Duckworth on Education: Contextual Learning

“Learning should not be confined to the classroom.”

While most EMS educators would agree with this statement, it can be difficult to figure out how to take advantage of learning opportunities that might be available in dynamic and uncontrolled environments.

While it is sometimes thought of as a prime example of classroom healthcare education, in its “Resuscitation Education Science: Education Strategies” scientific statement, the American Heart Association declared contextual learning—the use of “real-world” training contexts—one of the key education strategies to lead to improvement in real-world resuscitation performance.

Contextual Learning

Students often struggle with learning new concepts in a classroom, then applying them in real-world contexts. Contextualizing learning uses a variety of experiences to help students process and connect with new concepts in a way that lets them use what they’ve learned. These can include simulations as well as working with real patients.

But contextual learning is more than just learning in different settings beyond the classroom. While it does include experiences such as internships, ride-alongs, and clinical rotations, it is much more than just the idea of “learn by doing.” While exact definitions may differ, many would agree that contextual learning fosters the idea that the right answer for an EMS provider to give, and the right action for them to take, will often depend on the context in which the provider finds themselves. This is becoming more and more important as healthcare in general and EMS specifically move away from the “always” and “never” rules many of us have been taught, such as “never enter a scene until it is completely safe” and “always give oxygen.” As we seek to prepare emergency responders with critical thinking skills to make difficult decisions in the field, contextual learning is an important tool to use.

Each learner brings their own expertise, attitudes, skills, and knowledge gaps to each context. One implication of this idea is that you can put a team of three learners in the same situation, and the context will be different for each. Not only will each learner likely perform different functions—such as team leader, airway management, etc.—each will have their own priorities and perspectives. As the learner’s “guide on the side,” the educator should take this into account when seeking to help the learner learn from and perform in the situation.

GRASPS for Better Performance

Context is not just a location. Context is the situation in which the student finds themselves. If we don’t give students the key information to understand the context when they are learning or being tested, it can lead them to misunderstand or perform incorrectly. The GRASPS mnemonic helps focus teaching and testing more specifically on the context of the task.

• Goal—What is the big picture the student is trying to achieve in this context?
• Role—What is the specific role that the student is playing in this context?
• Audience—To or for whom is the task being performed? (This is usually a specific patient.)
• Situation—What is the “real-life” situation here? This includes not only the place and time but also the problems and resources involved.
• Products—What specifically is the student seeking to accomplish here?
• Standards—What are the required elements to be achieved to call this task successful?

Performance can be improved and better assessed by ensuring the GRASPS elements are clear for both students and educators/evaluators.

Integrating Methods

The ideas at the heart of contextual learning integrate well with other proven education methods, especially those that focus on critical thinking and decision-making. For EMS educators this can mean improving your teaching sessions by doing the following:

• Focus on real-world situations and issues;
• Emphasize real-world problem solving;
• Keep in mind different student experiences and perspectives;
• Encourage collaborative learning among students;
• Encourage and assist with connecting theory (classroom) with application (real world);
• Emphasize that teaching and learning occur in a variety of contexts;
• Ensure assessments use clear and authentic contexts.

Contextual learning isn’t new. American psychologist and educational reformer John Dewey promoted these concepts in the early 1900s. To steer educators away from the idea of teaching as a simple transfer of knowledge, Dewey said, “Education is not preparation for life; education is life itself.” He was promoting the idea we now call “lifelong learning,” saying that a learner, properly equipped by a great educator, should be able to effectively learn from and improve in all contexts in which they find themselves.

Rommie L. Duckworth, LP, is a dedicated emergency responder and award-winning educator with more than 25 years working in career and volunteer fire departments, hospital healthcare systems, and public and private emergency medical services. He is currently a career fire captain and paramedic EMS coordinator.