More recently, Hiemstra and Brockett proposed that previous models underemphasized the effect of context on SDL and proposed a “Person, Process, Context” model, highlighting the equal importance of each of these three dimensions. Candy subdivided these dimensions into four phenomena: personal autonomy, self-management, learner control in academic settings, and the individual, noninstructional pursuit of learning opportunities in the “natural societal setting.” Garrison outlined three similar dimensions: self-management (task control), self-monitoring (cognitive responsibility), and motivation (entering and task). Brockett and Hiemstra developed a Personal Responsibility Orientation model of SDL with two dimensions: SDL (process) and learner self-direction (motivation).
![nvivo 10 link memo to internal nvivo 10 link memo to internal](https://4gnewyork.com/pictures/28922dde3551a67f480ffb8cc9a10027.jpg)
Starting with Knowles’ definition, theories of SDL have been developed to encompass three key components: process, personal attributes, and context. Knowles defined SDL as “a process in which individuals take the initiative, with or without the help of others, in diagnosing their learning needs, formulating goals, identifying human and material resources for learning, choosing and implementing appropriate learning strategies, and evaluating learning outcomes.” One review of SDL in medical education scholarship identified that many studies lacked a definition for SDL, highlighting that there is limited understanding of SDL and that clearer definitions and theories of SDL are needed to advance SDL research in medical education. Knowles incorporated SDL into his adult learning theory by emphasizing “the learners’ self-concept of being responsible for their own decisions” and stating that “the most potent motivations are internal pressures,” which contribute to “the transition from dependent to self-directing learners”. SDL originates from the adult education literature with Houle, Tough, and Knowles. The Accreditation Council for Graduate Medical Education requires that “residents and faculty members must demonstrate an understanding of their personal role in…attention to lifelong learning,” by developing skills and habits “to continuously improve patient care based on constant self-evaluation.” This “personal role” suggests that SDL is part of lifelong learning, and is an important competency for physicians to develop and maintain.
#NVIVO 10 LINK MEMO TO INTERNAL PROFESSIONAL#
Self-directed learning (SDL) is considered a component of physicians’ professional identities. We developed a theoretical model of SDL in medical education that can be used to promote and assess resident SDL through understanding the process, person, and context of SDL. Contextual factors included the need for external guidance, the influence of residency program structure and culture, and the presence of contextual barriers. Personal factors included motivations, individual characteristics, and the change in approach to SDL over time.
![nvivo 10 link memo to internal nvivo 10 link memo to internal](http://www.qualitative-forschung.de/fqs-supplement/fotos/zoom/11-1-34_18.jpg)
Residents progressed to formulating learning objectives, using resources, applying knowledge, and evaluating learning. The process of SDL began with a trigger that uncovered a knowledge gap. We developed a theoretical model of SDL to explain the process, personal, and contextual factors affecting SDL during residency training.
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Guided by a previous model of SDL, we developed a theoretical model that was revised through constant comparison with new data as they were collected, and we refined the theory until it had adequate explanatory power and was appropriately grounded in the experiences of residents. Team members organized open codes to create axial codes, which were applied to all transcripts. We processed the data by using open coding and writing analytic memos. Using a constructivist grounded theory approach, we conducted 7 focus group interviews with 46 internal medicine residents at an academic medical center. We explored the experience with and perception of SDL among internal medicine residents to gain understanding of the personal and contextual factors of SDL in graduate medical education.
![nvivo 10 link memo to internal nvivo 10 link memo to internal](https://instatalentapp.com/wp-content/uploads/604208/download-501c3-donation-receipt-letter-for-tax-purposes.jpg)
Previous medical education research has largely focused on the process of SDL. Existing theories of self-directed learning (SDL) have emphasized the importance of process, personal, and contextual factors.