skip to Main Content


Cognitive constructivism

Also in the 1950’s, another paradigm of education emerged in response to a shift in philosophy about the nature of knowledge. The constructivist paradigm viewed knowledge not as something that exists separately that can be mapped onto learners, but rather as something that is constructed by individuals.

Cognitive constructivism views learning as the process of constructing meaning; it is how people make sense of their experience. This was a radical shift from the objectivist assumptions of the behaviourist and cognitivist paradigms. Cognitive constructivists are still concerned with mental representations of learners, however the overall purpose of education is not only to acquire knowledge, but also to enable learners to create new knowledge, building on prior knowledge from past experiences.

Because knowledge is actively constructed, learning is presented as a process of active discovery. The role of the teacher is to facilitate this discovery by providing the necessary resources and by guiding learners as they attempt to assimilate new knowledge to old, and to modify the old to accommodate the new. Teachers must take into account the knowledge that the learner currently possesses, their stage of cognitive development, their cultural background, and their personal history when deciding how to construct the curriculum and how to present, sequence, and structure new material.

Key Principles

  • Purpose of education is to enable learners to create new knowledge
  • Learning is the process of constructing meaning
  • Emphasis is on active discovery
  • Learners actively construct new knowledge, building on what they already know and past experiences
  • Teachers facilitate discovery by providing necessary resources

Key Theorists

Jean Piaget, 1896-1980

Jean Piaget was a Swiss psychologist known for his work on child development. He disagreed with the idea that intelligence was a fixed trait, and regarded cognitive development as a process which occurs due to biological maturation and interaction with the environment. He believed that children construct an understanding of the world around them, experience discrepancies between what they already know and what they discover in their environment, then adjust their ideas accordingly.

He described learning as interplay between two mental activities that he called assimilation and accommodation. Assimilation is the interpretation of new information in terms of pre-existing concepts, information or ideas. In contrast, accommodationis the process of taking new information in one’s environment and altering pre-existing schemas in order to fit in the new information. This happens when the existing schema (knowledge) does not work, and needs to be changed to deal with a new object or situation.

John Dewey, 1859-1952

John Dewey was an American philosopher and educator who rejected the notion that schools should focus on repetitive, rote memorization and proposed a method of directed living where students would engage in real-world, practical workshops in which they would demonstrate their knowledge through creativity and collaboration. He emphasized the importance that previous experience and prior knowledge play in the development of new understanding

Dewey not only re-imagined the way that the learning process should take place, but also the role that the teacher should play within that process. He pushed for the creation of practical classes that could be applied outside of a school setting. He also thought that education should be student-oriented, not subject-oriented. He emphasizes that material should be provided in a way that is stimulating and interesting to the student since it encourages original thought and problem solving.

Concepts & Practices in Health Professions Education

Productive failure

Productive failure is an education strategy that asks learners to solve complex, novel problems they have not yet been taught. Through this process, learners develop a diversity of linked representations and methods for solving the complex problems, even when ultimately unsuccessful in their problem-solving efforts. If followed by direct instruction, the experience results in deeper conceptual understanding and flexibility at solving new problems. Learners who experience productive failure followed by direct instruction significantly outperform learners who have only experienced direct instruction. By providing students with direct instruction too early, they may not yet have the appropriate prior knowledge to be able to build or discern what is important and may struggle to understand why concepts, representations, and methods are assembled in that way.

Preparation for future learning (PFL)

PFL is “the ability to learn new information, make effective use of resources, and invent new procedures in order to support learning and problem solving in practice” (Schwartz). We can’t possibly teach every situation a health professional will find themselves in; instead we can prepare health professionals to learn (in the future) so they can come up with new solutions when dealing with problems they haven’t seen before.


  • Block J. Assimilation, accommodation, and the dynamics of personality development. Child Development. 1982;53(2):281-95.
  • Chin DB, Dohmen IM, Cheng BH, Oppezzo MA, Chase CC, Schwartz DL. Preparing students for future learning with teachable agents. Educational Technology Research and Development. 2010;58(6):649-69.
  • Dewey J. Democracy and Education: An Introduction to the Philosophy of Education. Macmillan; 1923.
  • Dewey J. Experience and education. The Educational Forum. 1986;50(3):241-252.
  • Kapur M. Examining productive failure, productive success, unproductive failure, and unproductive success in learning. Educational Psychologist. 2016;51(2):289-99.
  • Kapur M, Bielaczyc K. Designing for productive failure. Journal of the Learning Sciences. 2012;21(1):45-83.
  • Lin X, Schwartz DL, Bransford J. Intercultural adaptive expertise: Explicit and implicit lessons from Dr. Hatano. Human Development. 2007;50(1):65-72.
  • Mylopoulos M, Brydges R, Woods NN, Manzone J, Schwartz DL. Preparation for future learning: a missing competency in health professions education? Medical Education. 2016;50(1):115-23.
  • Mylopoulos M, Woods N. Preparing medical students for future learning using basic science instruction. Medical Education. 2014;48(7):667-73.
  • Piaget J. The Origin of Intelligence in the Child. Routledge and Kegan Paul; 1953.
  • Schwartz DL, Bransford JD, Sears D. Efficiency and innovation in trans-fer. In Mestre J, ed. Transfer of Learning. Greenwich, CT: Information Age Publishing; 2005, pp. 1-51.
  • Schwartz DL, Martin T. Inventing to prepare for future learning: The hidden efficiency of encouraging original student production in statistics instruction. Cognition and Instruction. 2004;22(2):129-84.
  • Wadsworth BJ. Piaget’s Theory Of Cognitive And Affective Development: Foundations Of Constructivism. White Plains, NY, England: Longman Publishing; 1996.
  • Woods NN, Mylopoulos M. How to improve the teaching of clinical reasoning: from processing to preparation. Medical Education. 2015;49(10):952-3.
Back To Top