Medical students' self-assessments and their allocations of learning time

Purpose. To investigate the impact of self-assessed diagnostic strengths an d weaknesses on medical students' allocation of learning time (one indicato r of self-directed learning) during a third-year internal medicine clerkshi p. Method. In 1997-98, 107 students at the University of Michigan Medical S chool self-assessed their diagnostic skills in 14 clinical areas before and after the clerkship and reported the relative amounts of time spent learni ng about these topics during the clerkship. Results. Individual-level analy ses indicated that, for the average student, self-assessed strengths and we aknesses did not correlate with allocation of educational time, but that ri me allocation was positively related to changes in self-assessed skill. Con siderable variations in these relationships, however, suggest a need For cl oser study. Conclusion. Although individual students evidenced different le vels of self-directed learning, this study suggests overall that students a t dris level of training are neophytes in applying both information generat ed through self-assessment and principles of self-directed Learning in thei r clinical education. Attempts to advance students beyond this level depend on many factors, including the extent: to which the learning environment e ncourages or even permits self-directed learning, the progression and time frame through which students become self-directed practitioners, and the im pact of educational interventions to promote this development.