Outcomes of Irish graduate entry medical student engagement with self-directed learning of clinical skills

BMC Medical Education

Colum P Dunne¹  Lisa Murphy¹  Ailish Hannigan¹  Margaret Toomey¹  Sanath Rao¹  Louise Crowley¹  Deirdre McGrath¹ 

[1]Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland

关键词: Student engagement;    Graduate entry medicine;    Self-directed learning;    Clinical skills;   

Others  :  1127917
DOI  :  10.1186/s12909-015-0301-x

 received in 2014-05-09, accepted in 2015-02-04,  发布年份 2015

【 摘 要 】

Background

Existing literature is mixed as to whether self-directed learning (SDL) delivers improvements in knowledge, skills or attitudes of medical students compared with traditional learning methods. This study aimed to determine whether there is an association between engagement in SDL and student performance in clinical examinations, the factors that influence student engagement with SDL in clinical skills, and student perceptions of SDL.

Methods

A retrospective analysis of electronic records of student bookings of SDL sessions from 2008 to 2010 was performed for students in the pre-clinical years of an Irish Graduate Entry Medical programme to assess their level of engagement with SDL. The extent to which this engagement influenced their performance in subsequent summative examinations was evaluated. A cross-sectional survey of students across the four years of the programme was also conducted to determine student perceptions of SDL and the factors that affect engagement.

Results

The level of engagement with SDL decreased over time from 95% of first years in 2008 to 49% of first years in 2010. There was no significant difference between the median exam performance for any clinical skills tested by level of engagement (none, one or more sessions) except for basic life support in first year (p =0.024). The main reason for engaging with SDL was to practice a clinical skill prior to assessment and the majority of respondents agreed that SDL sessions had improved their performance of the specific clinical skills being practised.

Conclusion

Students viewed SDL as an opportunity to practise skills prior to assessment but there were no significant differences in subsequent summative assessment by the level of engagement for most clinical skills.

【 授权许可】

   
2015 Mcgrath et al.; licensee BioMed Central.

【 图 表 】

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【 参考文献 】

• [1]Tight M: Lifelong learning: Opportunity or Compulsion? British Journal of Educational Studies 1998, 46(3):251-63.
• [2]Knowles M: (1975). Self-Directed Learning: A Guide for Learners and Teachers. Associated Press, New York, NY; 1975.
• [3]Ainoda N, Onishi H, Yasuda Y: Definitions and goals of self-directed learning in contemporary medical education literature. Ann Acad Med Singapore 2005, 34:515-9.
• [4]Murad MH, Varkey P: Self-directed learning in health professions education. Ann Acad Med Singapore 2008, 37(7):580-90.
• [5]Jennings SF: Personal development plans and self-directed learning for healthcare professionals: are they evidence based? Postgrad Med J 2007, 83(982):518-24.
• [6]Smith SJ, Kakarala RR, Talluri SK, Sud P, Parboosingh J: Internal medicine residents’ acceptance of self-directed learning plans at the point of care. J Grad Med Educ 2011, 3(3):425-8.
• [7]Morrow G, Rothwell C, Wright P: Self-directed learning groups: a vital model for education, support and appraisal amongst sessional GPs. Educ Prim Care 2012, 23(4):270-6.
• [8]Li ST, Paterniti DA, Co JP, West DC: Successful self-directed lifelong learning in medicine: a conceptual model derived from qualitative analysis of a national survey of pediatric residents. Acad Med 2010, 85(7):1229-36.
• [9]Kalkat RK, Khan KS: Meeting advanced learning needs of senior postgraduate trainees through practice-based reflective medical education: evaluation of a formal structured training programme in obstetrics and gynaecology. J Obstet Gynaecol 2010, 30(2):115-8.
• [10]van Schaik S, Plant J, O'Sullivan P: Promoting self-directed learning through portfolios in undergraduate medical education: the mentors’ perspective. Med Teach 2013, 35(2):139-44.
• [11]Watmough SD, O'Sullivan H, Taylor DC: Graduates from a reformed undergraduate medical curriculum based on Tomorrow's Doctors evaluate the effectiveness of their curriculum 6 years after graduation through interviews. BMC Med Educ 2010, 10:65. BioMed Central Full Text
• [12]Cheng SF, Kuo CL, Lin KC, Lee-Hsieh J: Development and preliminary testing of a self-rating instrument to measure self-directed learning ability of nursing students. Int J Nurs Stud 2010, 47(9):1152-8.
• [13]Kocaman G, Dicle A, Ugur A: A longitudinal analysis of the self-directed learning readiness level of nursing students enrolled in a problem-based curriculum. J Nurs Educ 2009, 48(5):286-90.
• [14]Newman M: A pilot systematic review and meta-analysis on the effectiveness of problem based learning. Newcastle, Learning and Teaching Subject Network; 2003.
• [15]Neufeld VR, Barrows HS: The “McMaster Philosophy”: an approach to medical education. J Med Educ 1974, 49(11):1040-50.
• [16]Albanese MA, Mitchell S: Problem-based learning: a review of literature on its outcomes and implementation issues. Acad Med 1993, 68(1):52-81.
• [17]Colliver JA, Markwell SJ: Research on problem-based learning: the need for critical analysis of methods and findings. Med Educ 2007, 41(6):533-5.
• [18]Okuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, et al.: The utility of simulation in medical education: what is the evidence? Mt Sinai J Med 2009, 76(4):330-43.
• [19]Zendejas B, Brydges R, Wang AT, Cook DA: Patient outcomes in simulation-based medical education: a systematic review. J Gen Intern Med 2013, 28(8):1078-89.
• [20]Zendejas B, Wang AT, Brydges R, Hamstra SJ, Cook DA: Cost: the missing outcome in simulation-based medical education research: a systematic review. Surgery 2013, 153(2):177-178.
• [21]Hays R: Self-directed learning of clinical skills. Med Educ 2009, 43(6):505-6.
• [22]Schmidt HG, Rotgans JI, Yew EH: The process of problem-based learning: what works and why. Med Educ 2011, 45(8):792-806.
• [23]Brydges R, Carnahan H, Safir O, Dubrowski A: How effective is self-guided learning of clinical technical skills? It's all about process. Med Educ 2009, 43(6):507-15.
• [24]Roppolo LP, Heymann R, Pepe P, Wagner J, Commons B, Miller R, et al.: A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: The two-person CPR study. Resuscitation 2011, 82(3):319-25.
• [25]Findlater GS, Kristmundsdottir F, Parson SH, Gillingwater TH: Development of a supported self-directed learning approach for anatomy education. Anat Sci Educ 2012, 5(2):114-21.
• [26]Bergman EM, Sieben JM, Smailbegovic I, de Bruin AB, Scherpbier AJ, van der Vleuten CP: Constructive, collaborative, contextual, and self-directed learning in surface anatomy education. Anat Sci Educ 2013, 6(2):114-24.
• [27]Murad MH, Coto-Yglesias F, Varkey P, Prokop LJ, Murad AL: The effectiveness of self-directed learning in health professions education: a systematic review. Med Educ 2010, 44(11):1057-68.
• [28]Finucane P, Kellett J: A new direction for medical education in Ireland? Eur J Intern Med 2007, 18(2):101-3.
• [29]Finucane P, Arnett R, Johnson A, Waters M: Graduate medical education in Ireland: a profile of the first cohort of students. Ir J Med Sci 2008, 177(1):19-22.
• [30]Finucane P, Flannery D, Keane D, Norman G: Cross-institutional progress testing: feasibility and value to a new medical school. Med Educ 2010, 44(2):184-6.
• [31]Finucane P, Flannery D, McGrath D, Saunders J: Demographic attributes and knowledge acquisition among graduate-entry medical students. Med Teach 2013, 35(2):134-8.
• [32]Jalili M, Hejri S, Norcini J: Comparison of two methods of standard setting: the performance of the three-level Angoff method. Med Educ 2011, 45(12):1199-208.
• [33]Inuwa IM: Perceptions and Attitudes of First-Year Medical Students on a Modified Team-Based Learning (TBL) Strategy in Anatomy. Sultan Qaboos Univ Med J 2012, 12(3):336-343.
• [34]Hendry GD, Ginns P: Readiness for self-directed learning: validation of a new scale with medical students. Med Teach 2009, 31(10):918-20.
• [35]Price CS, Bell SF, Janes SE, Ardagh M: Cardio-pulmonary resuscitation training, knowledge and attitudes of newly-qualified doctors in New Zealand in 2003. Resuscitation 2006, 68(2):295-9.
• [36]Mazmanian P, Feldman M: Theory is needed to improve education, assessment and policy in self-directed learning. Med Educ 2011, 45(4):324-6.
• [37]Tagawa M, Imanaka H: Reflection and self-directed and group learning improve OSCE scores. Clin Teach 2010, 7(4):266-70.
• [38]Malta S, Dimeo SB, Carey PD: Self-direction in learning: does it change over time? J Allied Health 2010, 39(2):e37-41.