompatible with their existing cognitive structures. The existence of cognitive dissonance motivates individuals to seek equilibrium by either avoiding a situation that caused it or, more positively, by seeking to understand the nature of the conflict and achieving resolution. Cognitive dissonance is an important concept in Constructivist and Experiential Learning theories.

Cognitive load A body of theory in cognitive psychology, which considers designs for learning as having three aspects: intrinsic (what is to be learnt); germane (how it is to be learnt); and extraneous (any other aspect not intrinsic or germane).

Cognitive scaffolding Teachers' use of structures to reduce their learners' cognitive load when acquiring subject matter.

Cognitivism Focuses on perception, memory, and meaning. The various cognitive perspectives share two important assumptions that: (a) the memory system is an active processor of information and (b) knowledge plays an important role in learning. Learning is seen as reorganising experience to increase meaning.

Competency The ability to handle a complex professional task by integrating the relevant cognitive, psychomotor, and affective skills.

Complexity theory This theory concerns the interactivity of elements in open systems, where the magnitude of effects cannot be predicted in a linear fashion from the magnitude of the elements relative to each other.

Constructivism A theory of knowledge (epistemology) whose philosophical roots can be traced back to Kant and whose psychological assumptions can be traced back to Piaget. It holds that the reality humans perceive is constructed by their social, historical, and individual contexts such that there can be no absolute shared truth. In an educational context, constructivism can be seen as a process whereby learners actively construct understandings based on their perceptions, previous experiences, and knowledge of the world. They assimilate new ideas and information by linking them to existing ideas and information. That is in contrast to a view of learning as having knowledge transmitted by a teacher. Constructivism is not a specific pedagogy, but today it underlies many approaches to learning. In small groups, those include ascertaining prior knowledge, challenging misconceptions, promoting active learning, and encouraging learners to take responsibility for their learning.

Consultant Registered and licensed specialist physician (UK).

Context The circumstances in which a task is undertaken; can be subdivided into a physical and a social context.

Contextualising learning Locating procedural skills training (or any other competence) in the context in which learners will eventually be expected to perform the skill. This is likely to include psychological, social, and physical representations of the working environment.

CoP (Community of practice) Cognitive anthropologists Jean Lave and Etienne Wenger used this term to describe a group of people who share an interest, a craft, and/or a profession. In Lave and Wenger's terms, members of a CoP are in pursuit of a shared enterprise. It is in the process of participating in that group that the members learn from each other and develop themselves personally and professionally. A CoP can be defined as an informal network that supports professional practitioners in their efforts to develop shared understandings and engage mutually in work-relevant knowledge building.

Curriculum (without a pronoun) That which underpins any learning and may be seen in the actions of teachers and learners in situ.

Curriculum in action The education actually being provided.

Curriculum, intended Curriculum on paper; the formal educational programme devised for an educational context.

Deep learning; see also approaches to learning A term first developed by Marton and Säljö, which refers to a learning strategy adopted by learners when they are able to interact with learning resources and teachers. In this environment, which is often a small group teaching session, learners attempt to understand material by questioning and challenging, and elaborate their understanding by application and problem solving. Learners have an opportunity to see how their knowledge fits into an overarching framework and the bigger picture. The opposite of ‘surface’ learning.

Epistemology The theory or science of the method or grounds of knowledge.

Evaluation The process of assessing the strengths and weaknesses of educational programmes, policies, and organisations to improve their effectiveness. In North America, this also applies to the personnel, so learners may be ‘evaluated’ rather than ‘assessed’. The information is often used to support quality improvement.

Experienced curriculum What students actually experience or learn at an educational site.

Experiential Learning Theory It derives from the work of David Kolb and builds on prior theories of Lewin, Piaget, Jung, and others. It asserts that learning is a process whereby knowledge is created through the transformation of experience. Raw experience is subjected to reflection, which constructs conceptual understanding and leads on to potential action. Experiential Learning Theory underpins professional development frameworks, the use of reflective portfolios, and the measurement of ‘learning styles’.

Feedback Technically, it is the use of output from a process to modulate or modify the activity of the process. In educational terms, it is giving learners information about their performance to help them improve their knowledge, skills, or attitudes. Feedback is a fundamental component of formative assessment and assessment for learning.

Foundation Doctor or Foundation Trainee The Foundation Programme is a two-year postgraduate training programme designed to bridge the gap between medical school and specialty training; in the UK it is an important, formal part of the lifelong learning continuum.

GMC (General Medical Council) Oversees the licensing of physicians in the UK. The purpose of the GMC “is to protect, promote, and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.”

Implicit learning The acquisition of knowledge independently of conscious attempts to learn and in the absence of explicit knowledge about what was learnt.

Informal education/learning Learning that results from unplanned activities within an educational programme and/or daily life activities related to work, family, or leisure. It is not structured in terms of learning objectives or teaching. Informal learning may be intentional but in most cases it occurs incidentally.

Intern Historical name for a first-year postgraduate trainee in the US medical education system. An intern has an MD degree but not a license to practise unsupervised care. This term has been largely replaced with resident, with the year of training indicated by postgraduate year 1 (PGY1). The term is roughly equivalent with the European term ‘foundation trainee’.

Learning A social, cognitive, and emotional process that is an integral and inseparable aspect of social practice.

Learning environment The material and social context wherein learners ‘learn’ (learning should be understood here as ‘acquiring knowledge’ as well as ‘participating in practice’), which influences learners' behaviour, emotions, and practical competences.

Learning outcomes Statements defining what learners should be able to do at the end of a learning experience. They are often categorised into knowledge, skills, and attitudes and can be used to make a constructively aligned top-down curriculum.

Learning strategies These are the ways individual learners choose to achieve their goals. They may include using diagrams, taking notes, practicing skills, creating concept maps, and teaching each other.

Lifelong learning An ongoing process, through which individuals acquire the knowledge, skills, and values they will need through their life.

Maslow's hierarchy of needs A conceptual framework developed by Maslow which proposes that, in order to achieve optimal personal growth and learning (‘self-actualisation’), layers of psychological and biological pre-conditions must be met. So, for example, basic physical and safety needs have to be fulfilled before one can go to ‘higher-level’ needs and eventually reach self-actualisation. It implies that physical surroundings matter and therefore has practical utility in ensuring that, for example, physical conditions for small group teaching and learning are adequate.

Medical (education) workplace Any place where patients, learners, and practitioners come together for the conjoint purpose of providing/receiving medical care and learning.

Metacognition The process of thinking about how one thinks and learns. It is a reflective activity frequently used to encourage learners to identify the optimum conditions for their own learning. It can be initiated via a variety of psychometric tests, for example, Kolb's or Honey and Mumford. Refers to people's abilities to predict their performances on various tasks and monitor their current level of mastery and understanding.

Minute paper An exercise, which is often used at the end of educational sessions, to inform teachers whether students are achieving intended learning outcomes. Students are asked to reflect briefly and identify for the teacher and themselves where they are having difficulty, their major learning point(s) from the session, or a question that remains unanswered. It is useful for evaluation purposes.

Motivation; extrinsic Motivation to perform a behaviour arising from forces external to the behaviour itself such as persuasion or threats from others, material rewards, or internalisation of societal norms.

Motivation; intrinsic Motivation to perform a behaviour arising from its inherently satisfying nature.

PBL (Problem-based learning) A small group teaching technique in which groups of learners and a facilitator engage with work-related problems and scenarios to identify their learning needs and objectives, followed by self-directed learning, and receiving feedback and arriving at conclusions within the group. It is widely used in medical education and education for other professions.

Pedagogy A body of theory and practice involved in educating young and/or junior individuals by their elders.

Portfolio A collection of information and artefacts pertaining to a learner and reflecting either ‘all’ or ‘the best’ of them for one or more educational purposes. There are very many approaches to portfolios and, as such, the specificity of the term is becoming increasingly ill-defined. A portfolio may be digital or paper-based and content may be prescribed or left to students' discretion. Despite variations in content and format, portfolios basically contain evidence about work done, feedback received, and progress made. Additionally, portfolios may stimulate reflection because collecting evidence for inclusion in a portfolio requires looking back and analysing what one has accomplished. Very often, written reflections and plans for improving competence are included.

Postgraduate trainee, see resident.

Practical theories of learning and teaching These are based on individuals' experiences, the combination of their formal and informal knowledge, and their values and beliefs. Practical theories strongly determine educational practice.

Practice Includes both clinical and non-clinical health-related work such as diagnosis, treatment, surveillance, health communications, management, and sanitation engineering.

Professionalism A concept associated with the education, training, attitudes, and ethical practices of a group of workers or practitioners. It includes a regulated educational and training system that has specific standards that are monitored and maintained. It has an ethical framework concerned with good working practices between practitioners and their clients. The work of Schön emphasises that professionalism is characterised by a variety of reflective practices that practitioners engage in to maintain their skills.

Quality improvement; see Total Quality Management An approach that is based on a manufacturing philosophy and set of methods for reducing time from customer order to product delivery, costing less, taking less space, and improving quality. Common forms of QI activities include Continuous Quality Improvement and Total Quality Management.

Reflection; reflective learning Letting future behaviour be guided by a systematic and critical analysis of past actions and their consequences or, as Eva and Regher describe it, “a conscious and deliberate reinvestment of mental energy aimed at exploring and elaborating one's understanding of the problem one has faced (or is facing) rather than aimed at simply trying to solve it.” Reflective learning is the process of learning from experience through systematic reflection, returning to experience in order to re-evaluate it and glean learning that may affect one's predispositions and action in the future.

Registrar; see resident

Reliability The consistency and reproducibility of a measurement, or the degree to which an instrument, under the same condition with the same subjects, would produce an identical outcome. In the context of assessment, it is a measure of the ability of a test to differentiate reproducibly between test subjects. It is defined as the subject variability divided by the sum of subject variability and measurement error and lies between 0 and 1. Various forms include test–retest reliability and inter-rater reliability.

Resident (Registrar, post-graduate trainee); see also specialist trainee, intern, Foundation Doctor Medical school graduates undergo practice-based specialist training to be approved in their specific specialty. Resident is the common term in use in the US and, increasingly, internationally. Specialist trainee (formerly specialist registrar) is the term used in the UK. Both are post-graduate trainees.

Review; see also scoping review Literature reviews are collections of previously conducted research or evaluation studies. Reviews may be exploratory, narrative, critical, or systematic.

Scaffolding The introduction and subsequent removal of support and guidance to a learner proportionate to and in reaction to their developing mastery of a subject.

Schema building A cognitive model of understanding as a series of discrete clusters of interlinked knowledge. Learning is about adapting existing schemas and creating new ones.

Scoping review; see also review An exploratory type of review that aims to undertake a broad scope of a particular field before more extensive review work can be undertaken.

Self-actualisation A psychological concept, particularly associated with Maslow and Rogers, which asserts that all individuals wish to become the best person they can be by fulfilling all their potential; to ‘become everything that one is capable of becoming’.

Self-directed learning Refers to an ongoing process through which individuals identify their learning needs, identify means to meet them, engage in relevant learning activities, and evaluate their progress and achievement in meeting their needs.

Self-efficacy From social cognitive theory, an individual's perception of their ability to perform a particular task to a desired level. Varies according to the situation and in the light of feedback from the social environment. An important influence on the goals that learners set and on their motivation to achieve.

Self-regulated learning Learners are involved in diagnosing their own learning needs, formulating goals, identifying resources, implementing appropriate strategies and activities, and self-assessing, and reflecting on both the process and outcomes of their learning. These skills are developed over time and supported by both teachers and resources in the learning environment. Self-regulated learning involves four phases: planning (identifying needs and articulating goals), learning (understanding expectations and identifying effective strategies), assessing (self-monitoring one's progress toward goals and synthesising with external feedback), and adjusting (reflecting on assessment and making necessary changes). Also involved are psychological attributes such as self-efficacy and motivation, personal choices in planning and effort, and judgements of the success of personal action.

Simulation Consensual pretence and illusion in support of training or assessment, typically through using some device, person, or environment. It should be more accurately termed ‘dissimulation’ as the intent is not to truly deceive.

Social cognitive theory; see also self-efficacy A theory of motivation, learning, and behaviour, which emphasises the reciprocal dynamic relationship between thoughts, actions, and society on behaviour. According to this theory, learning occurs through interaction with others and the environment. It emphasises the importance of cognition in mediating learning and function. It asserts that a significant amount of learning is associated with observing the behaviour of others in a process of vicarious experience. Self-efficacy is an important component of this theory. A major exponent is Albert Bandura.

Socio-cultural Current conceptualisations of socio-cultural theory draw heavily on the work of Vygotsky. A key feature of this emergent view of human development is that higher-order functions develop out of social interaction. Social relationships and culturally constructed artefacts – including language and tools – mediate learning and there is a two-way relationship between culture and individual learning. People learn meanings through activities that take place within individual, social, and institutional relationships.

SP (Simulated patient) An actor who is trained to portray a patient in a clinical simulation and to provide feedback to a learner.

Specialist trainee In the UK medical education system, it refers specifically to a practitioner being trained for a specialty who has completed two years as a ‘Foundation Doctor’.

Student centred An educational concept that emphasises that learning should start from the needs and requirements of learners and that teachers should act more as facilitators of learning.

Summative assessment Coming to a view of someone's learning for the purpose of regulating the progression of that person and/or for some form of certification.

Surface learning; see also deep learning A concept, first developed by Marton and Säljö, which refers to a learning strategy adopted by learners when confronted by large quantities of information taught in passive and largely didactic learning environments. In such environments, learners adopt a minimalist approach, rote learn factual information, and focus on specific exam requirements at the expense of overarching understanding and the bigger picture. The opposite of ‘deep learning’.

Syllabus The content of a curriculum.

Tacit knowledge Knowledge (factual or procedural) that is learnt and/or applied almost unconsciously.

Tacit learning; see also implicit learning The acquisition of knowledge independently of conscious attempts to learn, and without knowing exactly what has been learnt.

Teacher-centred An educational concept that emphasises that learning should be initiated by the prescriptions of teachers who decide what will be taught and by what methods.

Total Quality Management; see also quality improvement A culture within an organisation that is aimed at continuous improvement of educational quality.

Transferable skills Skills developed by engaging in an activity or experience that can be subsequently used in a different environment. For example, the skills of interpersonal communication that are developed during problem-based learning sessions can be used in professional conversations and patient interactions. Sometimes termed ‘process’ or ‘generic’ skills.

Validity An expression of how far the scores generated by an assessment tool make it possible to draw accurate inferences about the domain of interest; while various taxonomies exist, the concept of validity has traditionally included content validity (Does the test content correspond to the domain to be measured?), criterion validity (Do the test results correlate with results of other measures of the same domain, either concurrently or predictively?), construct validity (Do the test results accurately reflect expectations based upon underlying theory relevant to the construct being measured?), and face validity (Does it feel right?). In the context of assessment, validity is the strength of inferences which can be drawn from the outcomes (Has an assessment effectively measured what it was intended to measure?)

ZPD (Zone of proximal development) A concept developed by Vygotsky, which asserts that there is a cognitive state (the ZPD) in which learners can be helped to achieve higher levels of understanding by means of the action of others. For example, learners can be helped through the ZPD by teachers providing appropriate stimuli and intellectual scaffolding.