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Article review: What’s wrong with self-guided learning?

Michelle Lin, MD |


There is a constant tug-of-war between self-guided learning and supervised learning. With the advances in technology for medical education such as asynchronous learning modules, simulation, there has been a movement away from traditional, instructor-led teaching and towards more independent, self-guided learning. There is less supervision of learning.
But left unsupervised, are learners learning the right things and doing so optimally? The authors, in this review, say yes and no.

How can learners optimize the practice of self-guided learning? 

The authors delved into the educational psychology literature. The trick is to use under-appreciated cognitive tools in the learning process.

  • Self-monitoring: Keep a record of and be cognizant of the learning process. An example is keeping a record of learning behaviors or personal performance while learning about a particular skill or topic. This reflective approach has been shown to increase self-awareness and improves learning outcomes.
  • Selecting what to study: Metacognition research shows that learners are only average at being able to identify learning needs. Interestingly without any time pressure, learners focus first on difficult concepts and then easier concepts later. WITH time pressure (which is pretty much all of medical education), learners focus first on easier items or most proximal topics.  
  • Self-testing: Frequent “retrieval practice”, or self-testing, has been shown to improve learning retention. Many learners don’t do this because subconsciously it’s natural to want to avoid being wrong.

Why do we even need instructor supervision then?

Expert instruction is still vital in education. Instructors can…
  • more accurately identify and learner’s skill/knowledge level and set appropriate learning goals. It’s the instructor’s job to constantly challenge and push the learner to learn more.
  • challenge learners in a different way than learners can challenge themselves. This includes teaching which dispels any false illusions of competence on the part of the learner. This may include scheduling class time to do self-tests, practicing random (instead of a focused) skills, providing summary rather than more real-time feedback. 
  • provide support in challenging learning environments.

The authors advocate for a hybrid learning approach called “directed self-guided learning” where the instructor has a behind-the-scenes presence in the independent learning experience. This presence may include designing a structured, step-wise curriculum which the learner can progress through at his/her own pace with multiple checkpoints on learner competency. More studies need to look into the good and bad habits of self-guided learning, how to incorporate external resources into self-guided learning, and the best approach to challenge our learners.

This article is worth a read, although I had to read it a couple of times to really let the content sink in. It’s a pretty densely packed article.

Brydges R, Dubrowski A, Regehr G. A new concept of unsupervised learning: directed self-guided learning in the health professions. Academic Medicine. 2010, 85(10 Suppl): S49-55. PMID:20881703

Author information

Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

The post Article review: What’s wrong with self-guided learning? appeared first on ALiEM.

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