The institution that was most relevant here was, of course, the hospital and the health system as a whole. Learning in a hospital is very different from learning in school. This is something that we failed to attend to with sufficient care as we worked with our adult learners. One of the key differences between adult and young learners (as described above) is the distinction between problem finding and problem solving. We focused on problem solving without ever realizing how frustrating such a focus was to our patients. In the future I will present material in a way that encourages adult learners to begin to ask their own questions about (for example), what health means to them, how they personally deal with the issue of change, what they believe to be the ongoing goals that are of greatest importance to them.

Another change that I would make in the future is the way in which leaders of such diabetes education clinics is the way in which time was used. Again, this is a question in some measure that arises because of differing expectations between adult and young learners. Children have spent their formal learning and education experiences in schools where time is constantly being segmented. Children understand from a great deal of personal experience the fact that they will be expected to be moved from one subject to another or from one classroom to another at predictable intervals.

Adult learners for the most part will have experienced this same routine as children but will have gotten out of the practice of doing so. Thus our agenda, which focused on the same kind of time-based modules tended to increase rather than reduce stress, which had been our goal. Weber and Berthoin (2003, p. 355) wrote that "Time pressure can both accelerate and slow down learning processes" depending on whether temporal increments are "experienced as motivating or threatening" depending...

And when this occurs "learning can be slowed or made impossible altogether" (p. 355).
Just as children are not simply small adults, adults are not simply large children when it comes to what they need in terms of the most effective learning environments. Incorporating adult learning theory as I go forward will allow me to serve adults far better.

References

Arlin, P.K. (1984). Adolescent and adult thought: A structural interpretation. In M.L. Commons, F.A. Richards, and C. Armon (Eds.), Beyond formal operations: Late adolescent and adult cognitive development. New York: Praeger.

Child, J. & Heavens, S.J. (2003). The social constitution of organizations and its implications for organizational learning. In M. Dierkes, A. Berthoin Antal, J. Child & I. Nonaka (Eds.), Handbook of organizational leadership and knowledge (pp. 308-326). New York: Oxford University Press, Inc.

Clark, S., & Mirabile, R. (2004). Knowledge mapping: An application model for organizations. In M. Goldsmith, H. Morgan & A.J. Ogg (Eds.), Leading organizational learning (pp. 113-120). San Francisco: Jossey-Bass.

Gardner, H. (1993). Multiple intelligences: The theory in practice. New York: Basic Books.

Gardner, H. (1999). Multiple intelligences for the 21st century. New York: Basic Books.

Knowles, M.S. (1980). The modern practice of adult education: From pedagogy to andragogy. (2nd ed.) New York: Cambridge Books.

Weber, C., & Berthoin Antal, A. (2003). The role of time in organizational learning. In M. Dierkes, A. Berthoin Antal, J. Child & I. Nonaka (Eds.), Handbook of organizational learning and knowledge (pp. 351-368). New York: Oxford University Press, Inc.