Many Registered Dietitians (RD) work with adults, and few RDs work solely with children or adolescents.
RDs working with adults are primarily in acute-care clinical, outpatient, community, public health, telehealth, sports, or private practice settings. Every nutrition education or counseling session is an opportunity to teach a patient or client about food and nutrition.
Therefore, RDs must be effective teachers to facilitate their patient's or client's learning.
The science and art of adult learning is called andragogy. Andragogy was popularized by Malcolm Knowles in the 1960s when he developed six assumptions or systems of concepts about adult learners.
We covered the first four assumptions in the two previous articles, which can be found here:
What are Knowles’ assumptions about adult learners?
Assumptions of Adult Learners 1 - 4:
As a person matures, his or her self-concept moves from that of a dependent personality toward one of a self-directing human being.
An adult accumulates a growing reservoir of experience, which is a rich source for learning.
The readiness of an adult to learn is closely related to the developmental tasks of his or her social role.
There is a chance in time perspective as people mature from future application of knowledge to immediacy of application. Thus, an adult is more problem-centered than subject-centered in learning.
In this article, we will not only review the fifth and sixth adult learner assumptions but also demonstrate their direct application to nutrition and dietetics.
By understanding these principles, RDs can tailor their teaching methods to the unique needs and motivations of their patients or clients, thereby enhancing the effectiveness of their nutrition education and counseling sessions.
Assumption 5: The most potent motivations are internal rather than external.
This assumption about the adult learner is one most RDs will be familiar with. Patients or clients are most successful in goal acquisition when internally motivated rather than externally motivated.
Motivation is the inner force that drives a person toward achieving a goal.
Internal (or intrinsic) motivation comes from within the individual and is usually driven by interest, enjoyment, or personal satisfaction.
External (or extrinsic) motivation comes from outside forces such as pay, competition, or coercion.
Research has shown internal motivators to be more effective than external motivators, at least in the long run (e.g., sustained weight loss). In reality, patients or clients usually have a blend of internal and external motivators.
How do RDs determine the learner's internal and external motivators? Of course, the RD can ask them. However, some patients or clients will need further unpacking.
It helps to understand the individual's learning orientation: goal-oriented, activity-oriented, or learning-oriented.
Goal-oriented learners use knowledge to achieve another goal, such as clients walking 10,000 steps to reduce medical insurance costs or older adults increasing their calcium intake to reduce the risk of osteoporosis.
Activity-oriented learners learn for the sake of the activity and social interaction, like undergraduate students joining clubs to connect with other students.
Learning-oriented learners seek knowledge for its own sake; this type of learner is rare in acute care or outpatient settings but may be found in private practice.
Understanding the individual's learning orientation will help reveal their internal and external motivators. Supporting the patient or client’s motivation and goals is essential to dietetics practice.
Dr. Raymond Wlodkowski, a pioneer in motivational strategies, established a motivational framework that uses expertise, empathy, enthusiasm, clarity, and cultural responsiveness to help motivate adult learners. RDs should foster and emphasize the learner’s internal motivation to ensure long-term success.
Assumption 6: Adults need to know why they need to learn something.
Adult learners need to be told or shown why something is important. Teaching adults is not like teaching children (i.e., pedagogy), where the individual does what they are told without question. Even this pedagogical approach is old-fashioned and ineffective.
Remember, adults are autonomous (Assumption 1) and can terminate the learning process at any time. Telling adults what to do without explaining the rationale is disrespectful and belittling.
Adults who are dictated to will end the RD-learner relationship immediately, especially seasoned learners. For instance, professional athletes are typically mature learners who understand every aspect of their sport and body. An RD telling a seasoned baseball player to start taking creatine monohydrate because "I am the food and nutrition expert" will be poorly received.
However, if the RD explains the science between creatine and sprinting performance, the athlete may be more willing to start taking the supplement. Informing a learner of why they should follow your nutrition advice will help them keep their dietary lifestyle within their locus of control and improve the likelihood of success. In brief, provide your nutrition advice, tell them why, and then sit back and let them decide.
Malcolm Knowles's six assumptions of the adult learner are a set of best practices designed to lead to effective learning. In short, RDs must consider the adult learner's…
autonomy and self-directedness,
past experiences and present knowledge,
readiness to learn,
current issues or problems,
internal motivations, and
desire to know why they should follow your recommendation.
Still, no one set of assumptions or concepts ensures patient or client lifestyle change. Numerous barriers to change include procrastination, preconditioned cultural beliefs, risk complacency, indifference or helplessness, rationalization, and many more. The best nutrition practice to support dietary change is evidence-based, ethical, and communicated effectively.
Malcolm Knowles Assumptions of Andragogy (AA)
As a person matures, his or her self-concept moves from that of a dependent personality toward one of a self-directing human being. Autonomy.
An adult accumulates a growing reservoir of experience, which is a rich source for learning. Experience.
The readiness of an adult to learn is closely related to the developmental tasks of his or her social role. Readiness.
There is a chance in time perspective as people mature from future application of knowledge to immediacy of application. Thus, an adult is more problem-centered than subject-centered in learning. Situation.
The most potent motivations are internal rather than external. Motivation.
Adults need to know why they need to learn something. Understanding.
Do you desire to effectively teach nutrition to adults?
Consider their autonomy, experience, readiness, situation, motivation, and understanding.
“If there is no struggle, there is no progress.” ~ Frederick Douglass
Additional Reading References:
This guest post was written by Brandon Lee, MS, RD, CCRP. Read his story on the community page.
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