11 General introduction and self-directed processes. [16] Hence, treating adult learning in the same manner as children’s learning is inappropriate, as the two follow significantly different paradigms. David Kolb incorporated the concept of experiential learning in his theory of learning, presenting a dynamic learning cycle characterized by four interconnected stages: (1) concrete experience, (2) reflective observation, (3) abstract conceptualization, and (4) active experimentation. [17] This cycle forms a continuous and iterative process, facilitating a comprehensive understanding of the learning experience. In Kolb’s framework, guidance plays a pivotal role in facilitating the learning process and enhancing the effectiveness of experiential learning. This guidance can come from various sources, including teachers, mentors, or peers, enabling learners to maximize their experiences, navigate the learning cycle stages, and promote deeper reflection, conceptualization, and thoughtful experimentation, thereby enhancing their understanding and skills. [17] Kolb’s strong emphasis on experiential and reflective learning continues to hold significance in contemporary medical education. [18-21] Research has shown that present-day medical education curricula have indeed integrated experiential learning and reflection as essential components. [22] Nevertheless, questions arise regarding whether these educational principles are effectively applied in SDM training, considering that a gap persists in the transfer of SDM skills following training. [5] Moreover, it is crucial to recognize that even with high-quality SDM training initiatives, achieving the desired learning outcomes can be challenging. The decline in professional skills that residents experience when they transition into practice, as described earlier in this chapter, [2, 3] might similarly apply to SDM training initiatives. These unintended or even undesirable training results have been acknowledged before and are often called ‘informal learning’. Informal learning is characterized by the spontaneous and self-directed acquisition of knowledge and skills through day-to-day experiences and interaction. [23] It closely relates to the ‘hidden curriculum’ concept, which encompasses unspoken and implicit lessons, values, and behaviors unintentionally transmitted alongside formal education. [24, 25] Therefore, when considering training initiatives for residents, it is essential to consider both formal learning within structured programs and informal learning within residents’ workplace and, thus, social environment. Consequently, it is crucial to delve into the dynamics of this social environment, focusing on its intricate connection with culture before further exploring behavior change. The social environment, culture, and behavior change Recognizing the pivotal role of the social environment in workplace learning, Etienne Wenger and Jean Lave introduced the concept of ‘communities of practice’. They defined these as social environments comprised of individuals who share common interests and knowledge domains and engage in activities relevant to their field. [26] Within these communities, learners actively 1
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