Individualized Learning Plans: Wright State University Annotated Bibliography

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1 Individualized Learning Plans: Wright State University Annotated Bibliography Eva KW, Regehr G. Self-Assessment in Health Pressis: A Reformulati and Research Agenda. Academic Medicine. 2005; 80:s46-s54. This review paper is a clearly written, insightful discussi many important facrs in way physicians self regulate and improve. Self-efficacy and self-ccept, cogniti and metacognitive ory, social cogniti, models expert performance and how expertise is developed, and ccept reflective practice are all reviewed in a literature based manner. Future directis for research in this area are expanded up at end article. Stuart E, Sectish T, Huffman L. Are residents ready for self directed learning? A pilot program individualized learning s in ctinuity clinic. Ambulary Pediatrics. 2005;5: The ly article written regarding pediatric residents and individualized learning s. Learning s were de in written form (not computerized). Results reveal ILPs were helpful in providing a framework and focus for learning. Barriers were time cstraints and difficulty in producing learning goals and strategies. The mean number goals per learning reviewed (n = 16) was reported as 3.23 (range: 1-7). The authors provided a two-hour workshop. The faculty informati focused basic principles ting and adult learning with a focus promoting reflecti and awareness learning. Some suggestis faculty had were: start with PL-1s, set time aside for doing this, and give a specific list specific goals per year residency. McDermott MM, Curry RH, Stille FC, Martin GJ. Use learning ctracts in an fice-based primary care clerkship. Medical educati. 1999;33: This is a report a nicely designed research project look at implementati a learner centered learning goal in a clerkship at Northwestern. Interestingly, third year students rated it more favorably than fourth year med students. The advantages learner-centered exercise were re was more ability explore pics at ir own pace. They cclude having learners develop ir own learning goals is an efficient and valuable adjunct patient care activities in clinical care setting. Bravata D, Huot S, Abernathy HS et.al. The Development and Implementati a curriculum improve clinicians self-directed learning skills: a pilot project. Biomed Central Medical Educati. A pilot study at Stanford in Internal Medicine Department. The purpose was develop and implement a curriculum t physicians self-directed learning skills during inpatient wards rotatis. A very good background secti discusses self-directed learning. The curriculum utilized is interesting. It involves assessment, a learning resource exercise, a clinical questi diary and a journal reading exercise. It is geared wards direct reflecti in acti type learning. No learning terminology was utilized.

2 Parsell G, Bligh J. Ctract learning, clinical learning and clinicians. Postgraduate Medical Journal. 1996; 72: Parsell G. Handbooks, learning ctracts, and senior house ficers: a collaborative enterprise. Postgraduate Medical Journal. 1997;73: These are two papers written by a leader in field learning ctracts/ ILPs. The first is an excellent examinati oretical basis ctract learning and how it is relevant clinical settings. He is a physician in UK and his perspective is his locale, neless it is a well-written summary and discussi learner driven learning and learning s. The secd title is an actual descriptive research paper a process introduce ctract learning senior house ficers at a general hospital in UK. Generally positive respses were made by H.O. regarding program. Sectish T, Floriani V, Badat MC, Perelman R, Bernstein H. Ctinuous pressial development: raising bar for pediatricians. Pediatrics. 2002; 110: An outstanding review and discussi reas for shift ctinuous pressial development away older versis CME. It discusses Pedialink very nicely and reasing behind set-up. It also discusses proposed learning cycle clinicians by Dald Sch. Easy read. Chan SW, Chien WT. Implementing ctract learning in a clinical ctext: reporn a study. Journal Advanced Nursing. 2000;3:7. This paper reports a project in a descriptive manner about implementati and evaluati learning ctracts in clinical nursing. Specifically, a rotati in mental health nursing. The guidelines for creating a learning ctract were 1) identify learning objectives, 2) propose learning strategies and resources accomplish objectives, 3) identify evidence accomplishment, and 4) describe means for evaluating ir performance. Some described benefits learning ctacts were ir use increased learner aunomy, increased student motivati, strengned effectiveness rotati, and increased sharing amg learner peers and faculty. Some difficulties were faculty had limited time facilitate learner s objectives, and lack with using learning ctracts. Spencer J, Jordan R. Learner centered es in medical educati. BMJ 1999;318; A nice summary why self-directed learning is a good educatial strategy most likely produce physicians prepared for lifelg learning. It reviews some terminology self-directed learning and gives a good overview. Renner JJ, Stritter F, Wg H. Learning Ctracts in Clinical Educati. Radiologic Technology. 1993;64(6):

3 This reference provides a literature review ctract learning and an actual study involving students in radiology science program at University North Carolina. The depth this ctract learning is deeper than more superficial e two times per year individual learning s we are required do with our residents. It is interesting see barriers and benefits identified by student users. Additial Bibliography self-reflecti and adult learning: Westberg J, Jas H. Fostering learners reflecti and self-assessment. Family Medicine. 1994; 26: A good overview reflective learning and how help students foster ir own selfassessment and reflecti. Mann K. Educating medical students: lesss research in ctinuing educati. Academic Medicine. 1994; 69(1): Reviews and explains ccepts ctinuing medical educati alg ctinuum student practitier. Pratt D. Andragogy as a relatial cstruct. Adult Educati Quarterly. 1988;38:3; Interesting summary and explorati adult learning and characteristics rein.

4 Background informati Individualized Learning Plans 1. Why do residents need do learning s? Most us didn t do learning s as residents and we turned out just fine. This is a comm sentiment amgst faculty members natiwide. a. It is a Pediatric RRC Requirement since January b. The self-assessment secti ILP assists those residents who may have no self-reflective skills. The ILP develops, oretically, e s ability self improve. c. Setting goals is a powerful practice. Some people do this in ir minds, but writing down a goal and reviewing it later is more tangible and clear. People comment y feel more accountable if a is written and discussed. d. The explicit goal ILP in residency training is develop skills in individual improvement. e. Prepares residents for American Board Pediatrics maintenance certificati (MOC) 2. What do individual learning s csist? What is difference between learning ctracts and learning s? An individual learning csists 1) delineati lg term goal/career choice, 2) self-assessment identify weaknesses 3) development learning Goals with S.M.A.R.T. Strategies/Objectives and 4) feedback with a menr or advisor. The overall point ILPs in pediatric graduate medical educati is encourage serious selfreflecti. A learning ctract is a term could interchange with learning. In literature learning ctract tends be used with a specific rotati or precepr. Learning s could be csidered more global. There is discussi in pediatrics about ccept near-term and lg-term (global) goals. For example, learning how read EKGs e s cardiology rotati is a near-term goal, while figuring out how improve e s self-cfidence may be a more global or lg-term goal (can not be de in 1-2 weeks). 3. How am I supposed help facilitate residents ILPs? Try emphasis fact ir goals need be SMART. That is: S: Specific M: Measurable A: Achievable R: Relevant T: Time based So for a resident write down y want, for example, increase ir knowledge base, y would need a) get much more specific, b) give you and mselves a measure ir progress (PREP, articles read etc.) c) make sure it is achievable in e

5 two year s time. d) and try tell you and mselves when y will accomplish goal by. PLEASE NOTE: if somee has a goal may seem hard achieve do not tell m change it, just discuss your ccern and let m think about it. You are re hold up mirror resident. Give m your perspective ir performance (you can review ir evaluatis such you have ors input who see resident in a different clinical setting)

6 Individualized Learning Plan In this exercise, you will be asked complete an Individualized Learning Plan. There is a Learning Plan opti your Pedialink Home Page. While not exactly like resident ILP it is a learning Plan. I would ask you work through following written ILP. Step 1: Career Goals: Lg-term a. b. c. Short-term a. b. c. Step 2: Ranking Attributes: Please rank following with 1 (strgest) 12 (weakest) Initiative Perserverance Ability recognize limitatis Ability work with ors Attenti Detail Time management Cfidence Respse Feedback Communicati Skills Strive for Excellence Write in Write in

7 The The Dreyfus Dreyfus Model Model Step Three: Self-Assessment Skill Level Novice: Novice: Governed Governed by by Rules; Rules; unable unable rely rely previous previous for for guidance guidance Advanced Advanced Beginner: Beginner: Still Still rule rule focused; focused; learning learning is is tied tied ccrete ccrete situatis; situatis; able able identify identify aspects aspects comm comm situatis. situatis Competent: Competent: Relies Relies past past an an patient s patient s situati; situati; learns learns csequences csequences resulting resulting Pricient: Pricient: Modifies Modifies in in respse respse given given situatis; situatis; begins begins streamline streamline patient. patient Expert: Expert: Recognizes Recognizes clues; clues; attuned attuned d t d t fit fit routine; routine; practice practice is is guided guided by by tacit tacit knowledge. knowledge. Directis: Directis: please please use use descriptis descriptis self self assess. assess. Mark Mark (with (with appropriate appropriate correspding correspding number number 1-5) 1-5) your your perceived perceived level level based based Dreyfus Dreyfus model. model. Feel Feel free free add add specific specific subject subject matter matter /tasks /tasks apply apply you. you. Patient Care Compassiate, appropriate, and effective for treatment health problems and promoti health: Garing essential and accurate informati about patient. Making informed diagnostic and rapeutic decisis. Developing and carrying out management s. Performing medical procedures. Counseling patients and families Providing effective primary care and anticipary guidance. Using technology optimize patient care. Medical Knowledge Established and evolving biomedical, clinical, and cognate (e.g. epidemiology and social-behavioral) sciences and applicati this knowledge patient care: Knowing basic and clinical supportive services appropriate pediatrics. Critically evaluating and applying current medical informati and scientific evidence pediatrics.

8 The The Dreyfus Dreyfus Model Model Novice: Novice: Governed Governed by by Rules; Rules; unable unable rely rely previous previous for for guidance guidance Advanced Advanced Beginner: Beginner: Still Still rule rule focused; focused; learning learning is is tied tied ccrete ccrete situatis; situatis; able able identify identify aspects aspects comm comm situatis. situatis Competent: Competent: Relies Relies past past an an patient s patient s situati; learns situati; learns csequences csequences resulting resulting Pricient: Pricient: Modifies Modifies in in respse respse given given situatis; situatis; begins begins streamline streamline patient. patient Expert: Expert: Recognizes Recognizes clues; clues; attuned attuned d t d t fit fit routine; routine; practice practice is is guided guided by by tacit tacit knowledge. knowledge. Directis: Directis: please please use use descriptis descriptis self self assess. assess. Mark Mark (with (with appropriate appropriate correspding correspding number number 1-5) 1-5) your your perceived perceived level level based based Dreyfus Dreyfus model. model. Feel Feel free free add add specific specific subject subject matter matter /tasks /tasks apply apply you. you. Practice-Based Learning and Improvement Involves investigati and evaluati ir own patient care, appraisal and assimilati scientific evidence, and improvements in patient care: Using life-lg learning skills improve knowledge, skills and practice. Analyzing practice recognize strengths, deficiencies, and limits in knowledge and expertise. Using feedback improve performance. Applying evidence patient care. Participating in educati patients, families, students, residents, and or health pressials. Interpersal and Communicati Skills Result in effective informati exchange and teaming with patients, ir families, and or health pressials: Communicating effectively with patients and families. Communicating effectively with or health pressials. Teamwork. Acting in a csultative role or health pressials. Maintaining comprehensive, timely and legible medical records.

9 The The Dreyfus Dreyfus Model Model Novice: Novice: Governed Governed by by Rules; Rules; unable unable rely rely previous previous for for guidance guidance Advanced Advanced Beginner: Beginner: Still Still rule rule focused; focused; learning learning is is tied tied ccrete ccrete situatis; situatis; able able identify identify aspects aspects comm comm situatis. situatis Competent: Competent: Relies Relies past past an an patient s patient s situati; situati; learns learns csequences csequences resulting resulting Pricient: Pricient: Modifies Modifies in in respse respse given given situatis; situatis; begins begins streamline streamline patient. patient Expert: Expert: Recognizes Recognizes clues; clues; attuned attuned d t d t fit fit routine; routine; practice practice is is guided guided by by tacit tacit knowledge. knowledge. Directis: Directis: please please use use descriptis descriptis self self assess. assess. Mark Mark (with (with appropriate appropriate correspding correspding number number 1-5) 1-5) your your perceived perceived level level based based Dreyfus Dreyfus model. model. Feel Feel free free add add specific specific subject subject matter matter /tasks /tasks apply apply you. you. Pressialism Commitment carrying out pressial respsibilities, adherence ethical principles, and sensitivity a diverse patient populati: Demstrating respect, compassi, integrity and hesty. Demstrating a respsiveness needs patients and society supersedes self-interest. Demstrating accountability patients, society and pressi. Adhering ethical principles. Sensitivity a diverse patient populati. Systems-Based Practice Demstrate an awareness and respsiveness larger ctext and system health care and ability effectively call system resources provide care is optimal value: Knowing types medical practice and delivery systems. Practicing cost-effective health care. Advocating for quality patient care and assisting patients in dealing with system complexities. Advocating for health promoti and disease preventi. Acknowledging medical errors and examining systems prevent m.

10 Step Four: Setting Objectives/Strategies Try come up with three objectives you will work achieve over next six mths. Take in csiderati strengths and weaknesses you just identified earlier in ILP process. Each Objective should try follow SMART criteria: Specific, Measurable, Achievable, Relevant, Time based. Objective #1 Strategies: Objective #2 Strategies: Objective #3 Strategies: Additial thoughts/objectives: