Does medical training promote or deter self-directed learning? A longitudinal mixed-methods study.
OBJECTIVE
The School of Medicine, University of Saskatchewan curriculum promotes self-direction as one of its learning philosophies. The authors sought to identify changes in self-directed learning (SDL) readiness during training.


METHODS
Guglielmino's SDL Readiness Scale (SDLRS) was administered to five student cohorts (N = 375) at admission and the end of every year of training, 2006 to 2010. Scores were analyzed using repeated-measurement analysis. A focus group and interviews captured students' and instructors' perceptions of self-direction.


RESULTS
Overall, the mean SDLRS score was 230.6; men (n = 168) 229.5; women (n = 197) 232.3, higher than in the average adult population. However, the authors were able to follow only 275 students through later years of medical education. There were no significant effects of gender, years of premedical training, and Medical College Admission Test scores on SDLRS scores. Older students were more self-directed. There was a significant drop in scores at the end of year one for each of the cohorts (P < .001), and no significant change to these SDLRS scores as students progressed through medical school. Students and faculty defined SDL narrowly and had similar perceptions of curricular factors affecting SDL.


CONCLUSIONS
The initial scores indicate high self-direction. The drop in scores one year after admission, and the lack of change with increased training, show that the current educational interventions may require reexamination and alteration to ones that promote SDL. Comparison with schools using a different curricular approach may bring to light the impact of curriculum on SDL.
Dr. Premkumar is curriculum consultant and faculty development specialist, and associate professor, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr. Pahwa is professor, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Ms. Banerjee was a third-year master's student, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, at the time this article was written. Dr. Baptiste was a fourth-year medical student, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, at the time this article was written. Mr. Bhatt is biostatistician, University of Alberta, Edmonton, Alberta, Canada. When this article was written, he was biostatistician, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr. Lim is professor, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Kalyani
K
Premkumar
Punam
P
Pahwa
Ankona
A
Banerjee
Kellen
K
Baptiste
Hitesh
H
Bhatt
Hyun J
HJ
Lim
D000328:Adult; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D005260:Female; D017144:Focus Groups; D006801:Humans; D007858:Learning; D008137:Longitudinal Studies; D008297:Male; D013337:Students, Medical; D011795:Surveys and Questionnaires