Li Su-Ting T, Favreau Michele A, West Daniel C
Department of Pediatrics, University of California Davis, Sacramento, California, USA.
BMC Med Educ. 2009 Apr 13;9:16. doi: 10.1186/1472-6920-9-16.
The development of self-assessment and self-directed learning skills is essential to lifelong learning and becoming an effective physician. Pediatric residents in the United States are now required to use Individualized Learning Plans (ILPs) to document self-assessment and self-directed learning. A better understanding of resident and faculty attitudes and skills about self-assessment and self-directed learning will allow more successful integration of lifelong learning into residency education. The objective of this study was to compare faculty and resident attitudes, knowledge and skills about self-assessment, self-directed learning and ILPs.
Survey of pediatric residents and faculty at a single institution. Respondents rated their attitudes, knowledge, and self-perceived skills surrounding self-assessment, self-directed learning and ILPs.
Overall survey response rate was 81% (79/97); 100% (36/36) residents and 70% (43/61) faculty. Residents and faculty agreed that lifelong learning is a necessary part of being a physician. Both groups were comfortable with assessing their own strengths and weaknesses and developing specific goals to improve their own performance. However, residents were less likely than faculty to continuously assess their own performance (44% vs. 81%; p < 0.001) or continuously direct their own learning (53% vs. 86%; p < 0.001). Residents were more likely than faculty to believe that residents should be primarily responsible for directing their own learning (64% vs. 19%; p < 0.0001), but at the same time, more residents believed that assigned clinical (31% vs. 0%; p < 0.0001) or curricular (31% vs. 0%; p < 0.0001) experiences were sufficient to make them competent physicians. Interns were less likely than senior residents to have a good understanding of how to assess their own skills (8% vs. 58%; p = 0.004) or what it means to be a self-directed learner (50% vs. 83%; p = 0.04).Qualitative comments indicated that while ILPs have the potential to help learners develop individualized, goal-directed learning plans based on strengths and weaknesses, successful implementation will require dedicated time and resident and faculty development.
These findings suggest that training and experience are necessary for physicians to understand the role of self-directed learning in education. Deliberate practice, for example by requiring residents to use ILPs, may facilitate self-directed, lifelong learning.
自我评估和自主学习技能的培养对于终身学习和成为一名高效的医生至关重要。美国的儿科住院医师现在需要使用个性化学习计划(ILP)来记录自我评估和自主学习情况。更好地了解住院医师和教员对自我评估和自主学习的态度及技能,将有助于更成功地将终身学习融入住院医师教育。本研究的目的是比较教员和住院医师对自我评估、自主学习和ILP的态度、知识及技能。
对单一机构的儿科住院医师和教员进行调查。受访者对他们围绕自我评估、自主学习和ILP的态度、知识及自我感知技能进行评分。
总体调查回复率为81%(79/97);住院医师回复率为100%(36/36),教员回复率为70%(43/61)。住院医师和教员都认为终身学习是成为一名医生的必要组成部分。两组都对评估自己的优势和劣势以及制定具体目标以提高自身表现感到自在。然而,住院医师持续评估自己表现的可能性低于教员(44%对81%;p<0.001)或持续自主学习的可能性低于教员(53%对86%;p<0.001)。住院医师比教员更倾向于认为住院医师应主要负责自主学习(64%对19%;p<0.0001),但与此同时,更多住院医师认为指定的临床(31%对0%;p<0.0001)或课程(31%对0%;p<0.0001)经历足以使他们成为称职的医生。实习医师比高年级住院医师更不太可能很好地理解如何评估自己的技能(8%对58%;p = 0.004)或理解成为自主学习者意味着什么(50%对83%;p = 0.04)。定性评论表明,虽然ILP有潜力帮助学习者根据优势和劣势制定个性化的、目标导向的学习计划,但成功实施需要专门的时间以及住院医师和教员的发展。
这些发现表明,医生要理解自主学习在教育中的作用需要培训和经验。例如,通过要求住院医师使用ILP进行刻意练习,可能会促进自主的终身学习。