Three BIG Ideas

Big Idea 1: My Learners Are Adults

My students are not empty vessels; many arrive with significant life and work experience, and all are adults preparing for a demanding profession. Knowles’s distinction between pedagogy and andragogy reframed how I see them. As Loeng (2020) explains, andragogy and self-directed learning emerged together as attempts to define adult education as distinct from childhood schooling: the learner is understood to move toward increasing self-directedness, the teacher’s role is to encourage that movement, and the learner’s accumulated experience becomes a source for learning rather than something of little importance. In the pedagogical model I had unconsciously imported, the teacher decides what and how to teach, the learner is dependent, and motivation is extrinsic, tied to grades and passing the exam. That was an uncomfortably accurate portrait of how I had been running my classroom.

Loeng (2020) also adds a caution that matters in a high-stakes program: self-direction is not a universal trait adults automatically bring into every setting. Drawing on Candy and Pratt, he notes that when goals and content are externally determined beforehand, as much of a paramedic curriculum necessarily is, full self-direction is difficult, and being resourceful is not the same as being self-directed. True self-direction requires awareness of the learning process and the capacity to make critical judgments, and the development of that judgment, he argues, is central. That nuance protects me from a naive swing toward simply letting the adults figure it out, and points instead toward deliberately cultivating judgment.

Akyıldız (2019) extends this progression to heutagogy, in which learners take genuine control of what and how they learn. What makes heutagogy more than a slogan, for my purposes, is its emphasis on developing capability, the ability to take effective action in unfamiliar conditions, alongside competency, and its use of double-loop learning, in which learners interrogate not only their actions but the values and assumptions underneath them. Capability under novel conditions is precisely what distinguishes a paramedic who can follow a protocol from one who can adapt when the call does not match it.

This idea resonates because self and peer assessment are already part of my practice, yet I had been treating them as soft add-ons to the “real” testing. Andragogy and heutagogy reposition them as central. If my learners are capable of self-direction, and if my job is to develop that capacity rather than assume it, then inviting them to judge their own and one another’s performance is not a courtesy. It is how they build the critical judgment a paramedic must exercise alone at three in the morning, when no examiner is present and the situation does not fit the textbook.

Big Idea 2: Assessment for Learning and Programmatic Assessment

The second idea is the shift from assessment of learning to assessment for learning. Schuwirth and van der Vleuten (2019) trace a three-stage evolution: assessment began as a measurement problem (is this a good test?), matured into an educational design problem (how does this assessment shape learning?), and has become a problem of staff expertise (can our assessors exercise sound judgment?). They capture this with a toolkit metaphor: in the testing era the question was whether a hammer beat a screwdriver, while in the programmatic era value lies in the interaction between the quality of the tool and the expertise of the person wielding it. That reframing positioned assessment as something my colleagues and I must become skilled at, not merely something we administer.

In programmatic assessment, information about a learner’s competence is combined, triangulated, and evaluated across many assessment moments to reach meaningful, content-based conclusions. Schuwirth and van der Vleuten (2019) argue that this mirrors clinical reasoning: a clinician does not average “no abdominal pain” with “considerable neck ache” into “average pain,” but combines neck pain, fever, and an abnormal white-cell count into a diagnosis of possible meningitis. Because results generalize better across formats with similar content than across content within one format, triangulating a weak skills station against a written item and a mini-clinical-evaluation tells a more valid story than any single score. This view of validity, as a series of convincing narratives that may contain numbers but are not reducible to them, was new to me, and it directly challenges the single-verdict habit described earlier.

Crucially, the authors distinguish assessment for learning from mere formative assessment. In formative assessment, feedback is given without stakes, and its effect depends entirely on whether the student acts on it; if they do not, there are no consequences. In assessment for learning, the onus shifts to the learner to collect, collate, and analyze information about their own competence and translate it into doable learning goals, usually supported by a coach or mentor and a portfolio (Schuwirth & van der Vleuten, 2019). The summative dimension does not disappear; it migrates to the quality of the learning goals the student sets and demonstrably achieves. This maps almost perfectly onto paramedic education and dignifies the messy, longitudinal way clinical competence actually develops.

Big Idea 3: Building a Culture of Assessment from First Principles

The third idea reaches beyond technique to culture. Hong and Moloney (2020) describe first-principles thinking as a questioning process that strips a practice down to its underlying assumptions until only what is demonstrably true remains, then rebuilds from there: surfacing the “natural scripts” we have repeated so often that they feel like truth, breaking the problem down to its basics, and constructing new solutions aligned with those truths. The scripts they name, that assessment must happen a certain way because it always has, or because it proves to others that we have a culture of assessment, sounded uncomfortably familiar.

What gives the approach traction is the set of core truths Hong and Moloney (2020) offer as foundations: that assessment is fundamentally about students and their learning; that it can shift the paradigm from teaching to learning; that it creates space for critical reflection and action; and that assessment data are valuable only when used. Tested against those truths, my pass/fail gates were hard to defend, because they generated a verdict rarely used to change anything. Grannan and Calkins (2018) complement this by showing how a culture of assessment is grown deliberately, through peer-led, evidence-based conversation among faculty, rather than imposed through compliance or by trying to sell faculty on buy-in.

This resonates most directly with my position. I am a relatively new educator inheriting an established assessment culture, and it would be easy simply to perpetuate the scripts handed to me, including the pass/fail reflex I arrived with from the field. The first-principles approach of Hong and Moloney (2020) gives me both permission and a method to ask why we assess the way we do, to name the assumptions out loud, and to rebuild from what we actually value rather than from habit.