title: Mentor-guided self-directed learning affects resident practice.
abstract: OBJECTIVE
  Self-directed learning (SDL) can be as effective as instructor-led training. It employs less instructional resources and is potentially a more efficient educational approach. Although SDL is encouraged among residents in our surgical training program via 24-hour access to surgical task trainers and online modules, residents report that they seldom practice. We hypothesized that a mentor-guided SDL approach would improve practice habits among our residents.
  
  
  METHODS
  From 2011 to 2013, 12 postgraduate year (PGY)-2 general surgery residents participated in a 6-week minimally invasive surgery (MIS) rotation. At the start of the rotation, residents were asked to practice laparoscopic skills until they reached peak performance in at least 3 consecutive attempts at a task (individual proficiency).
  
  
  METHODS
  Trainees met with the staff surgeon at weeks 3 and 6 to evaluate progress and review a graph of their individual learning curve. All trainees subsequently completed a survey addressing their practice habits and suggestions for improvement of the curriculum.
  
  
  RESULTS
  By the end of the rotation, 100% of participants improved in all practiced tasks (p < 0.05), and each reported that they practiced more in this rotation than during rotations without mentor-guided SDL. Additionally, 6 (50%) residents reported that their skill level had improved relative to their peers. Some residents (n = 3) felt that the curriculum could be improved by including task-specific goals and additional practice sessions with the staff surgeon.
  
  
  CONCLUSIONS
  Mentor-guided SDL stimulated surgical residents to practice with greater frequency. This repeated deliberate practice led to significantly improved MIS skills without significantly increasing the need for faculty-led instruction. Some residents preferred more discrete goal setting and increased mentor guidance.
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Johnathon M
authors: JM
authors: Aho
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Raaj K
authors: RK
authors: Ruparel
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Elaina
authors: E
authors: Graham
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Benjamin
authors: B
authors: Zendejas-Mummert
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Stephanie F
authors: SF
authors: Heller
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: David R
authors: DR
authors: Farley
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: bingenercasey.juliane@mayo.edu.
authors: Juliane
authors: J
authors: Bingener
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008611:Mentors; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D020377:Self Efficacy; D000066908:Simulation Training
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; education; mentor; residents; self-directed learning; simulation