Dr. Schumacher is associate program director, Boston Combined Residency Program in Pediatrics, Boston Children's Hospital/Boston Medical Center, and assistant professor of pediatrics, Division of Pediatric Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts. Dr. Englander is senior director, Competency-Based Learning and Assessment, Association of American Medical Colleges, Washington, DC. Dr. Carraccio is vice president, Competency-Based Assessment Programs, American Board of Pediatrics, Chapel Hill, North Carolina.
Acad Med. 2013 Nov;88(11):1635-45. doi: 10.1097/ACM.0b013e3182a6e8f8.
As a result of the paradigm shift to a competency-based framework, both self-directed lifelong learning and learner-centeredness have become essential tenets of medical education. In the competency-based framework, learners drive their own educational process, and both learners and teachers share the responsibility for the path and content of learning. This learner-centered emphasis requires each physician to develop and maintain lifelong learning skills, which the authors propose culminate in becoming a "master leaner." To better understand the development of these skills and the attainment of that goal, the authors explore how learning theories inform the development of master learners and how to translate these theories into practical strategies for the learner, the teacher, and the learning environment so as to optimize this development.The authors begin by exploring self-determination theory, which lays the groundwork for understanding the motivation to learn. They next consider the theories of cognitive load and situated cognition, which inform the optimal context and environment for learning. Building from this foundation, the authors consider key educational theories that affect learners' abilities to serve as primary drivers of their learning, including self-directed learning (SDL); the self-assessment skills necessary for SDL; factors affecting self-assessment (self-concept, self-efficacy, illusory superiority, gap filling); and ways to mitigate the inaccuracies of self-assessment (reflection, self-monitoring, external information seeking, and self-directed assessment seeking).For each theory, they suggest practical action steps for the learner, the teacher, and the learning environment in an effort to provide a road map for developing master learners.
由于向基于能力的框架转变，自我导向的终身学习和以学习者为中心已成为医学教育的基本原则。在基于能力的框架中，学习者主导自己的教育过程，学习者和教师共同承担学习路径和内容的责任。这种以学习者为中心的重点要求每位医生发展和保持终身学习技能，作者提出这些技能的最终目标是成为“掌握型学习者”。为了更好地理解这些技能的发展和目标的实现，作者探讨了学习理论如何为掌握型学习者的发展提供信息，以及如何将这些理论转化为学习者、教师和学习环境的实际策略，以优化这种发展。
作者首先探讨了自我决定理论，该理论为理解学习动机奠定了基础。他们接下来考虑了认知负荷理论和情境认知理论，这些理论为学习的最佳情境和环境提供了信息。在此基础上，作者考虑了影响学习者作为学习主要驱动者的能力的关键教育理论，包括自我导向学习（SDL）；SDL 所需的自我评估技能；影响自我评估的因素（自我概念、自我效能感、虚幻优势、填补差距）；以及减轻自我评估不准确的方法（反思、自我监控、外部信息寻求和自我导向评估寻求）。
对于每一种理论，他们为学习者、教师和学习环境提出了实际的行动步骤，为培养掌握型学习者提供了路线图。
