The development and implementation of a curriculum to improve clinicians' self-directed learning skills: a pilot project.
BACKGROUND
Clinicians need self-directed learning skills to maintain competency. The objective of this study was to develop and implement a curriculum to teach physicians self-directed learning skills during inpatient ward rotations.


METHODS
Residents and attendings from an internal medicine residency were assigned to intervention or control groups; intervention physicians completed self-directed learning curricular exercises.


RESULTS
Among the 43 intervention physicians, 21 (49%) completed pre- and post-curriculum tests; and 10 (23%) completed the one-year test. Immediately after exposure to the curriculum, the proportion of physicians defining short- and long-term learning goals increased [short-term: 1/21 (5%) to 11/21 (52%), p = 0.001; long-term: 2/21 (10%) to 15/21 (71%), p = 0.001]. There were no significant changes post-curriculum in the quantity or quality of clinical question asking. The physicians' mean self-efficacy (on a 100-point scale) improved for their abilities to develop a plan to keep up with the medical literature (59 vs. 72, p = 0.04). The effects of the curriculum on self-reported learning behaviors was maintained from the immediate post-curriculum test to the one-year post curriculum test: [short-term learning goals: 1/21 (5%) pre-, 11/21 (52%) immediately post-, and 5/10 (50%) one-year after the curriculum (p = 0.0075 for the pre- vs one-year comparison); long-term learning goals: 2/21 (10%) pre-, 15/21 (71%) immediately post-, and 7/10 (70%) one-year (p = 0.0013 for the pre- vs one-year comparison). At one-year, half of the participants reported changed learning behaviors.


CONCLUSIONS
A four-week curriculum may improve self-directed learning skills.
Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA. dawn.bravata@yale.edu
Dawn M T
DM
Bravata
Stephen J
SJ
Huot
Hadley S
HS
Abernathy
Kelley M
KM
Skeff
Dena M C
DM
Bravata
D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D007858:Learning; D010865:Pilot Projects