Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Nashville

Poster Presentation:


UTILIZING INDIVIDUALIZED LEARNING GOALS (LG) IN THE PEDIATRIC CLERKSHIP

Authors:

Jennifer B. Soep, MD, MD, University of Colorado, Aurora, CO, Michelle E. Kiger, MD, University of Colorado, Aurora, CO, Tai M. Lockspeiser, MD, University of Colorado, Aurora, CO


Background: Self-directed lifelong learning is an important skill for physicians to develop to maintain competency in an ever-evolving field.  Setting goals places the learner at the center of the learning process, allowing for individualization and practice in self-assessment. 
Objectives: 1. Categorize LGs written by students during their pediatric clerkship based on the ACGME competencies.  2.  Describe students’ self-reported progress on LGs. 3.  Identify barriers to meeting LGs.
Methods: 3rd year medical students were asked to develop 3 LGs during their pediatric clerkship orientation.  They were given written instructions on writing LGs using the I-SMART approach (important, specific, measurable, accountable, realistic, timely) and a worksheet that guided them through identifying a goal, articulating why they selected it, developing plans for achieving it, and measuring the anticipated outcome. At the end of the rotation, students were asked to self-report their progress on meeting each LG using a 5-point Likert scale (1=no progress and 5=met my objective).  They were also asked to identify challenges they faced.  All LGs were reviewed by two investigators and categorized using the ACGME competencies.
Results:  45 students documented 133 LGs over 3 blocks.  LGs covered all ACGME competencies except for professionalism and system-based practice: 55% patient care, 33% communication, 8% medical knowledge, 4% practice-based learning and improvement.  The majority of LGs focused on oral presentations, written notes, physical exam skills, and development of differential diagnoses.  A few students identified goals that did not fit well into the competency scheme, including exploring pediatrics as a career.  On average, students rated their progress toward their LGs at 4.1. Barriers to meeting goals included: difficulties asking for feedback and with patient cooperation, and lack of time, confidence, experience or opportunities to see patients that matched their goals. 
Conclusions: The majority of the LGs written by 3rd year students related to patient care and communication.  Students felt they made significant progress towards meeting their goals despite identifying several barriers. Next steps include assessing the quality of the LGs using a scoring rubric, determining the impact of LGs on a student’s learning in the clerkship, and finding ways to overcome barriers.