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Self-directed learning in undergraduate medical education in India: Addressing the existing challenges and exploring the strategies for its successful implementation


1 Department of Community Medicine, Member of the Medical Education Unit and Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission09-Feb-2020
Date of Decision03-Apr-2020
Date of Acceptance24-Jun-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava,
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpattu District, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_37_20

  Abstract 


For a significant period of time in the field of medical education, delivery in India emphasis has been given toward didactic lectures, practical, and tutorials. Among the five goals laid down for an Indian Medical Graduate, being a lifelong learner is what we are aiming for as the field of medicine is changing with each day. This cannot be accomplished if we do not encourage self-directed learning (SDL) among the students, and this need has been realized and has been given due weightage in the recently adopted competency-based undergraduate medical curriculum. However, it is important to acknowledge that the success of SDL depends on the readiness of the students to adopt the same and to accomplish that we have to strategically deal with all the existing challenges, which comes along with it. In conclusion, SDL has an extensive scope and application in the delivery of undergraduate medical education in India. However, there are challenges pertaining to its planning and evaluation, and there lies the role of a faculty member, who has to be more proactive in ensuring that it is implemented effectively and the students are benefited.

Keywords: Medical education, self-directed learning, teachers



How to cite this URL:
Shrivastava SR, Shrivastava PS. Self-directed learning in undergraduate medical education in India: Addressing the existing challenges and exploring the strategies for its successful implementation. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 Sep 20]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=310598




  Introduction Top


For a significant period of time in the field of medical education, delivery in India emphasis has been given toward didactic lectures, practical, and tutorials.[1] Even though, in most of the settings, we have resorted to innovative and more of interactive teaching–learning methods, a lot still needs to be done to improve the delivery of the medical curriculum.[1] Among the five goals laid down for an Indian Medical Graduate, being a lifelong learner is what we are aiming for as the field of medicine is changing with each day.[1] This cannot be accomplished if we do not encourage self-directed learning (SDL) among the students, and this need has been realized and has been given due weightage in the recently adopted competency-based undergraduate medical curriculum by assigning specified number of hours per year.[1]


  Self-Directed Learning Top


In general, SDL refers to the process wherein the student takes the initiative on their own to identify their learning needs, set goals, explore sources/subjects required for learning, select appropriate learning methods, and finally evaluate their efforts.[2] In other words, encouragement of SDL teaches students how to learn instead of focusing on what all to be learned. Further, we aim toward application of the gained skills (viz., communication, research, critical thinking, clinical reasoning, and problem-solving). It is important to understand that SDL has to be given a direction by the faculty members, who have to act as a facilitator, and it should not be looked upon as “self-study.”[3],[4]


  Merits of Self-Directed Learning Top


The advantage of such an approach is that it enhances the extent of independence of the students in every aspect of their own learning, augments the average time spent on reading/writing, promotes collaborative learning, brings out creativity, and all in one becomes more of a fun-driven learning.[1],[5],[6] Furthermore, it plays a big part in improving self-determination, confidence, and ability to communicate with varied learners from different parts of the globe (online course), makes them proficient in using technical applications, widens their knowledge base as they have more online access to a wealth of resources, and finally gives them an opportunity to learn by trial and error as they get an environment to do new things on their own.[5],[6]

A wide range of approaches such as problem-based learning, online courses, online platforms, video-assisted learning, flipped classrooms, YouTube, learning management system, WhatsApp-Twitter-Facebook-Instagram, blogs, and simulation laboratories are available to promote SDL.[1],[7],[8]


  Identified Challenges and Barriers Top


However, it is important to acknowledge that the success of SDL depends on the readiness of the students to adopt the same and to accomplish that we have to strategically deal with all the existing challenges which comes along with it.[2] The barriers from the students' perspective include lack of awareness about this modality of learning, especially in the initial years of the course, readiness to practice SDL, cognitive barrier (information overload or lack of clarity on what to focus), being motivated throughout the course, lack of interest, indiscipline, and varied competence levels of students to use e-learning methods.[2],[3] Another important challenge remains the assessment of SDL sessions.[5],[9]

From the teachers' perspective, reluctance to encourage SDL, lack of awareness about SDL or the methods to promote the same, and limited input/feedback from the teachers to facilitate the entire process as some concepts can be misunderstood can affect the overall outcome of the process. From the educational environment perspective, the barriers range from type of schooling exposed, the workload during the course itself, time constraints to perform the assignments, extent of extracurricular activities, the absence of the list pertaining to trusted sources of references, internet accessibility, lack of flexibility, and overdependence on online learning, which can take traditional teaching out of the equation.[2],[3]


  Proposed Strategies for Ensuring Successful Implementation Top


All these challenges need to be sorted out, and efforts have to be taken to bridge the gap between students who need direction and the teachers who are not doing the same.[10] The faculty members need to be trained to encourage SDL and the ways to do the same, and this essentially includes making their sessions more engaging and interactive, provision of trusted sources of references, mentoring, providing feedback to the students, ensuring that they do not learn wrong things, and addressing the needs of those students who are not good with e-learning.[11]

For dealing with the student challenges, they need to be motivated about the entire process, and this can be accomplished by orienting them about the value and scope of SDL and what all can be done from their side to make it more fruitful and cast a positive impact on their learning progression.[12] To make everything accountable, students can be asked to maintain logbook/portfolios, wherein they can document their learning. In the recently adopted curriculum, for the optimal utilization of the allotted time, the department has to engage in a proper planning regarding the topics to be kept for SDL, their scheduling in the time table for most effective outcome, and ensuring that all the SDL sessions are assessed subsequently.[3],[12] For all this to happen, all the faculty members have to work in collaboration and, if the need be, perform needs assessment for the identification of the topics.[11],[12],[13]

To streamline the assessment process of SDL, we can either adopt self-assessment (where students assess their learning on their own), peer assessment (wherein students can either work in groups and learn/assess simultaneously like in hybrid problem-based learning or flipped classrooms), or by means of assessment by faculty.[1] The faculty can assess SDL sessions by evaluating the given assignments or by reviewing logbooks or portfolios maintained by the students.[1] Further, at each stage, faculty members can give their feedback to improve the learning outcome of SDL sessions.[11] Most of these practices have been adopted in Shri Sathya Sai Medical College and Research Institute, a Constituent Unit of Sri Balaji Vidyapeeth, Puducherry.


  Conclusion Top


SDL has an extensive scope and application in the delivery of undergraduate medical education in India. However, there are challenges pertaining to its planning and evaluation, and there lies the role of a faculty member, who has to be more proactive in ensuring that it is implemented effectively and the students are benefited.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Medical Council of India. Assessment Module for Undergraduate Medical Education 2019; 2019. Available from: https://www.mciindia.org/CMS/wp-content/uploads/2019/11/Module_Competence_based_02.09.2019.pdf. [Last accessed on 2020 Feb 09].  Back to cited text no. 1
    
2.
Premkumar K, Vinod E, Sathishkumar S, Pulimood AB, Umaefulam V, Prasanna Samuel P, et al. Self-directed learning readiness of Indian medical students: A mixed method study. BMC Med Educ 2018;18:134.  Back to cited text no. 2
    
3.
Kohan N, Soltani Arabshahi K, Mojtahedzadeh R, Abbaszadeh A, Rakhshani T, Emami A. Self- directed learning barriers in a virtual environment: A qualitative study. J Adv Med Educ Prof 2017;5:116-23.  Back to cited text no. 3
    
4.
Gandomkar R, Sandars J. Clearing the confusion about self-directed learning and self-regulated learning. Med Teach 2018;40:862-3.  Back to cited text no. 4
    
5.
Hill M, Peters M, Salvaggio M, Vinnedge J, Darden A. Implementation and evaluation of a self-directed learning activity for first-year medical students. Med Educ Online 2020;25:1717780.  Back to cited text no. 5
    
6.
Atta IS, Alghamdi AH. The efficacy of self-directed learning versus problem-based learning for teaching and learning ophthalmology: A comparative study. Adv Med Educ Pract 2018;9:623-30.  Back to cited text no. 6
    
7.
Aldallal SN, Yates JM, Ajrash M. Use of YouTube™ as a self-directed learning resource in oral surgery among undergraduate dental students: A cross-sectional descriptive study. Br J Oral Maxillofac Surg 2019;57:1049-52.  Back to cited text no. 7
    
8.
Gatewood E. Use of simulation to increase self-directed learning for nurse practitioner students. J Nurs Educ 2019;58:102-6.  Back to cited text no. 8
    
9.
Shrivastava SR, Shrivastava PS. Assessment in competency-based medical education: Significance and the existing challenges. Int Arch Health Sci 2019;6:147-8.  Back to cited text no. 9
  [Full text]  
10.
Sahoo S. Finding self-directed learning readiness and fostering self-directed learning through weekly assessment of self-directed learning topics during undergraduate clinical training in ophthalmology. Int J Appl Basic Med Res 2016;6:166-9.  Back to cited text no. 10
    
11.
Aho JM, Ruparel RK, Graham E, Zendejas-Mummert B, Heller SF, Farley DR, et al. Mentor-guided self-directed learning affects resident practice. J Surg Educ 2015;72:674-9.  Back to cited text no. 11
    
12.
Sandars J, Walsh K. Self-directed learning. Educ Prim Care 2016;27:151-2.  Back to cited text no. 12
    
13.
Spormann RC, Pérez VC, Fasce HE, Ortega BJ, Bastías VN, Bustamante DC, et al. Factors associated with self-directed learning among medical students. Rev Med Chil 2015;143:374-82.  Back to cited text no. 13
    




 

 
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