Letter to the Editor
Self-directed learning activi-ties of paediatric residents
Editor – Self-directed learning activities
have been shown to be important in
terms of enabling doctors to keep up
with current clinical practice.1 Self-
directed learning has been defined as a
�process in which individuals take the
initiative, responsibility for and control
of their own learning.�2 Educators
attempt to foster this process during
residency training. Self-directed learn-
ing activities include time spent in in-
dependent study, medical discussions
with colleagues, use of medical libraries
and computer-aided instruction. Little
information is available on current levels
of self-directed learning activities among
paediatric residents. Thus, we aimed to
investigate the amount of self-directed
learning activities practised by paediat-
ric residents.
This study was conducted at two
large, university-based paediatric resi-
dency training programmes. All paedi-
atric and medicine-paediatric residents
(post-graduate years 1–4) who were on
paediatric rotations at the time of the
study were surveyed. An institutional
review board at each institution
approved the study protocol.
To assess self-directed learning
activities, we adapted a self-report
questionnaire previously described
elsewhere.3 Residents were asked to
report the number of hours per week
spent on the following self-directed
learning activities:
1 independent study (including topic
reviews, reading about admitted
patients, etc.);
2 medical discussions with colleagues
(excluding lectures and ward
rounds);
3 use of computers (for Medline sear-
ches, access to medical databases,
websites, etc.), and
4 use of the library to retrieve paper or
electronic journal articles.
At the time the study was conducted,
most resident education experiences
consisted of lectures, case presentations,
grand rounds, morning reports, ward
rounds, continuity clinic conferences
and journal clubs. To increase the
accuracy of resident recall, we asked
residents to recall the range of time
spent on each of the four types of self-
directed activity. The ranges were 0, 1–
2, 3–4 and more than 5 hours per week.
For data analysis we used the lower
limits of the range to create four categ-
ories of 0, 1, 3 and 5 hours, respectively.
The sum of these categories is the total
number of hours spent on all four self-
directed learning activities. Continuous
variables were analysed using Student’s
t-test and ANOVA, while categorical var-
iables were analysed using chi-square
analysis.
A total of 130 (82%) residents
returned surveys. Of these, 63% were
graduates of US medical schools, and
69% were female. The mean number of
hours spent on self-directed learning
activities was 7Æ5 hours per week. Of the
responding residents, 40% spent less
than 5 hours per week on self-directed
learning activities, 38% spent
5–10 hours per week, 14% spent
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
Independentstudy
Num
ber
of h
ours
per
wee
k
Discussionwith colleagues
Computer use Library use
Post-graduate year 1Post-graduate year 2Post-graduate years 3 and 4
Figure 1 Effect of year of residency on self-directed learning activities.
Correspondence: Eugene Dinkevich MD,
Department of Pediatrics, SUNY-
Downstate Medical Center, 450 Clarkson
Avenue, Box 49, Brooklyn, New York 11203,
USA. Tel.: 00 1 718 270 1411; Fax: 00 1 718
270 1985; E-mail: [email protected]
388 � Blackwell Publishing Ltd MEDICAL EDUCATION 2003;37:388–389
10–15 hours per week and 9% spent
more than 15 hours per week. First year
residents spent an average of 6Æ0 hours
per week on self-directed learning ac-
tivities, while second and third year
residents spent 7Æ9 and 9Æ5 hours per
week, respectively (P < 0Æ01). Interna-
tional medical graduates reported an
average of 8Æ4 hours per week, com-
pared to 7Æ0 hours per week for US
medical graduates (P ¼ 0Æ02). Rotation
type, previous residency experience and
resident gender did not impact on time
spent on self-directed learning. Figure 1
displays the number of hours spent on
different types of self-directed learning
activities. It is of note that third and
fourth year residents spent an average of
only 2Æ5 and 1Æ3 hours per week on
computer and library use.
We conclude that the amount of time
devoted to self-directed learning activit-
ies was generally low and may not be
enough to prepare residents for self-
directed learning after residency training.
In response to the results of this survey,
curricula promoting self-directed learn-
ing was developed at both programmes.
A study of the impact of these curricula is
underway.
Eugene Dinkevich &
Philip O Ozuah
New York, USA
References
1 Bligh JG. Independent learning among
general practice trainees: an initial sur-
vey. Med Educ 1992;26:497–502.
2 Knowles M. Self-Directed Learning: a
Guide for Learners and Teachers. New
York: Association Press 1975.
3 Ozuah PO, Curtis J, Stein RE. Impact of
problem-based learning on residents’
self-directed learning. Arch Pediatr Ado-
lesc Med 2001;155:669–72.
Letter to the Editor 389
� Blackwell Publishing Ltd MEDICAL EDUCATION 2003;37:388–389
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