Summary of Slotnick, Physician Self-Directed Learning
1. Activities vary with the nature of the problem instigating the learning episode and the stage the doctor is at in resolving the problem
2. Stages in self-directed learning episodes are distinguished in terms of their goals, discrepancies, learning resources, reflection and criteria for completion
3. Self-directed learning episodes can terminate for reasons that may or may not be justified. The doctor will then return to the scanning stage
4. Unresolved is the question of where doctors turn for skills and knowledge they need to complete each stage. See learning resource use in the Slotnick article in Unit 2. Page 19S
4 stage theory of Physician Self-Directed Learning Episodes:
From Slotnick HB. How doctors learn: physicians’ self-directed learning episodes. Acad Med 1999;74:41-52
Learning stage/Problem type / Specific (Patient need) / General (Updating store of skill and knowledge)Stage 0: Scanning for problems, interest / Alert for potential resources / Alert for problems that might need to be solved, and when potential problems are encountered, moves on to the next stage
Stage 1/ Evaluating the problem and deciding whether the problem is worth pursuing / Senses a need for immediate action and decides whether to take on the problem
Or reads, talks with others and decides quickly / Feels uneasy; asks: “Is there likely a solution to the problem?
“Are resources available so I can do the learning?
“Am I prepared to make the changes in my practice required by the learning I do?
Stage 2/ Learning skills and knowledge
Learning what is needed to address the problem / Learning involves reading, talking with others who may offer suggestions / Learning involves comprehensive reading, course attendance, taking appropriate courses of action
Stage 3/Gaining experience using what has been learned / Learning means trying the problem solutions on the problem and seeing what happens / Learning means trying the new skills and knowledge in a range of settings and gaining experience. Reading again, to see what kinds of experience others have had with it.