Tai M Lockspeiser1, Su-Ting T Li, Ann E Burke, Adam A Rosenberg, Alston E Dunbar, Kimberly A Gifford, Gregory H Gorman, John D Mahan, Michael P McKenna, Suzanne Reed, Alan Schwartz, Ilene Harris, Janice L Hanson. 1. T.M. Lockspeiser is assistant professor, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. S.T. Li is associate professor, vice chair of education, and pediatric residency program director, Department of Pediatrics, University of California Davis, Sacramento, California. A.E. Burke is associate professor and residency program director, Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio. A.A. Rosenberg is professor and director, Pediatric Residency Program, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. A.E. Dunbar III is program director, Pediatric Residency Program, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana. K.A. Gifford is assistant professor and pediatric residency program director, Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. G.H. Gorman is associate professor and pediatrics residency program director, Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland. J.D. Mahan is professor, vice chair for education, and pediatric residency program director, Department of Pediatrics, Nationwide Children's Hospital/Ohio State University College of Medicine, Columbus, Ohio. M.P. McKenna is director of career mentoring and associate pediatric program director, Indiana University School of Medicine, Indianapolis, Indiana. S. Reed is assistant professor and pediatric residency associate program director, Department of Pediatrics, Nationwide Children's Hospital/Ohio State University College of Medicine, Columbus, Ohio. A. Schwartz is professor and associate head, Department of Medical Education, and research professor, Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois. I. Harris is professor, head, and director of graduate studies, Department of Medical Education, University of Illinois College of Medicine, Chicago, Il
Abstract
PURPOSE: Medical education aims to equip physicians for lifelong learning, an objective supported by the conceptual framework of self-regulated learning (SRL). Learning goals have been used to develop SRL skills in learners across the medical education continuum. This study's purpose was to elicit residents' perspectives on learning goal use and to develop explanations suggesting how aspects of the learning environment may facilitate or hinder the meaningful use of learning goals in residency. METHOD: Resident focus groups and program director interviews were conducted in 2012-2013, audio-recorded, and transcribed. Programs were selected to maximize diversity of size, geographic location, type of program, and current use of learning goals. Data were analyzed using the constant comparative method associated with grounded theory. Further analysis compared themes frequently occurring together to strengthen the understanding of relationships between the themes. Through iterative discussions, investigators built a grounded theory. RESULTS: Ninety-five third-year residents and 12 program directors at 12 pediatric residency programs participated. The analysis identified 21 subthemes grouped into 5 themes: program support, faculty roles, goal characteristics and purposes, resident attributes, and accountability and goal follow-through. Review of relationships between the themes revealed a pyramid of support with program support as the foundation that facilitates the layers above it, leading to goal follow-through. CONCLUSIONS: Program support facilitates each step of the SRL process that leads to meaningful use of learning goals in residency. A strong foundation of program support should include attention to aspects of the implicit curriculum as well as the explicit curriculum.
PURPOSE: Medical education aims to equip physicians for lifelong learning, an objective supported by the conceptual framework of self-regulated learning (SRL). Learning goals have been used to develop SRL skills in learners across the medical education continuum. This study's purpose was to elicit residents' perspectives on learning goal use and to develop explanations suggesting how aspects of the learning environment may facilitate or hinder the meaningful use of learning goals in residency. METHOD: Resident focus groups and program director interviews were conducted in 2012-2013, audio-recorded, and transcribed. Programs were selected to maximize diversity of size, geographic location, type of program, and current use of learning goals. Data were analyzed using the constant comparative method associated with grounded theory. Further analysis compared themes frequently occurring together to strengthen the understanding of relationships between the themes. Through iterative discussions, investigators built a grounded theory. RESULTS: Ninety-five third-year residents and 12 program directors at 12 pediatric residency programs participated. The analysis identified 21 subthemes grouped into 5 themes: program support, faculty roles, goal characteristics and purposes, resident attributes, and accountability and goal follow-through. Review of relationships between the themes revealed a pyramid of support with program support as the foundation that facilitates the layers above it, leading to goal follow-through. CONCLUSIONS: Program support facilitates each step of the SRL process that leads to meaningful use of learning goals in residency. A strong foundation of program support should include attention to aspects of the implicit curriculum as well as the explicit curriculum.
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