My first course in grad school was “Theory in Higher Education.” I confess to being lost and slightly bewildered during the initial classes. It felt like the first months of medical school with a new language to master and new ways to organize knowledge. My solution to my confusion was to find the four other physicians in the class. (The other students were already well versed in this lexicon via their previous social science or humanities education.) Each Tuesday evening, after the class concluded at 10:00 PM, the five of us would meet at a local restaurant and try to decipher what happened. New words we attempted to define. More importantly, we tried to decipher the theories presented in class. (This predated Google and instantaneous access to resources such as Education Theory Made Practical [ETMP].) Over time I became less clumsy with the language, and I began to appreciate how a theory could organize, predict, expand, or challenge the concepts and ideas I was encountering as a very new clinician-educator.

For a time, I imagined that there was a meta-framework that connected, ordered, and ranked all education theories. In hindsight, I perceive the influences of my medical training and the hidden (or perhaps not so hidden) influence of evidence-based medicine with its associated hierarchy of evidence. As a new educator, I struggled to find the “right” theory to explain or understand a phenomenon. With time, experience, and great mentoring, I realized the problem with such an approach. 

Medical education is not a discipline with discrete borders, specific methods and accepted theories, like molecular biology. Rather it is a field with fuzzy boundaries, informed by the sciences, social sciences and humanities and drawing upon their mix of associated theories.¹ Neuroscience, sociology, and philosophy all have an equal place in medical education. Medical education is richer for such interconnectedness, requiring a negotiation and collaboration between different ways of seeing the issue confronting a clinician-educator. Deductive approaches to medical education research that use experimental data to support or refute a theory are complimented by inductive approaches, where theory is constructed from data without any presupposed starting position. In this way, medical education can use multiple theories to help make sense of the issues confronting learners, teachers and educators.² But, unlike the clinical domain clinician-educators simultaneously reside in, there is no hierarchy of better/best theories in medical education. There is no one theory to rule them all. The issues in medical education are too nuanced and complex for such a rigid approach. 

Here lies the value of ETMP. While I have specific theories (looking at you Cognitive Load Theory) that I draw on more regularly, I appreciate a vast number of theories relevant to my work in medical education. While I have grown as a clinician-educator since my first grad school course, there is still much for me to discover and learn. ETMP introduces to me, in an applied manner, theories that can bring fresh insight or better explanation to the questions I face in my education practice. Krzyzaniak, Messman, Robinson, Schnapp, Li-Sauerwine, Gottlieb, and Chan have edited a concise, well-referenced, practical, and highly readable resource for clinician-educators, regardless of level of experience. I look forward to discovering Joplin’s model of experiential learning, while contrasting it with the chapter on Kolb’s experiential learning. Scanning the table of contents reveals chapters relevant to teaching, learning, assessment, wellness, and more. 

I wish I had ETMP when I started grad school. I prescribe it to my grad students and medical education fellows now. Volume Four is an excellent addition to the cannon of ETMP.

Jonathan Sherbino, MD, MEd

Professor of Medicine

Assistant Dean of Health Professions Education Research

McMaster University

1. van Enk, A., & Regehr, G. (2018). HPE as a field: implications for the production of compelling knowledge. Teaching and learning in medicine, 30(3), 337-344.

1. Varpio, L., Paradis, E., Uijtdehaage, S., & Young, M. (2020). The distinctions between theory, theoretical framework, and conceptual framework. Academic Medicine, 95(7), 989-994.