The approaches to learning of specialist physicians.

Recent studies have provided information about the approaches to studying and learning used by medical students. However, no published work is available on the approaches of practising doctors. The Adelaide Diagnostic Learning Inventory for Medical Students (ADLIMS) was modified and administered to a random sample of 308 physicians (internists). Generally speaking, physicians seem to have lower scores on surface approach and higher scores on deep approach than students. Level of clinical experience did not appear to influence this finding. However, marked differences were apparent between the approaches adopted by physicians with additional postgraduate academic training and those without. The former had a much stronger tendency to use the more desirable deep approach. The latter seemed to rely more on the less desirable surface approach. Further longitudinal studies will be required to determine whether this difference is attributable to self-selection of those who have already developed a deep approach or is causally related to a training in research. Although these findings must be interpreted with caution, some implications are clear. Physicians should become more aware of the way they learn and about the way they teach. Inappropriate patterns of learning may be entrenched during the undergraduate and immediate postgraduate years. If validated, these findings may provide support for the inclusion of research projects in medical school and during specialist training.