Published: 10/03/2005, Volume II5, No. 5946 Page 34

Needs assessment and personal development plans can often have the opposite effect to that intended. But what is the best way for staff to pursue training needs? Kieran Walsh reports

Education went a bit mad in the 1960s.

Out went rote learning and the cane and in came creative learning and personal development. Old headmasters retired, and while they cared for their gardens, educationalists cared for the kids.

Like many parties it was fun while it lasted. The hangover was a long time coming, but when it did everyone had an enormous headache: children, parents, teachers and employers. The creative learners had reading ages of nine, thought 1066 had to come before 'and all that' and couldn't fill out job application forms.

To their credit, the government and teachers took action and went back to basics - reading, writing and maths.

What has all this got to do with healthcare? Healthcare education in this country is in the age of Aquarius - about 1969. We are lost in a haze of learning-needs assessment and personal development plans.

Recently a junior manager told me that if one more person asked her to reflect on her learning needs she would scream. She said her main learning need was to get her MBA. This may be heresy to person-centred learning, but it makes sense to her: she wants to become a senior manager.

And what about the seniors? A ward sister once told me that she had been in her post for 10 years and had spent most of her study days during that time fulfilling her learning needs. She felt that after 10 years perhaps it was time to pay attention to her learning wants. She worked on a respiratory ward but wanted to learn some cardiology. She went on a cardiology course she came back refreshed and ready for work.

But how would she have done this if she was only paying attention to her learning needs? Pick up a book on a coffee table and you will learn things that no learning-needs assessment exercise would ever have told you about.

And what of personal and professional development plans? Recording your learning is all very well, but sometimes it can get in the way of the learning.

Supposing I decide that I must learn about clinical governance. First I must decide that I will start next week and achieve my learning goals a month from now and use a range of learning resources. Then I must choose relevant resources and start learning.

But why can't I just pick up a book? It is impossible to record all your learning in any case. I pick up many things in fiveminute conversations in the corridor, but these learning nuggets would not fit easily into any organised plan.

Ironically, if we were to make more of this practice, we would be adhering to the principles of adult learning theory: adults are self-directing; they are interested in immediate problem-centred approaches;

they are mainly motivated to learn by internal drivers. Learning-needs assessment and professional development plans have their place. They should help us learn, but should not get in our way.

Some people like lectures, others prefer workshops and some are enthusiastic about online learning. But whatever your learning style, the best way to learn is just to get on with it.

And what are the three Rs that we all need to know something about? They are knowledge, skills and attitudes. No matter if you are a manager or nurse or doctor, no matter what your grade, anyone can learn new knowledge or hone rusty skills or improve their attitudes to work or patients.

And these are the things patients would like us to learn about.

Conversely, they may not be impressed by an enormous folder packed with learning needs and plans to meet these needs.

Too often in the past patients have been used as a prop in healthcare teaching - medical students were told 'to go and see that case who has Marfan's disease in ward three'.

And with unerring logic the medical students picked up the hidden message - patients are objects that we can practise on. They remembered this long after they forgot all about Marfan's disease.

In future patients will have an increasing role in deciding what healthcare professionals learn about. But the most important message is that learning is first nature to all of us - everything else just gets in the way. So pick up a book or go to a talk now: you may avoid a hangover later.

Kieran Walsh is editorial registrar at bmjlearning. com