Experiential Learning and its application in Clinical Rotations and Clerkships

What is Experiential Learning Theory (ELT)?

In simple words, it is learning from experience. More than two thousands years ago Aristotle described it this way- “For the things we have to learn before we can do them, we learn by doing them" (The Nicomachean Ethics).

Many of us can remember the first time we tried to ride a bicycle or drive a car. Some read the instructions or watched a video to prepare, while others jumped in immediately and kept endeavouring and working at it until they grasped it.

There are many theories and assumptions about how adults learn. Experiential learning theory (ELT) is relevant to teaching in medical education, especially in the clinical years. ELT was based on theories such as the Constructivist adult learning theory. It implies learning is the process whereby the creation of knowledge is through the transformation of experience. The constructivist theory focuses on the role of reflection in the learning experience. Another key dimension of ELT was established on the socio-cultural theories that emphasize learning is situated and depends on the context of the experience.

Many theorists have contributed to ELT and proposed different models of how people learn from experience. John Dewey suggested that “for learning to happen the experience should exhibit continuity and interactions" (Experience and Education). Learners must connect what they learned in experience and also see future implications. Theorists built on Dewey’s ideas and contributed significantly to the development of ELT include Lewin, Piaget, Knowles, and Kolb1.

How do we learn from life experiences?

Kolb and Kolb proposed six characteristics of experiential learning. Their effort was built on the work done by John Dewey and others and was noticeable in various models of EL. According to Kolb’s notion, these features are essential to learning from experiences.1,4

  1. Learning is best conceived as a process, not in terms of outcomes.
  2. Learning is relearning a continuous process grounded in experience.
  3. Learning requires the resolution of conflicts between dialectically opposed modes of adaptation because learning is by its very nature full of tension.
  4. Learning is a holistic process of adaptation to the world.
  5. Learning involves transactions between the person and the environment.
  6. Learning is the process of creating knowledge that is the result of the transaction between social knowledge and personal knowledge

The work of David Kolb remains the most influential and his approach will be discussed here as a model for use in clerkships. He says, “Knowledge results from the combination of grasping and transforming experience". He proposed Kolb’s learning cycle (figure 1.)


Figure 1. Kolb’s Experiential learning cycle

Kolb’s Cycle as a Model for Clerkship Teaching

Clerkships present many challenges to both instructors and students. Instructors confront difficulties in effectively delivering information to students who differ in their learning styles. More often, students do not have a conscious awareness of how they learn. Applying teaching approaches based on Kolb’s model of experiential learning can contribute to improving learning in clinical rotations especially in the clerkships

Kolb proposed that learning from experiences requires four different kinds of abilities. A description and example for each is provided below3,4,5.

Abilities to learn in Kolb’s cycle Clerkship experiences
1. Concrete experience: An openness and willingness to involve oneself in new experiences The student is assigned a patient in a clinical rotation, takes history/ performs physical exam, develops differential diagnosis and a plan.
2. Reflective Observation: An ability to think about what has been observed during the new experience. The student “makes sense" of what has been observed. The student reflects on the clinical encounter. At this learner level, this is best achieved when it’s triggered by feedback from a more experienced clinician (a resident or an attending). Students should ask for feedback if it’s not given.
3. Abstract conceptualization: Also known as “figurative representation" and “transformation of that representation of experience" The student uses the reflection to self-improve his/her knowledge, physical exam techniques and problem-solving skills. A student identifies what they need to learn to build on existing knowledge and gets engaged in active learning through self-directed learning (SDL). Reading about each encounter will enrich the learning. The illness might be similar to a previous experience, but the patient and the contextual background might add a new perspective to the encounter
4. Active experimentation: ‘learners try out for themselves what they have learned in response to different experience.’ The outcome of feedback and the SDL helps a student to experiment with a new approach (e.g. problem solving skill, physical exam technique,..) and test it on a new experience. The new experience will generate a new reflection, approach and new experience.

What is the Kolb Learning Style Inventory?

In 1985 Kolb published the learning Style Inventory (LSI), a standardized test that measures an individual’s approach to learning. It is based on his four-stage learning cycle (as described above). In this respect, Kolb’s model differs from others. It offers both a way to understand individual learning styles (hence the name LSI) and how they fit into an explanation of a cycle of experiential learning that applies to all learners. According to Kolb, the Diverging learner is sensitive, imaginative and emotional and prefers to work in groups. While the Assimilating learner focuses on people as well as on ideas and concepts. The Converging learner prefers technical tasks and is less concerned with people. Lastly, the Accommodating learner uses other people’s analysis and prefers to work in teams.1,4

Students’ awareness of their LS will help them adapt better to the Kolb’s cycle of EL and hence it is worth asking students to do LSI prior to the clinical rotations. Kolb also explains that as individuals mature they have a tendency to reconcile and integrate appropriately the four learning styles. Kolb as identifies these development stages:

  1. Acquisition − from birth to adolescence
  2. Specialization − schooling, early work and personal experiences of adulthood
  3. Integration − mid-career through to later life.

In Summary

There are critics who believe that ELT is uncomfortable for those who do not understand the reflective process, that it is time-consuming and that it may create confusion about which situation or experience to reflect upon. Nonetheless, ELT is well adapted for use in medical education for the following reasons: it increases learning from experiences by identifying the learner’s strengths and areas for improvement. Furthermore, ELT augments individual’s understanding of their values, beliefs, and self-directed learning skills and provides feedback.

The author would like to acknowledge the support of Dr. Mary Anne Baker in editing the article.

For further reading on this topic, please refer to the following selected references.


  1. Caffarella, R. S., & Baumgartner, L. M. (2007). Experience And Learning. In S. B. Merriam (Author), Learning in Adulthood (3rd ed., pp. 159-186). San Francisco, CA: Jossey-Bass.
  2. Dewey, J. (1938). Experience and education. New York: Macmillan.
  3. Greenberg, L., & Blatt, B. (2010). Perspective: Successfully Negotiating the Clerkship Years of Medical School: A Guide for Medical Students, Implications for Residents and Faculty. Academic Medicine, 85(4), 706-709. doi:10.1097/acm.0b013e3181d2aaf2
  4. Kolb, A. Y., & Kolb, D. A. (2005). Learning Styles and Learning Spaces: Enhancing Experiential Learning in Higher Education. Academy of Management Learning & Education, 4(2), 193-212. doi:10.5465/amle.2005.17268566
  5. Yardley, S., Teunissen, P. W., & Dornan, T. (2012). Experiential learning: AMEE Guide No. 63. Med Teach Medical Teacher, 34(10), E102-E115. doi:10.3109/0142159x.2012.742724

Written for June 2015 by
Mai A. Mahmoud, MD, FACP
Assistant Professor of Medicine
Co-Director- Medicine Clerkship
Director Introductory to Clerkship
Weill Cornell Medical College in Qatar