Constructivism: reflections on twenty five years teaching the constructivist approach in medical education

There is no single overarching theoretical framework that accounts for how we learn in all situations. There are many theories of how we learn from our experiences and there are many theories of what experiences are. We know that we do learn and that we have knowledge but there is no consensus on the relationship between the mechanism by which our brains learn and the optimal way in which we should be taught. In other words there is no necessary connection between epistemology and pedagogy. We seem capable of learning from a wide variety of pedagogical processes and although there is empirical evidence that some ways of learning are more effective than others in specific situations no one pedagogical method dominates. However, reflecting on twenty five years as a medical educationalist I have come to the conclusion that there is one framework that makes more connections between different epistemological and pedagogical theories than others and that could have support from neuroscience. I wish to explore the connections between a variety of educational, communication and psychotherapeutic processes and try to show that constructivism holds the promise of providing some unity to the practice of education and learning.