Thinking about learning: implications for principle-based professional education.

The understanding of teaching and learning in medical education has increased to improve medical education at all levels. Selected approaches to understanding learning provide a basis for eliciting principles that may inform and guide educational practice. In this article, these approaches are discussed from two perspectives: the cognitive and the environmental. The cognitive perspective includes activation of prior knowledge, elaboration of new learning, learning in context, transfer of learning, and organization of knowledge. The environmental perspective includes the dynamic interaction of learners with their environment, observational learning, incentives and rewards in the environment, goal setting and self-monitoring, self-efficacy, and situated learning. Implications are presented for facilitation of effective learning and support of the learning environment throughout the continuum of medical education.