Pregnancy-Related Issues in the Management of Addictions

1. Pregnancy-Related Issues in the Management of Addictions Train the Trainer Workshop Problematic Substance Use in Pregnancy (PSUP) www.addictionpregnancy.ca Last modified: March 2008

2. Conflict of Interest Disclosure • Financial support for this workshop was provided by Health Canada • Funding for the PRIMA Pocket Reference was provided by the Lawson Foundation • No commercial sponsorship has been received to support this program

3. Pregnancy-Related Issues in the Management of Addictions Teaching Strategies What works best?

4. Learning Objectives At the end of this session, the participants will be able to: • Discuss the Kolb experiential learning cycle. • Describe the preferred learning events for accommodators, divergers, assimilators and convergers. • Discuss the situational nature of learning.

5. What works best is what gets the message across to the learner! • Many different ways to look at learning: • Early theorists: Rogers, Jung, Piaget • Neurolinguistic Programming: auditory, visual, kinesthetic • Myers-Briggs Personality Inventory • Women’s Ways of Knowing – feminist perspective • David Kolb: experiential learning cycle

6. Kolb Experiential Learning Concrete Experience CE Reflective Observation RO Active Experimentation AE Abstract Conceptualization AC

7. Learning to ski • Divergers: watch others ski, think about what they are doing, get a mental picture and start: observing and doing – problem-based model Concrete Experience Diverger Active Experimentation Reflective Observation Abstract Conceptualization

8. Learning to ski • Assimilators: google ‘skiing’, watch other skiers, read some more, practice in the living room, then try – observing and thinking – analytical model Concrete Experience Active Experimentation Reflective Observation Assimilator Abstract Conceptualization

9. Learning to ski • Convergers: think about it, go ahead and try it out, if they feel ok they will move on, if not they will try something else – thinking and experimenting – “hands on model” Concrete Experience Active Experimentation Reflective Observation Converger Abstract Conceptualization

10. Learning to ski • Accommodators: feel good about the challenge, are game for anything, and just take off! experimenting and doing – Nike model (just do it!) Concrete Experience Accommodator Active Experimentation Reflective Observation Abstract Conceptualization

11. Kolb Experiential Learning Concrete Experience CE Accommodator AE + CE: doing Diverger CE + RO: feeling Reflective Observation RO Active Experimentation AE Converger AC + AE: planning Assimilator RO + AC: thinking Abstract Conceptualization AC

12. Accommodators: doing and feeling CE/AE • ‘Hands-on', and rely on intuition rather than logic • Use other people's analysis and prefer to take a practical, experiential approach • Attracted to new challenges and experiences • Act on 'gut' instinct rather than logical analysis • Tend to rely on others for information than carry out their own analysis • Set targets and actively work in the field trying different ways to achieve an objective Work well in all types of learning environments

13. Divergers: feeling and watching CE/RO • Able to look at things from different perspectives • Are sensitive, imaginative, emotional, strong in the arts • Prefer to watch rather than do, tending to gather information and use imagination to solve problems • Best at viewing concrete situations from several different viewpoints • Perform better in situations that require idea-generation, for example, brainstorming Prefer to work in groups, to listen with an open mind, and to receive personal feedback

14. Assimilators: watching and thinking AC/RO • Prefer a concise, logical approach • Require good clear explanation rather than practical opportunity • Excel at understanding wide-ranging information and organizing it a clear logical format • Less focused on people and more interested in ideas and abstract concepts • More attracted to logically sound theories than approaches based on practical value Prefer readings, lectures, exploring analytical models, and having time to think things through

15. Convergers:doing and thinking AC/AE • Good at solving problems and will use their learning to find solutions to practical issues • Prefer technical tasks, and are less concerned with people and interpersonal aspects • Best at finding practical uses for ideas and theories • More attracted to technical tasks and problems than social or interpersonal issues • Enables specialist and technology abilities Prefer to experiment with new ideas, to simulate, and to work with practical applications.

16. Knowing Your Audience • Know that all types of learners will be in the audience • Include some teaching strategy that will engage everyone • Have cases for the divergers to discuss. • Have slides for the assimilatorsto think about. • Have problems for the convergers to solve. • Have role-plays so the accommodators can volunteer.

17. Learning changes with context and is situational! • Assimilators were the norm in medical teaching: lecture, lecture, lecture • Divergers began to appear with the problem-based learning model • More direct “hands-on” patient work appealed to the Convergers(many family docs in this group) • Accommodators are slowing gaining ground (BUT less Nike (Just do it!) more New Balance!)

18. Pregnancy-Related Issues in the Management of AddictionsSlide presentation developed by members of the National PRIMA group: Ron Abrahams* Talar Boyajian Jennifer Boyd Wendy Burgoyne Katherine Cardinal Rosa Dragonetti Lisa Graves* Phil Hall • Samuel Harper • Georgia Hunt* • Meldon Kahan • Theresa Kim • Lisa Lefebvre • Nick Leyland • Margaret Leslie • Deana Midmer* • Stephanie Minorgan* • Pat Mousmanis* • Alice Ordean* • Sarah Payne* • Peter Selby • Melanie Smith • Ron Wilson • Suzanne Wong *Principal Authors Prima.medicine@utoronto.ca