InnovAiT, 0(0), 1–5

Learning styles
Dr Anish Kotecha
GP, Cwmbran Village Surgery, South Wales
Email: dr.anishkotecha@gmail.com

G eneral practice requires a breadth of knowledge and continual learning. Professional

development requires ongoing commitment, dedication and a strong work ethic. Often
acceptance of the need to learn is not matched by knowledge of how best to learn.
Educational theory suggests that being aware of individual learning preference allows
more effective learning. There are several methods of learning and different learning
activities will suit people according to preferred learning styles. A trainer, for example,
can prepare more effective tutorials with this knowledge. This article considers some of the
models of learning style to inform more effective individual learning.

The GP curriculum and learning styles

Professional module 2.04: Enhancing professional knowledge states that:

. As a GP you should have the skills to learn, critically appraise and teach
. You should be able to appraise research and guidelines critically, understanding their generalisability and validity
. You should be able to apply evidence in the context of the patient, the community and the healthcare setting
. You should be able to audit your own practice and that of your organisation, and develop changes in the light of the
findings
. You should be able to work within a multidisciplinary team so that the views and knowledge of the whole team are
applied when discussing the care of a patient
. You should be able to demonstrate the competences of shared leadership so as to maximise the effectiveness of healthcare
delivery
. You should ensure you are up-to-date in managing the acute care of patients
. You should, as part of supervising others in your team, be able to teach the need for safer practice and better patient care
. You should be willing to receive feedback as a teacher from individuals or groups in order to improve and learn from your
teaching and educational sessions
. You should be aware that your own health and that of your colleagues should be optimal to ensure safe practice

Background . Limited clinical experience of a wide range of conditions

Learning is a lifelong process and requires active engagement . The rarity of certain important conditions and
from the learner. There is a rich environment for learning in presentations
medicine with many different and innovative ways of absorb- Gaps in knowledge will vary between individuals based on
ing information including professional conversations, events a range of factors. However, it is important to understand the
and conferences, books, online modules, webcasts and pod- unknown gaps in knowledge. This concept has been illu-
casts. Learning in general practice is challenged by: strated by the Johari Window created by Joseph Luft and
. The wide range of problems presenting to GPs Harrington Ingram (1955) (Fig. 1). This affirms that there are
. A generalist information base lacking depth on many spe- ‘blind spots’ in knowledge, but also highlights that individuals
cialist conditions may not know what they do not know.

InnovAiT, 2019, Vol. 0(0), 1–5, ! The Author(s) 2019.

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Figure 1. Johari’s window. Figure 2. Kolb’s learning cycle.

Known to self Unknown to self Concrete

experience
Open Blind spot (doing/having an
Known to

experience)
others

Acve Reflecve
Hidden Unknown to all
Unknown
to others

experimentaon observaon
(planning/trying out (reviewing/reflecng
what you've learned on the experience

These ‘blind spots’ can be identified formally or informally,
for example, within consultations, in discussions with col-
leagues, by scrutiny of the RCGP curriculum or in reviewing
guidelines, such as those from the National Institute of Health
and Care Excellence. A trainer might give a trainee insight
from a variety of experiences that impact on the trainee’s
learning. This could include exploring use of different styles
of learning to enhance learning opportunities and remove or
reduce the ‘blind’ or ‘unknown’ areas.
Lynn Curry (1999) suggests that variables affecting our
learning can be recognised in three groups (which can be
illustrated by the layers of an onion):
. The inner layer represents the ‘cognitive style’: These are
the factors that motivate us to learn and are difficult to
change
. The middle layer represents our ‘learning style’: This mainly
refers to the learning styles showing how we process infor-
mation but is also influenced by our preference to learn
through social interaction or by working alone
. The outer layer represents ‘affective style’: This describes
the environmental factors that affect learning and can be
easily modified
This article will introduce the basic principles of some of the
common models of learning styles, but does not provide an
exhaustive list. Different models make sense to different
people, and there is not one which is more right than another.
They all share the philosophy that learning is a dynamic pro-
cess. An early session between a trainer and trainee should
concentrate on identifying the learner’s preferred learning
style and learning how they learn best. As well as optimising
the trainee’s learning, these models can help us understand why
we teach in a certain way and assist in analysing a problematic
learning situation to look for an alternative way of proceeding.
Kolb’s learning cycle
David Kolb (2014) stated that new experiences create a
mechanism for the development of new concepts. His well-
known learning cycle comprises four stages (Fig. 2). He
hypothesises that learning is effective when individuals pro-
gress through each stage of the cycle. Therefore, after a
Abstract
conceptualisaon
(concluding/learning
from the experience)
concrete experience, one must reflect on that experience
and reach conclusions with new concepts arising that can
then be implemented. This gives new experiences from
which the cycle can be repeated. Kolb viewed this as an
integral process where full execution of each stage was
necessary for effective leaning.
VARK model
Neil Fleming and Colleen Mills (1992) co-contributed to the
VARK learning style model (Box 1). An individual may have a
preferred style or might learn well through a combination of a
few approaches. Certain individuals might have a multimodal
learning style displaying equal preference for more than one
approach.
Multiple intelligences
Howard Gardner identified seven intelligences documenting
how individuals learn in different ways (Box 2) (http://multi-
pleintelligencesoasis.org/). There is a suggestion that learners
are better served if education is formatted and assessed in a
variety of ways.
Honey and Mumford
Peter Honey and Alan Mumford (2015) identified four styles
that people use to learn. Usually people will follow one or two
of these preferences. Being aware of your personal learning
style or that of your trainee allows targeted educational activ-
ities that are more likely to be beneficial. Effective learners are
flexible and can function to some degree in all styles and take
advantage of most educational situations.
Activists – learn best by doing. They usually involve them-
selves in new experiences and act before considering the

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Box 1. VARK learning style model.
Visual
These learners generally prefer diagrams, illustrations,
handouts and videos. Lesson planning might concentrate
on flash cards, allowing for mental imagery, using visuals
including different colours. Different spatial arrangement
may also help. Mind maps and charts can be useful.
Auditory
These learners prefer group discussions, lectures, listening
to podcasts or audiobooks and can pay particular attention
to tone, pitch and speed of the trainer. They might read
notes out loud or record them.
Read/Write
These learners tend to like reading words or writing notes.
They often rearrange work into lists or points and re-write
notes in different ways and in their own words to help
them identify particular concepts.
Kinesthetic
These learners use strategies involving activity and move-
ment. They might listen to music while working or walk
around during revision. They will also stay active in class
by taking notes or drawing charts. Connecting learning
material to real-life situations helps them.
Box 2. Multiple intelligences.
. Visual-spatial : These people are aware of their envir-
onment and prefer learning through multimedia,
images, graphics, three-dimensional models,
photographs
. Bodily-kinesthetic: These individuals are aware of their
body. They read body language and learn using hands-
on experience, role play and physical activities
. Musical: These people are sensitive to music and
sounds. They work well with music in the background
and might prefer using audio-learning tools. Musical
arrangements of the education might suit them well
. Interpersonal: These individuals like interacting with
others and prefer group activities and dialogue in
conferences
. Intrapersonal: These people tend to prefer working
alone and use diaries. They have self-motivation and
strong determination and like the privacy of their own
space
. Linguistic: These individuals like using words and have
highly developed skills with vocabulary. Preferential
teaching methods would include reading, using word
documents and poetry
. Logical-mathematical: These people like using concepts
and patterns. Puzzles are often a good source of
education
consequences. Leading a group or working with others is pre-
fered and they like having opportunities to have a go. They
usually learn less if they have to attend lectures, analyse a lot
of data or follow precise instructions.
Pragmatists – learn best when there is an obvious link
between a topic and its intended learning need. They are
keen to try things and look for ideas to apply to a given prob-
lem. Using techniques with clear advantages and an example
helps them. They tend not to favour open-ended discussions
and learn less if there is no obvious benefit or clear guidelines.
Theorists – learn best by understanding the theory leading
to action. They prefer to have systematic ideas and concepts
within a structured situation. Subjective assessments tend to
alienate them and analysis and synthesis of information is
important to them. They learn less when talking about emo-
tions or feelings and having circumstances without obvious
clarity or direction.
Reflectors – learn best by observation and thinking about
what has happened. They are cautious and thoughtful, and
will consider all possible options and implications of each
before coming to a considered decision. Their preference is
to have time to think and review the situation and to prepare
before acting. They do not like working under pressure of
deadlines.
Myers and Briggs
The Myers–Briggs type indicator was developed to enable
people to discover their personality types and uses prefer-
ences rather than abilities or characters (The Myers & Briggs
Foundation, 2014). It is based on the understanding that
people differ in how they perceive situations and reach con-
clusions and can help identify how individuals may best learn.
Each of the following letters corresponds to a specific per-
sonality type. An individual will either be one or the other (or
have a stronger preference) within each pair:
I ¼ Introversion – preference of focusing on your own inner
world
E ¼ Extraversion – preference of focusing on the outer world
N ¼ Intuition – preference to interpret and add meaning to
information
S ¼ Sensing – preference to focus on basic information given
F ¼ Feeling – preference to look at people and circumstances
when making decisions
T ¼ Thinking – preference to look at consistency and logic
when making decisions
P ¼ Perceiving – preference to stay open to new information
when dealing with the outside world
J ¼ Judging – preference to make decisions when dealing with
the outside world
Once a person has decided on their preference in each
category, they will have a four-letter code which places
them in one of 16 personality types that are shown in a type
table (Fig. 3). These codes correspond to specific descriptors
of a person’s characteristics which can be found on the Myers–
Briggs website (details found in the references and further
information section below).
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Figure 3. Myers Briggs type table.
MBTIÕ Type Table www.myersbriggs.org/my-mbti-personality-type/
mbti-basics/home.htm?bhcp¼1. Adapted from Looking at TypeÕ : The
Fundamentals by Charles R. Martin. 1997. Used with permission from
Center for Applications of Psychological Type, Inc.
Applying learning styles in practice
Models of learning styles certainly have their place and can be
useful in an introductory tutorial to identify preferred ways of
learning. Identifying how a trainee likes to learn, what motiv-
ates them and any areas of difficulty can be insightful.
However, these theories have limitations. They may be
useful for understanding ourselves better and to confirm
ways we like to learn. Trainers can learn from experience
and from identifying the strengths and weaknesses of different
trainees. If learning is ineffective, these models may inform
explanations and challenge trainers to find new ways of
teaching.
The context of what is being learnt will obviously influence
the approach to teaching, but consideration of the learner
should be a priority. Trainees will often have their own
ideas about learning and these models can inform their think-
ing and may even offer some objectivity to subjective prefer-
ences. In group teaching, a variety of learning activities is
more likely to cater for different individual learning styles or
preferences. Be mindful that no particular learning style is
superior to another or indicative of level of intelligence.
Remember that patients will also have preferences on how
they are given information during the consultation. How do
we take this into account when giving information, advice and
explanations to patients? Do we consider whether conversa-
tion, diagrams, leaflets or reflection are most appropriate? To
clarify our explanations of disease and management it may be
helpful to consider a wider repertoire of techniques and to
more carefully check patients’ understanding.
The practical application of learning styles is important in
general practice. This can be appreciated by considering the
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example in Box 3 with colleagues. Work through these scen-
arios with colleagues and explore how differences are
informed by the different theories and learning styles.
Box 3. Putting learning styles into practice.
Think about your preferred learning style. How would you
approach each of the following scenarios?
1. Preparation of a tutorial on ‘consultation models’ for a
fellow GP trainee
2. Revision for the RCGP Clinical Skills Assessment exam
3. Explanation of chronic kidney disease and manage-
ment of risk factors to a newly diagnosed patient
4. Learning how to do joint injections
It is useful to compare your ideas against your colleagues’
and to reflect on possible reasons for differences by con-
sidering individual, predominant learning style. Do any
patterns emerge between colleagues? How do they link
back to educational theory?
Conclusion
Use of learning styles in education is controversial and there is
currently a lack of evidence to reliably inform choices.
However, by considering different learning styles, trainers,
trainees and patients may improve their communication.
Informed discussion about learning styles has the poten-
tial to enhance a learner’s educational experience,
encourage a wider variety of teaching methods and improve
learning.
KEY POINTS
. There are different learning styles and there are various
tools to identify individual preferences
. People are likely to have more than one preferred learn-
ing style
. Using different educational methods can strengthen less
preferred styles so individuals can benefit from more
learning opportunities
. Educational activities can be chosen to suit a preferred
learning style
. Trainers should acquire knowledge of trainees’ pre-
ferred learning styles
. Information and discussion about different learning
styles may enhance general practice education by
encouraging variety in teaching methods
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References and further information
Curry L (1999) Cognitive and learning styles in medical education.
Academic Medicine 74(4): 409–413.
Duncan P and Cox V (2013) Tips for GP trainees interested in
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Education Endowment Foundation. Learning styles teaching and
learning toolkit. Available at: https://educationendowmentfoun-
dation.org.uk/evidence-summaries/teaching-learning-toolkit/
learning-styles (accessed 10 July 2018).
Fleming ND and Mills C (1992) Not Another Inventory, Rather a
Catalyst for Reflection. To Improve the Academy 11: 137–155.
Honey and Mumford (2015) The e-learning network resources.
Honey and Mumford’s learning styles. Available at: http://
resources.eln.io/honey-and-mumford-learning-styles/
(accessed 28 June 2018).
Kolb D (2014) Experiential Learning: Experience as the Source of
Learning and Development. NJ, USA: Pearson FT Press.
Life Train. www.emtrain.eu/learning-styles (accessed 3 June 2018).
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California.
RCGP. Professional module 2.04: Enhancing professional know-
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gp-curriculum-overview/online-curriculum/working-in-sys-
tems-of-care/2-04-enhancing-professional-knowledge.aspx
(accessed 3 June 2018).
RCGP. How to learn general practice. Available at: www.rcgp.or-
g.uk/training-exams/training/gp-curriculum-overview/online-
curriculum/1-being-a-gp/how-to-learn-general-practice.aspx
(accessed 3 June 2018).
Rohrer D and Pashler H (2012) Learning styles: Where’s the evi-
dence? Medical Education 46: 630–635.
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