A Roadmap for Learning in Medical Education

“…your education really IS the job of a lifetime. And it commences: now.” -David Foster Wallace

Medical students are inundated with opinions, resources, and strategies from professors, upperclassmen, peers, mentors, and online forums. While the guidance can be helpful, students may struggle with identifying effective study plans for academic success and achievement. With semesters moving quickly, time for trial and error can be limited.

LAS recognizes this challenge, thus cultivating a self-directed learning process is an essential goal of LAS plans. American educator Malcolm Knowles popularized “andragogy” as the art and science of how adults learn. Knowles highlights the move “from dependency [in K-12 education] to increasing self-directedness as [adults] mature and can direct their learning.”1.

But what is self-directed learning?

In short, self-directed learning empowers students to be managers, facilitators, and evaluators of their learning experiences. This involvement in their learning process supports learners’ content and skill mastery.

Educators developing curriculums identify the learning goals, integrate opportunities to assess knowledge acquisition, and scaffold lessons to promote independence. These features represent a systematic and adaptable approach to learning. Medical students benefit from implementing this active, patient, and holistic approach to their own learning.

Consider the following to develop an effective, self-directed learning approach:

• Understand the learning objectives and use them to guide learning

Students must be familiar with the curriculum–from the daily objectives to the weekly and monthly goals.

Lecturers and professors post detailed syllabi and learning objectives with assigned readings and scientific literature to deepen knowledge. Before the lecture, self-directed learners preview the material through the assigned reading or online videos. When students attend the lecture, the material is not unfamiliar; Students can reinforce concepts and details within the lecture and assess comprehension afterward. Ultimately, students should keep a bird’s eye view of the content and goals for a particular unit or system. This knowledge decreases ambiguity about the course’s trajectory and allows for more comprehensive backward planning.

• Locate resources and implement them consistently

Besides the multiple lectures, labs, discussion sessions, and other weekly commitments, medical students are also presented with resources to learn the material meaningfully.

Resources like Boards and Beyond, First Aid, Sketchy, Anki, etc., can all be powerful learning tools. Also, students gain access to digital question banks (Q-Banks) to assess their knowledge periodically. These Q-Banks are a compelling resource for standardized test preparation and fundamental to a daily workflow based on recall practice.

Students must be able to navigate these learning opportunities and decide what lectures to supplement, what labs to participate in, and which review sessions to attend before an exam.

LAS medical coaches work with students to identify and schedule time for each resource. By backward planning, students will develop a timeline incorporating the necessary components to support mastery learning and exam achievement.

• Utilize evidence-based strategies for achievement and progress tracking

One goal is to move away from “memorization” and “fast facts” and towards higher-order learning and recall through regular practice–activating the “testing effect.” Read more here. Students will feel more prepared to adapt and navigate the robust medical school curriculums–committing the knowledge to long-term memory.

Also, medical school compels students to engage in high-order thinking skills. They must learn beyond simple recognition to analyze, synthesize, and evaluate using sustainable, self-directed processes, like the very skills needed for clinical decision-making. Coaches schedule time for recall practice, maintenance of knowledge, and empirical data points to track progress, increase accuracy, and hone test-taking skills. So, when students prepare for a clinical reasoning exam, they can respond to vignette-style questions, activating knowledge and skills beyond reliance on rote memorization.

• Create a sustainable workflow that supports achievement and self-care

With competing demands, the challenge is developing a routine that supports the students’ goals, assesses progress empirically, and builds clinical decision-making skills. LAS Coaches provide the scaffolding support, structure, and accountability needed to target learning, assess test readiness, and maintain self-care.

Scheduling time for intentional self-care practices is paramount to students’ study plans. Examples are specific to the student and often include fitness, nutrition/cooking, therapy sessions, spiritual and social time, mindfulness, and quality sleep. These are essential facets of any plan because they help mitigate stress, anxiety, and burnout.

• Develop ways to evaluate if the plan works

Self-reflective exercises prompt students to evaluate their relative strengths and weaknesses with test-taking and content knowledge. Read more on LAS’ Error Analysis protocol. Through self-reflection, students can adjust and raise achievement in areas of relatively lower scores before an exam. So, periodic assessments of “Is this plan working?” are necessary. This question will prompt students to look at their practice scores for empirical feedback and their overall confidence. Plans should be adaptable and have space to adjust as students progress to other blocks, clerkships, and schedules.

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Self-directed learning skills are an essential component of success in medical school. Additionally, it lays the foundation for a commitment to life-long learning beyond medical school.

• Why Medical Coaching?

For more than 27 years, LAS has helped hundreds of students and residents learn, achieve, and succeed in measurable ways. LAS is a referral resource to medical schools, allied health programs, and medical centers. Individually, LAS is a resource to students, residents, nurses, PAs, and faculty. Read more here.

Additionally, LAS Medical Coaching provides the structure, support, and accountability for course exams and board exams. Medical Coaches provide differentiated support, considering individual needs, and promoting overall academic and personal success.

Ultimately, medical students are doctors-in-training and are committing themselves to life-long learning. It is difficult to imagine the patient exam room, hospital floor, or surgical suite beyond these initial years of didactic study. However, building an evidence-based foundation begins in medical school, and an effective plan will continue to support future clinical experiences, residencies, and fellowships.

References

1. TEAL-Adult Learning Strategies: https://lincs.ed.gov/sites/default/files/11_%20TEAL_Adult_Learning_Theory.pdf
2. David Foster “This is Water:” https://fs.blog/david-foster-wallace-this-is-water