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Domain of Competence: Practice-Based Learning and Improvement

      The domain for self-directed learning and/or self-improvement as a physician is complex, involving 10 competencies focused on learning and improvement around abilities that allow a pediatrician to become a more masterful doctor. The notions of internal motivation, desire to improve and do better, and self-determination are all at work in this domain. Internal motivation is hard to directly observe but can be inferred by longitudinal observation of behaviors. Malcolm Knowles
      • Knowles M.
      Self Directed Learning: A Guide for Learners and Teachers.
      first established the definition of self-directed learning as a process in “which individuals take the initiative (with or without the help of others) in diagnosing their learning needs, formulating goals, identifying human and material resources for learning, choosing and implementing appropriate learning strategies, and evaluating learning outcomes.” Attributes of a self-directed, lifelong learner includeone who exhibits initiative, independence, and persistence in learning; one who accepts responsibility for his or her own learning and views problems as challenges; one who is capable of self-discipline and has a high degree of curiosity; one who has a strong desire to learn or change and is self-confident; one who is able to use basic study skills, organize his or her time and set an appropriate pace for learning, and to develop a plan for completing work; one who enjoys learning and has a tendency to be goal-oriented.
      • Guglielmino L.M.
      Development of the Self Directed Learning Readiness Scale.
      Practice-based learning and improvement lends itself to watching a learner over time, allowing for inference, over many episodes in which they demonstrate self-directed behaviors. These themes thread throughout the following milestones.

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      References

        • Knowles M.
        Self Directed Learning: A Guide for Learners and Teachers.
        Associated Press, New York, NY1975
        • Guglielmino L.M.
        Development of the Self Directed Learning Readiness Scale.
        ([dissertation]) University of Georgia, Athens, Ga1977