Self-directed learning activities of paediatric residents

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<ul><li><p>Letter to the Editor</p><p>Self-directed learning activi-ties of paediatric residents</p><p>Editor Self-directed learning activities</p><p>have been shown to be important in</p><p>terms of enabling doctors to keep up</p><p>with current clinical practice.1 Self-</p><p>directed learning has been defined as a</p><p>process in which individuals take theinitiative, responsibility for and control</p><p>of their own learning.2 Educatorsattempt to foster this process during</p><p>residency training. Self-directed learn-</p><p>ing activities include time spent in in-</p><p>dependent study, medical discussions</p><p>with colleagues, use of medical libraries</p><p>and computer-aided instruction. Little</p><p>information is available on current levels</p><p>of self-directed learning activities among</p><p>paediatric residents. Thus, we aimed to</p><p>investigate the amount of self-directed</p><p>learning activities practised by paediat-</p><p>ric residents.</p><p>This study was conducted at two</p><p>large, university-based paediatric resi-</p><p>dency training programmes. All paedi-</p><p>atric and medicine-paediatric residents</p><p>(post-graduate years 14) who were on</p><p>paediatric rotations at the time of the</p><p>study were surveyed. An institutional</p><p>review board at each institution</p><p>approved the study protocol.</p><p>To assess self-directed learning</p><p>activities, we adapted a self-report</p><p>questionnaire previously described</p><p>elsewhere.3 Residents were asked to</p><p>report the number of hours per week</p><p>spent on the following self-directed</p><p>learning activities:</p><p>1 independent study (including topic</p><p>reviews, reading about admitted</p><p>patients, etc.);</p><p>2 medical discussions with colleagues</p><p>(excluding lectures and ward</p><p>rounds);</p><p>3 use of computers (for Medline sear-</p><p>ches, access to medical databases,</p><p>websites, etc.), and</p><p>4 use of the library to retrieve paper or</p><p>electronic journal articles.</p><p>At the time the study was conducted,</p><p>most resident education experiences</p><p>consisted of lectures, case presentations,</p><p>grand rounds, morning reports, ward</p><p>rounds, continuity clinic conferences</p><p>and journal clubs. To increase the</p><p>accuracy of resident recall, we asked</p><p>residents to recall the range of time</p><p>spent on each of the four types of self-</p><p>directed activity. The ranges were 0, 1</p><p>2, 34 and more than 5 hours per week.</p><p>For data analysis we used the lower</p><p>limits of the range to create four categ-</p><p>ories of 0, 1, 3 and 5 hours, respectively.</p><p>The sum of these categories is the total</p><p>number of hours spent on all four self-</p><p>directed learning activities. Continuous</p><p>variables were analysed using Students</p><p>t-test and ANOVA, while categorical var-</p><p>iables were analysed using chi-square</p><p>analysis.</p><p>A total of 130 (82%) residents</p><p>returned surveys. Of these, 63% were</p><p>graduates of US medical schools, and</p><p>69% were female. The mean number of</p><p>hours spent on self-directed learning</p><p>activities was 75 hours per week. Of theresponding residents, 40% spent less</p><p>than 5 hours per week on self-directed</p><p>learning activities, 38% spent</p><p>510 hours per week, 14% spent</p><p>0.00</p><p>0.50</p><p>1.00</p><p>1.50</p><p>2.00</p><p>2.50</p><p>3.00</p><p>3.50</p><p>Independentstudy</p><p>Num</p><p>ber o</p><p>f hou</p><p>rs p</p><p>er w</p><p>eek</p><p>Discussionwith colleagues</p><p>Computer use Library use</p><p>Post-graduate year 1Post-graduate year 2Post-graduate years 3 and 4</p><p>Figure 1 Effect of year of residency on self-directed learning activities.</p><p>Correspondence: Eugene Dinkevich MD,</p><p>Department of Pediatrics, SUNY-</p><p>Downstate Medical Center, 450 Clarkson</p><p>Avenue, Box 49, Brooklyn, New York 11203,</p><p>USA. Tel.: 00 1 718 270 1411; Fax: 00 1 718</p><p>270 1985; E-mail: edinkevich@pol.net</p><p>388 Blackwell Publishing Ltd MEDICAL EDUCATION 2003;37:388389</p></li><li><p>1015 hours per week and 9% spent</p><p>more than 15 hours per week. First year</p><p>residents spent an average of 60 hoursper week on self-directed learning ac-</p><p>tivities, while second and third year</p><p>residents spent 79 and 95 hours perweek, respectively (P &lt; 001). Interna-tional medical graduates reported an</p><p>average of 84 hours per week, com-pared to 70 hours per week for USmedical graduates (P 002). Rotationtype, previous residency experience and</p><p>resident gender did not impact on time</p><p>spent on self-directed learning. Figure 1</p><p>displays the number of hours spent on</p><p>different types of self-directed learning</p><p>activities. It is of note that third and</p><p>fourth year residents spent an average of</p><p>only 25 and 13 hours per week oncomputer and library use.</p><p>We conclude that the amount of time</p><p>devoted to self-directed learning activit-</p><p>ies was generally low and may not be</p><p>enough to prepare residents for self-</p><p>directed learning after residency training.</p><p>In response to the results of this survey,</p><p>curricula promoting self-directed learn-</p><p>ing was developed at both programmes.</p><p>A study of the impact of these curricula is</p><p>underway.</p><p>Eugene Dinkevich &amp;</p><p>Philip O Ozuah</p><p>New York, USA</p><p>References</p><p>1 Bligh JG. Independent learning among</p><p>general practice trainees: an initial sur-</p><p>vey. Med Educ 1992;26:497502.</p><p>2 Knowles M. Self-Directed Learning: a</p><p>Guide for Learners and Teachers. New</p><p>York: Association Press 1975.</p><p>3 Ozuah PO, Curtis J, Stein RE. Impact of</p><p>problem-based learning on residents</p><p>self-directed learning. Arch Pediatr Ado-</p><p>lesc Med 2001;155:66972.</p><p>Letter to the Editor 389</p><p> Blackwell Publishing Ltd MEDICAL EDUCATION 2003;37:388389</p></li></ul>

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