Purpose: To investigate the impact of self-assessed diagnostic strengths and weaknesses on medical students' allocation of learning time (one indicator of self-directed learning) during a third-year internal medicine clerkship.
Method: In 1997-98, 107 students at the University of Michigan Medical School self-assessed their diagnostic skills in 14 clinical areas before and after the clerkship and reported the relative amounts of time spent learning about these topics during the clerkship.
Results: Individual-level analyses indicated that, for the average student, self-assessed strengths and weaknesses did not correlate with allocation of educational time, but that time allocation was positively related to changes in self-assessed skill. Considerable variations in these relationships, however, suggest a need for closer study.
Conclusion: Although individual students evidenced different levels of self-directed learning, this study suggests overall that students at this level of training are neophytes in applying both information generated through self-assessment and principles of self-directed learning in their clinical education. Attempts to advance students beyond this level depend on many factors, including the extent to which the learning environment encourages or even permits self-directed learning, the progression and time frame through which students become self-directed practitioners, and the impact of educational interventions to promote this development.