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Andragogy: How adults learn best

Javier Benitez, MD |

Andragogy refers to learning strategies which help adults to learn more effectively.

It is a term that was first used by Alexander Kapp in 1833 and later expanded by Malcolm Knowles to fit the needs of adult education. The concept is contrasted with pedagogy in which the child is lead through the learning process by the teacher. In andragogy most of the learning is self-directed and the teacher is a facilitator in the learning process. 

Pedagogy is more content-oriented.
Andragogy is more process-oriented.

This is essential in medical education due to the fact that by the time we reach medical school we are less receptive to teacher-centered education and are already in a phase where learning is more independent. Although I had already come across this concept a while ago, this concept was covered in an educator’s conference put together by Rob Rogers, MD (@EM_Educator). I followed this conference via Twitter and Livestream in mid-November and it was great.

Knowles identified six characteristics that motivate adult learners
Need to know Adults need to know the reasons for learning something
Foundation Experience (including error) provides the basis for learning activities
Self-Concept Adults need to be responsible for their decisions on education; involvement in the planning and evaluation of their instruction
Readiness Adults are most interested in learning subjects having immediate relevance to their work and/or personal lives
Orientation Adult learning is problem-centered rather than content-oriented
Motivation Adults respond better to internal vs external motivators

I think this concept should help us to become more effective educators because it provides a better look into the mind of the adult learner. It really shows that we are not satisfied when we are given a simple answer such as “because I said so” – an answer that might work with children.

Here are a few examples where you can find andragogy in medical school and residency:

  • Problem Based Learning (PBL): A group of trainees gather together to solve clinical problems.
  • Clinical Problem Solving: This makes learning more relevant to real life experiences.
  • Trainees have different backgrounds and they bring these experiences with them to a learning group and facilitate learning.
  • When the trainee looks up information without being prompted by the trainer it shows the learner is self-reliant.
Pedagogy Andragogy
Learner Dependent. Teacher directs what, when, how a subject is learned and tests that it has been learned. Moves toward independence. Self-directing. Teacher encourages and nurtures this movement.
Learner’s Experience Of little worth. Hence teaching methods are didactic. A rich resource for learning. Hence teaching methods include discussion, problem solving, etc.
Readiness to learn People learn what society expects them to. So that the curriculum is standardized. People learn what they need to know. So that learning programs organized around life application.
Orientation to learning Aquisition of subject matter. Curriculum organized by subjects. Learning should be based around experiences, since people are performance-centered in their learning.
A comparison of the assumptions of pedagogy and andragogy following Knowles (Jarvis 1985: 51)

Of course this concept is not without its criticisms and even Knowles recognized that this concept can also apply to children. It is clear that when we reach adulthood we should move to a more learner-oriented system and move away from teacher-oriented system. In the end during our training the learning process is a team project where the exchange of information can be interchanged between the trainer and the trainee. After training it is still our responsibility to become independent effective learners and stay up to date with the medical literature. If these concepts are applied effectively during our training the process will help us to become more effective long life learners.

I would love to read your comments on this topic. Are you a content-oriented, a process-oriented, or both type of learner?


  1. Wikipedia; Andragogy; Last update: Sept 17, 2012
  2. Smith, M. K. (1996; 1999) ‘Andragogy’, the encyclopaedia of informal education, Last update: May 29, 2012.
  3. Instructional design; Andragogy (Knowles)

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Javier Benitez, MD

Javier Benitez, MD

ALiEM Featured Contributor

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