Five Tips to Transform Medical Students and Residents into Self-Directed Learners

By Ryan O’Neill and Allison Beaulieu, MD on behalf of SAEM’s Residents and Medical Students As COVID-19 has moved our didactic sessions out of the classroom and into our homes, more emphasis has been placed on self-study and asynchronous learning. Although "SELF-DIRECTED LEARNING IS we anticipate some form of in-person learning to return, it is likely that a new hybrid model for graduate medical education BASED ON THE ASSUMPTIONS will exist in the future. Self-directed learning is based on the assumptions that adult learners are self-dependent, THAT ADULT LEARNERS intrinsically motivated, and rely on past experiences to build on an existing knowledge base. This guide will give all ARE SELF-DEPENDENT, users the tools needed to become a successful self-directed learner in residency and beyond! INTRINSICALLY MOTIVATED, Begin With a Self-Assessment Where to begin? From managing a cardiac arrest to delivering AND RELY ON PAST a baby, emergency medicine physicians are responsible for an incredibly large breadth of knowledge and must be able EXPERIENCES TO BUILD ON AN to perform a diverse range of procedures and skills. It can be daunting to find a launch point for self-study; however, by EXISTING KNOWLEDGE BASE." starting with a self-assessment, you will be able to narrow and refine your focus. • Seek feedback. Regularly seek feedback from your • Reflect. Whether you are on shift or attending a conference, attendings and peers. You can ask for both written and take time to reflect and fully understand the problem at verbal feedback. What do they see as your strengths? What hand. What do you need to clarify? What do you already could you improve upon? Do they see any gaps in your know? How can you build upon this knowledge? knowledge?

• Self-monitor. Self-monitoring includes your personal judgement of your abilities and awareness of a situation. How did that case go? What went well? What could be improved?

What adjustments should you make? • Ask for help. If you begin to feel overwhelmed or have difficulty with this initial step, understand that you do not have to do this alone. This skillset takes time to develop. It is okay to ask for help from faculty or peer mentors to refocus your learning efforts.

Specific

What action will be performed and by whom?

S M

Attainable

Is the objective achievable within a given time frame and with the resources available?

A R

Time-Bound

When will the objective be achieved? Create a timeframe for when the objectives will be met.

T

Measurable

How will success be measured? Quantify your anticipated results.

Relevant

Do the objectives align with the instructional method and assessment?

Create Goals and Objectives

After performing a self-evaluation, you can utilize the SMART framework to create a targeted outline to achieve your learning goals and objectives. A goal is a broad, generalized overview of a desired outcome. For example, your goal may be to achieve a higher score on the in-training examination. Objectives are the finer details that outline the process of achieving your desired outcome.

Identify Resources

With your goals in mind, the next step is to identify what types of resources will be used to achieve them. We have access to more educational content than ever before, and it can be easy to get lost in the weeds. This abundance of resources, however, also allows you to pick and choose those that best fit your preferences. Whether you prefer reading textbooks, utilizing question banks, or listening to podcasts, it is essential to evaluate which resources will best help you achieve your goals. SAEM and ALIEM have compiled comprehensive lists of resources. You should also consider utilizing the Social Media Index. This is a comparative index, similar to the impact factor, that has been shown to correlate with quality and can be used to identify reliable FOAM resources.

When in doubt, do not forget about the utilizing the human resources in your life. Peers and mentors can oftentimes point you in the right direction when navigating this process. While it could be tempting to try and use every resource you find, there is only so much time in a day, and it is best to choose a few resources that work best for you and stick with them. At its core, learning is the storage and retrieval of information. There are multiple learning strategies that can be utilized to enhance this process: Multimodal learning is a form of studying that uses multiple resources in varied formats. These formats could include textbooks, podcasts, videos, and more. This learning strategy not only provides repetition when learning a topic, but also allows you to process the same concepts from different perspectives. Interleaving refers to studying different topics simultaneously. Of all specialties, this learning strategy seems most relevant to emergency medicine. By studying multiple topics at once, both old and new, we are challenged to retrieve disparate bits of information. This challenge enhances our learning and provides an opportunity to draw previously unseen connections between topics. Spaced repetition is the practice of intermittently reviewing previously learned material. Over time, we are more and more likely to forget information we have acquired. By periodically reexposing ourselves to these concepts, we not only prevent this forgetting but also reinforce our understanding of them. Active retrieval challenges us to access the information we have already learned and apply it. This learning strategy can be done through flashcards, quizzes, and patient cases. By pushing ourselves to retrieve and utilize concepts, we strengthen our ability to do so again in the future, ultimately improving our clinical application of what we have learned.

Emergency Medicine Cases has a great podcast and article that dive further into this topic.

Evaluate Progress

Congratulations! You have taken the necessary steps to become a reflective, active, self-directed learner. At this stage you will evaluate whether or not you achieved your learning objectives and review what adjustments you can make in the future. Continue to work at this process. You will find the more time you take for self-assessment, creation of SMART goals, review of educational materials, and implementation of learning strategies, the more you will improve. The process of becoming a self-directed learner does not end here: continue to refine your skills in becoming a life-long learner!

ABOUT THE AUTHORS: Ryan O’Neill is a fourth-year medical student at The Ohio State University College of Medicine.

Dr. Beaulieu is a first-year medical education fellow and clinical instructor of emergency medicine at The Ohio State University Wexner Medical Center.