Helping trainees address knowledge gaps by engaging in meaningful self-

regulated learning

William B. Cutrer, MD MEd and Larry Gruppen, PhD

Disclosures

• Drs. Gruppen and Cutrer do not have any financial disclosures to make

Objectives

1) Describe how engaging in learning builds on the identification of knowledge gaps in the Master Adaptive Learner model

2) Explain several different strategies trainees could use to engage in active learning

3) Coach a trainee engaging in meaningful self-regulated learning

4) Develop an action plan for possible implementation of new strategies upon return to their home institution

Overview

• Setting the Stage• Learning Strategies • Small Group Work• Large Group Report Out• Action Plan Creation

Goal of Medical Education?

Expert Physicians

Expert Thinkers

Expert Learners

Setting the Stage

Slide adapted from Martin Pusic, MD PhD

Setting the Stage— Learning for Future Learning

Slide adapted from Martin Pusic, MD PhD

Self-Directed learner

Life-long learner

Self-regulated learnerExpert learner

AGILE LEARNERWorkplace learner

Engaged learnerSetting the Stage

Setting the Stage

• Richard Dollase (Brown)• Richard DeMillo (GA Tech)• Larry Gruppen (Michigan)• Rajesh Mangrulkar (Michigan)• Sally Santen (Michigan)• Martin Pusic (NYU)• Patrician O’Sullivan (UCSF)• Susan Masters (UCSF

• George Mejicano (OHSU)• Patricia Carney (OHSU)• Nicole Deiorio (OHSU)• Daniel Wolpaw (Penn St)• Therese Wolpaw (Penn St)• Bonnie Miller (Vanderbilt)• Bill Cutrer (Vanderbilt)

Master Adaptive Learner Working Group of the AMA Accelerating Change in Medical Education Consortium

What is a Master Adaptive Learner?

• Learning for now• Learning for next year– Progress testing– Integrated curricula

• Learning for 20 years from now– Habits– Methods

Setting the Stage

• Self-regulation is important in fostering health care providers who will: – MAINTAIN their knowledge and skills in practice– IMPROVE their knowledge and skills in practice

• Set of behaviors requires: – an awareness of personal knowledge gaps– a willingness to address knowledge gap

“Energy” that drives self-regulation

White, C. B., Gruppen, L. D., & Fantone, J. C. (2010). Self-regulated learning in medical education. Understanding medical education: Evidence, theory and practice, 271-82.

Self-Regulated Learning in Medical Education

Setting the Stage

Learning Strategies

Large Group Brainstorm

Learning Strategies1) Knowledge Retrieval Strategies

2) Spaced Repetitious Learning

3) Interleaving

4) Concept Mapping

Learning Strategies: Knowledge Retrieval Strategies

Learning Strategies:Spaced Repetitious Learning

Learning Strategies:Spaced Repetitious Learning

Learning Strategies:Spaced Repetitious Learning

Learning Strategies:Spaced Repetitious Learning

Learning Strategies:Interleaving

Learning Strategies:Concept Mapping

Work in pairs or triads(20 min)• Task: Design an educational intervention • Target learners: Pre-clerkship medical students • Learner Gap: Poor EKG interpretation (teacher identified)

• Goal: Improve EKG interpretation before entering clerkships

• Learning Strategies: Use at least one of the 4 strategies

SMALL GROUP EXERCISE #1

Work in pairs or triads (20 min)• Task: Design an educational intervention • Target learners: Clerkship medical students • Learner Gap: Antibiotic selection (student-identified)

• Goal: Help students develop a thoughtful approach to antibiotic selection for common infections

• Learning Strategies: Use at least one of the 4 strategies

SMALL GROUP EXERCISE #2

Report from the groups• Major themes/ideas identified

• Which strategies did you employ?

• What are the barriers to implementation?

• Did who identified the gap impact the strategy selection? (student-identified vs teacher-identified)

Large Group Report Out

Action Plan Creation

• What are 2 practical changes you can make in the next 3 months to incorporate one or more of these learning strategies into your teaching practice?

Questions?