HOW DOCTORS LEARN - THE ROLE OF CLINICAL PROBLEMS ACROSS THE MEDICAL-SCHOOL TO PRACTICE CONTINUUM

The author proposes a theory of how physicians learn that uses clinica l problem solving as its central feature. His theory, which integrates insights from Maslow, Schon, Norman, and others, claims that physicia ns-in-training and practicing physicians learn largely by deriving ins ights from clinical experience. These insights allow the learner to so lve future problems and thereby address the learner's basic human need s for security affiliation, and self-esteem. Ensuring that students ga in such insights means that the proper roles of the teacher are (1) to select problems for students to solve and offer guidance on how to so lve them, and (2) to serve as a role model of how to reflect on the pr oblem, its solution, and the solution's effectiveness. Three principle s guide instruction within its framework for learning: (1) learners, w hether physicians-in-training or practicing physicians, seek to solve problems they recognize they have; (2) learners want to be involved in their own learning; and (3) instruction must both be time-efficient a nd also demonstrate the range of ways in which students can apply what they learn. The author concludes by applying the theory to an aspect of undergraduate education and to the general process of continuing me dical education.