Promoting Self-Directed Learning Skills in Residency: A Case Study in Program Development
Open accessAbstract
Self-directed learning (SDL) skills are essential for the formation and ongoing competence of today's physicians who work in the context of expanding scientific knowledge and changing health care systems. In 2007-2008, the authors developed a program to promote SDL in the Brown University Family Medicine Residency. Through an iterative process, the project team juggled learning theories (i.e., Knowles' SDL model, Collins' cognitive apprenticeship model, and Quirk's expertise development model) with curricular goals, instructional options, and local constraints to design a practical and theoretically robust intervention.The intervention that emerged from this process features a faculty physician serving as a learning coach who meets individually each month with all second-year residents to assist them in generating learning goals, reflecting on their learning experiences, and practicing evidence-based medicine (EBM) skills. An electronic portfolio serves as a documentation tool that supports reflection; residents record their goals and reflections in the portfolio, which also contains their formative assessments, procedure logs, and special projects. To address the hidden curriculum, the program designers took special care to avoid increasing faculty and resident workload and created a forum for discussion and group reflection. Program evaluation combines qualitative and quantitative methods, such as surveys of and interviews with residents and faculty, to assess changes in residents' SDL and EBM skills and in the program's educational culture. The authors use Kern and colleagues' six-step model for curriculum development to describe both the unfolding of this complex project and the choices that resulted in the current program design.
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- Authors
- Nothnagle, M., Goldman, R., Quirk, M., & Reis, S.
- Affiliations
- Brown University (US)
- Corresponding author
- Nothnagle, Melissa
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-12
- Volume
- 85
- Issue
- 12
- Pages
- 1874-1879
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2015651866
- Cited by
- 54
- References
- 19
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 7 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 7 · 2014: 4 · 2013: 5 · 2012: 4
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- eScholarship@UMassChan (submittedVersion)
- Funders
- U.S. Public Health Service (D58HP08298)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Educational Leadership and Innovation
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Keywords
- self-directed learning, family medicine residency, learning coaches, e-portfolio, reflection, hidden curriculum, curriculum development, cognitive apprenticeship, formative assessment, program evaluation, educational culture
- MeSH terms
- Clinical Competence, Curriculum, Educational Measurement, Humans, Internship and Residency, Learning, Students, Medical, Program Development
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