Learning That Lasts: Integrating Learning, Development, and Performance in College and Beyond

Journal of Physical Therapy Education, Fall 2003 by Bentley, Kelli

Learning That Lasts: Integrating Learning, Development, and Performance in College and Beyond. Marcia Menthowski & Associates. San Francisco, Calif, Jossey-Bass Inc Publishers, 2000, hardcover, 536 pp, illus. $40.

Learning That Lasts is an outgrowth of a collaborative effort of over 2 decades of purposeful and systematic study of student learning processes and outcomes at Alverno College, Milwaukee, Wis. Alverno College, a 4-year liberal arts college for women, is well known for its work in the assessment of ability-based outcomes. The text provides evidence-based analysis of this work by Alverno College faculty and academic personnel as well as colleagues in a consortium of other institutions, therefore giving relevance to the results in coeducational settings.

The text is written for a diverse audience of educators and the concept has been adapted to many different health care professions. The book contains 12 chapters grouped into 4 parts. It is designed so readers can enter the book at any point dependent on their needs or interests. The beginning of each section as well as each chapter contains a brief overview with specific intentions and purposes of that section or chapter.

Part 1 contains 2 chapters that lay the guiding themes and foundational work for the book as a whole. These guiding themes are: (1) integrating learning, development, and performance; (2) connecting education, work, personal life, and citizenship; (3) transforming undergraduate education; and (4) taking responsibility for student learning. Part 2 contains 3 chapters that address the question "What is learning the that lasts?" These chapters look at the student as a learner, as a developing person, and as a graduate who is a performer and contributor in work, personal, and civic life. Part 3, titled "Interpreting and Envisioning Learning That Lasts," contains the educational theory of learning that lasts. This includes a model that is the theoretical centerpiece, a model of transformative learning. Part 4, "Fostering Learning That Lasts," has 5 chapters that provide examples and evidence in the application of the model. Here the researchers demonstrate examples of how they have integrated theory, research, and practice at Alverno College. They attempt to take the next step in application of the model, not only as individual educators in the classrooms, but rather broadening and collaborating across curriculum and ultimately institutions. The text includes 11 appendixes, 9 tables, 16 figures, 8 exhibits, both subject and name indexes, and an extensive 43-page reference section.

One of the most useful aspects of this book for physical therapy is the model of transformative learning that is outlined in chapter 6. The model places the active learner in the center of transformative learning cycles integrating 4 domains of growth: reasoning, performance, self-reflection, and development. While physical therapy curricula often focus on the domains of reasoning and performance, the domains of self-reflection and development of self are often lacking. These transformative learning cycles in which the learner moves from one domain to another include: (1) using metacognitive strategies; (2) self-assessing role performance; and (3) engaging diverse approaches, views, and activities. These cycles move from an external focus on competence, where reasoning and performance are the primary domains, to an internal focus on meaning, where the domains include development and self-reflection. This development of self and critical self-reflection are key elements of professional competence. Students who struggle to self-reflect upon their performance and appear to be immature in their development of self may complete the didactic portions of the physical therapy curriculum but are at risk during clinical education experiences, where the practice setting requires thought during performance and an appreciation of diverse approaches and multiple perspectives. This model may be helpful in curriculum evaluation and the enhancement of learning experiences to foster growth in these transformative cycles of learning in physical therapy curricula. Clinical simulations with standardized patients followed by immediate written reflection of performance may be one example of attempting to incorporate this model into curricula.

Appendix A contains an example of an ability-based learning program. The distinction with this type of program is the explicit expectation that students should be doing something with their knowledge. Physical therapy educators certainly expect their students to be "doing something" with their knowledge, and the clinical performance instrument (CPI) outlines 24 of these outcomes that students should have for professional (entry-level) competence in practice. Some of the specific abilities identified in the exemplar in Appendix A (eg, communication, problem solving) are similar to the criterion used to evaluate physical therapist student performance with the CPI. The appendix shows how these outcomes are made teachable through a series of developmental levels corresponding to student progress and applied throughout their college career. This may be helpful to physical therapy educators looking at curricular development and assessment. Appendix B outlines an example of a longitudinal study of graduates and might prove helpful for looking at student development over time in a professional program.