학부의학교육에서 포트폴리오를 활용한 SDL: 멘토의 관점 (Med Teach, 2013)
Promoting self-directed learning through portfolios in undergraduate medical education: The mentors’ perspective
SANDRIJN VAN SCHAIK, JENNIFER PLANT & PATRICIA O’SULLIVAN
Knowles는 SDL을 다음과 같이 정의했다.
Knowles (1975) describes self-directed learning (SDL) as a process that involves
- diagnosing one’s learning needs,
- formulating learning goals,
- identifying resources for learning,
- implementing appropriate learning strategies and
- evaluating learning outcomes.
이에 의과대학은 다음과 같은 것을 강조한다.
Medical schools should therefore focus on producing lifelong, self-directed learners with skills related to
- monitoring,
- regulating and
- planning one’s own learning(Spencer & Jordan 1999; Quirk 2006)
rather than solely encouraging acquisition of knowledge and clinical skills (Quirk 2006)
포트폴리오는 SDL의 과정을 돕기 위한 도구로서 떠오르고 있다. 포트폴리오는 근거를 모으고, 다양한 소스에서 피드백을 모으고, 학습자들이 자신들의 발전과정을 성찰하는 플랫폼이면서 학습요구를 진단하고 학슴고표와 계획을 만드는 것을 도와준다.
Portfolios have emerged as an educational tool in both undergraduate and graduate medical education to assist with the process of SDL. Portfolios allow for collection of evidence and feedback from various sources and function as a platform for learners to reflect on their progress, diagnose learning needs and create learning goals and plans (Van Tartwijk & Driessen 2009),
SDL은 개인적 차원의 활동으로 보면 안된다. Knowles는 SDL이 성공하기 위해서는 교수의 촉진자적 역할이 필수적이라고 했다. 이러한 것에 맞물려 몇몇 연구는 포트폴리오의 성공은 적절한 멘토쉽에 달려있다고 했다. 교수개발은 필수적이나, 좋은 포트폴리오 멘토를 만들어주는 것이 무엇인지는 잘 모른다. Gans는 프트폴리오 멘토는 'mindful practice'의 롤모델이 되어야 한다고 했는데, 왜냐하면 포트폴리오의 주 목적은 성찰을 촉진하는 것이고, 성찰이란 SDL과 관련된 메타인지 기술이면서 실무를 바탕으로한 전문직의 학습에 필수적인 기술이기 때문이다. 유사하게 포트폴리오의 목적이 SDL을 촉진하는 것이라면 효과적인 포트폴리오 멘토는 SDL의 롤모델이어야 하며, 잠재한 구인을 확실히 쥐고 있어야 한다. 교수가 SDL과 관련된 기술에 대한 단일한 이해를 가지는지, 그리고 관련된 기술을 평소에 잘 쓰고 있는지는 연구된 바 없다.
SDL should not necessarily be seen as an individualistic activity, and several authors, including Knowles, have emphasized that a teacher or faculty member with a facilitating role is essential for successful SDL (Knowles 1975; Pilling-Cormick 1997). In concordance with this role for faculty in SDL, several studies suggest that the success of portfolios is dependent on adequate mentorship (Driessen et al. 2005; Dekker et al. 2009). Faculty development is deemed essential (Dekker et al. 2009), but little is known about what makes a good portfolio mentor. Gans (2009) has argued that a portfolio mentor should be a role model of ‘mindful practice’, since a major purpose of portfolios is to promote reflection, one of the main metacognitive skills associated with SDL and an essential skill for practice-based professional learning (Scho¨n 1987; Quirk 2006). Similarly, if the goal of a portfolio is to promote SDL, one can argue that effective portfolio mentors should be role models of SDL and have a solid grasp of the underlying construct. Whether faculty mentors have a unified understanding of SDL and its associated skills and routinely practice these skills themselves has not been explored.
온라인 포트폴리오
The portfolio utilized an on-line platform(Mahara open source e-portfolios, www.mahara.org). Students selected three of six competencies (adapted from the ACGME competencies) and reflected on their progress towards corresponding milestones provided for their level of training.
멘토의 역할
Role of mentors
Advisory college mentors were each assigned 1/8th of a class of 160 medical students. In the academic years prior to the implementation of the portfolio, faculty mentors met with students individually on at least an annual basis to review progress and any potential problems; the structure, focus and duration of these meetings were at the discretion of the mentor and student. After implementation, mentors reviewed students’ portfolios prior to one-on-one meetings, which occurred twice a year, and focused on discussion of the portfolio contents.
질적 분석
Qualitative analysis
We analysed the data using a theory-driven approach to thematic analysis (Braun & Clarke 2006). Sandrijn van Schaik and Jennifer Plant read the first four randomly selected transcripts independently and created a list of initial codes. Through discussion, they then collapsed the initial list into one coding scheme, which they used to code all transcripts independently. They then discussed and reconciled differ- ences in coding for all transcripts. Subsequently, the primary investigator Sandrijn van Schaik identified major themes, which were reviewed by Jennifer Plant to ensure accuracy in comparison to the original data set and by Patricia O’Sullivan for internal consistency and coherency. We used HyperResearchTM for coding and qualitative data analysis.
멘토는 SDL를 서로 제각각 다르게 정의내리고 있다.
Theme 1: Mentors have varied definitions of SDL
일부는 self-motivated learning이라 정의한다.
Mentors have quite variable definitions of SDL, with some mentors defining it as self-motivated learning:
일부는 이니셔티브를 학습자 내부에 가지고 있는 것으로 생각하면서 process 이상의 의미를 갖는다고 본다.
Others, while acknowledging the self as the locus of initiative, described SDL more as a process:
절반의 멘토가 자기성찰의 중요성을 언급했지만 효과적인 SDL을 위해 필요하다고 느끼는 skill과 자질은 비슷했다.
Although half of the mentors mentioned the importance of reflection, there was similar variability in the skills and attributes they felt are needed for effective SDL.
tenacity, enthusiasm, creativity, capacity to work hard, staying focused, determining and understanding resources, taking responsibility over one’s own learning and looking at long-term goals.
SDL은 의과대학생들에게 중요하며, 이들은 내재적으로 이런 능력이 있다.
Theme 2: SDL is important for medical students, who have innate abilities in this domain
그 개념을 어떻게 정의하든 멘토는 SDL이 중요하다고 보았다. 이러한 맥락에서 멘토는 의과대학생들이 SDL능력을 내재하고 있다고 언급했다. 또한 많은 멘토들이 이 skill은 가르칠 수 있는 것이 아니라고 보았다.
Regardless of how they defined the concept, mentors saw SDL as important for students and physicians. In this context, mentors often mentioned that medical students have an innate ability for SDL and its associated skills. Many mentors felt that these skills cannot be taught:
다른 멘토들은 사람들은 SDL에 대해서 서로 다르다고 언급했으나 한 명의 멘토는 SDL의 개념이 의과대학생들에게 생소한 것이라고 했다.
Others noted variability among people in this regard, whereas only one mentor thought the concept of SDL was foreign to medical students:
멘토 자신의 SDL은 서로 차이가 많으나 지식 격차와 습득에 대한 강조는 모두 강조한다.
Theme 3: Mentors own SDL is variable, but the emphasis is on knowledge gaps and acquisition
멘토는 스스로의 SDL이 잘 조직화되어있다고 하진 않았으며, 대체로 지식적 측면에 맞춰져 있었다. 한 멘토는 성찰에 대해서 언급했다.
The approach the mentors themselves took to SDL was rarely organized and mostly focused on knowledge. One mentor mentioned reflection:
멘토는 스스로의 SDL도 가르치면서 동기부여가 된다고 했음.
Mentors mentioned that their own SDL is motivated by their teaching, as well as by issues that arise during patient care.
포트폴리오는 학생들의 SDL 활동과 멘토-학생 관계를 구조화하는데 도움을 준다.
Theme 4: The portfolio brings structure to students’ SDL activities and to the mentor–student relationship
멘토들은 포트폴리오가 학생들의 자기평가, 자기성찰, SDL을 도와주며 포트폴리오를 기록의 도구, 정보공유의 도구로 사용하는 수단으로 보았다.
Mentors discussed that the portfolio helps students with self- assessment, reflection and SDL and saw the portfolio as an instrument for documentation and sharing of information that demonstrates progress.
몇몇 멘토는 포트폴리오가 학습자 주도로 이뤄져야 한다고 강조했다. 멘토는 포트폴리오 과정이 학생과의 관계를 변화시킨다고 하였으며, 미팅에 구조를 부여한다고 했다.
Several mentors emphasized that the portfolio should be learner driven. Mentors felt that the portfolio process changed their relationship with the students, and provided more structure to the meetings:
대부분의 멘토는 이러한 관계의 변화를 도움이 된다고 보았지만, 한 명의 멘토는 부정적인 결과도 언급했다. (미팅을 즐기기보다는 일로 보는 것 같다)
Most mentors perceived these changes in the relationship as beneficial, although one mentor saw a negative consequence as well:
학습계획은 학생들이 공부해야 하는 것에 대한 구체적 계획을 제공한다.
Theme 5: A learning plan provides a concrete plan of action for what a student needs to work on
멘토들은 일관되게 학습꼐획을 구체적인 행동계획으로 보았고, 학생들이 이를 따라야 한다고 보았다.
Mentors had a fairly uniform understanding of the learning plan as a concrete plan of action for what a student needs to work on.
학생들이 포트폴리오를 활용하는 수준은 다양했다.
Theme 6: Students level of engagement with the portfolio is variable
학생들이 포트폴리오에 넣는 내용은 매우 다양했는데, 멘토는 학생들이 포트폴리오의 가치를 알지 못하고 '바쁜 일'정도로 본다고 우려를 표했다. 일부는 학생들이 포트폴리오가 자신의 이후 교육에 어떻게 관계되는지에 대한 명확한 인식이 없는 태도를 문제로 보았다.
The students’ entries in the portfolio were variable, and mentors expressed concerns that students did not value the portfolio but saw it as ‘busy work’. Some attributed the students’ attitude to lack of a clear perception howthe portfolio fits into the rest of their education.
다른 사람들은 학습 계획으로서의 자기성찰을 인위적인것이라 보았고, 특히 이것은 자기성찰이 지금 의학교육 문화의 한 부분이 아니기 때문이라고 보있다. (부모님하고 성관계에 대해서 이야기하는 것과 친구들과 성관계에 대해 이야기하는 것의 차이와 같다.)
Others commented that the reflection required as part of the learning plan felt artificial, especially since reflection is not (yet) part of the current culture of medical education. It’s like talking about sex with your parents versus your friends.
멘토들은 SDL에 대해 다양한 정의를 내리고 있었다. 물론 일부는 Knowles가 말한 내용을 포함하고 있긴 했다. 이러한 사실이 놀랍지 않은데, 문헌에서도 SDL에 대해서 다양한 용어가 언급되기 때문이다. 여러 용어들은 관련된 개념들을 다루고 있지만, 그 경계가 명확하지 않다. 이는 평생학습과 SDL에 대해서 특히 더 그런데, 의학교육문헌에서 서로 interchangeably 사용되고 잇다. 전문기관들은 '평생학습'이란 용어를 활용하고 있으며, 여러 전문과에서 certification을 유지하는 조건으로 요구한다.
Mentors had variable definitions of SDL, although many included elements from the description offered by Knowles (1975). This lack of a uniform definition is not surprising considering the confusion that exists in the literature: a variety of terms including SDL, lifelong learning, self-regulation, self- determination and metacognition are used to describe related concepts with significant overlap but often unclear boundaries to distinguish between them (Candy 1991; Quirk 2006; Mazmanian & Feldman 2011). This is particularly true for lifelong learning and SDL, two terms frequently used inter- changeably in the medical education literature (Mazmanian & Feldman 2011). Professional organizations have embraced the term ‘lifelong learning’, and documentation of the process is now required for maintenance of certification in many specialties (Batmangelich & Adamowski 2004).
SDL의 초점은 지식 습득 활동에 주로 맞춰져 있었다.
- 이는 Hojat이 평생학습에 사용한 개념과 비슷한데,
- 반대로 Campbell 등은 평생학습을 CPD와 동일한 것으로 보았고, 역량 바탕의 모델을 제시하면서 구체적인 활동보다는 학습 전략의 차원에서 강조하였다.
- SDL에 대한 다른 모델은 Li 등이 제시한 것으로 지식에 덜 초점을 맞추고 메타인지적 과정(자기성찰, 목표설정, 계획개발, 향상 평가)에 두었다.
- Mazmanian은 SDL의 독특한 통합적 모델이 필요하다고 하였다.
The focus tends to be on activities aimed at knowledge acquisition, which is consistent with the conceptualization of lifelong learning used by Hojat et al. (2003). In contrast, Campbell et al. (2010) equate lifelong learning to continuing professional development, and describe a model that is competency based and emphasizes strategies for learning rather than specific activities. Another model for ‘self-directed lifelong learning’ conceptualized by Li et al. (2010) focuses less on knowledge and more on metacognitive processes, such as self-reflection, goal generation, plan development and progress assessment. Mazmanian has argued that a unique and unified theoretical model for SDL is required to support research of best practices for instruction and assessment around SDL (Mazmanian & Feldman 2011).
이러한 상황은 Krupat 등이 비판적 사고에 대해서 지적한 것과 비슷하다. 의사에게 필요한 것이라 모두들 생각하지만, process인지 skill인지 innate quality인지에 대한 정의가 다양하다.
This situation appears to be analogous to the one described by Krupat et al. (2011) regarding critical thinking: it is uniformly seen as essential for clinicians but variably defined as either a process, a skill or innate quality.
유사하게, SDL의 구인에 대한 명확하고 공통된 이해가 멘토의 교육능력을 향상시킬 것이고, 교수개발의 초점이 되어야 한다.
Similarly, a clear and shared understanding of the construct of SDL may enhance mentors’ ability to teach students SDL skills, and this should be an explicit focus of faculty development offered to mentors.
The notion that SDL skills can be taught is not without controversy since many mentors argued that these are inherent to the student population they mentor. This seems at odds with their observation that students’ entries in the portfolio were of variable quality.
SDL과 CT가 모두 내재적 능력과 습득한 기술을 필요로 하는 것으로 보이며, 흔히 관찰되는 패러독스는 교수들의 이해 부족에 의한 것으로 보인다.
It is likely that both SDL and critical thinking require a combination of innate abilities and acquired skills, and that the observed paradox in each instance is the result of faculty members’ incomplete understanding of the underlying constructs.
A few mentors hypothesized that the portfolio and SDL are not yet part of the culture, and that this would need to happen for the students to appreciate the value:
‘It shouldn’t just be a twice a year put a learning plan in your portfolio because it’s constant self-improvement. If it’s part of the culture, it’s integrated from day one, they see it modeled in their faculty and in their fellow students, it’s wonderful to them’. [ACM04]
This perceived need for culture change to make curriculum effective is not be unique to SDL; professionalism is another area for which creating a culture in which faculty practice what they preach is felt to be essential in order to get learners engaged (Stern 1998; Coulehan 2005; Brainard & Brislen 2007). This requires faculty development to ensure that faculty have a shared definition and know what they are expected to model (Steinert et al. 2005), but also a culture change within institutions and organizations to create an environment that embraces the principles of what is being taught (Lesser et al. 2010).
The faculty mentors in our study varied in their own approach to SDL and there was remarkably little congruency between how each individual mentor defined SDL and how she/he described her or his own process and only one appeared to have a structured approach. Since SDL is thought to be essential for the lifelong learning process, all physicians are expected to engage in, this creates a gap between the official curriculum and what learners encounter in the so- called hidden curriculum or what they actually encounter in the workplace where much of their learning occurs (Hafferty 1998). As with professionalism, this gap may have detrimental effects on learners’ motivation and ability to develop into effective self-directed learners. While faculty development of mentors was part of the portfolio implementation at our institution, this was limited to instruction regarding reflection and learning plans, explanation of the portfolio process and the role of the portfolio in SDL. There were no expectations regarding mentors’ own SDL and the mentors were not required to engage with the portfolio outside of their mentor- ing role, and this may create significant limitations for their effectiveness as portfolio mentors.
Mazmanian P, Feldman M. 2011. Theory is needed to improve education, assessment and policy in self-directed learning. Med Educ 45(4):324–326.
Krupat E, Sprague JM, Wolpaw D, Haidet P, Hatem D, O’brien B. 2011. Thinking critically about critical thinking: Ability, disposition or both? Med Educ 45(6):625–635.
Lesser CS, Lucey CR, Egener B, Braddock CH, Linas SL, Levinson W. 2010. A behavioral and systems view of professionalism. JAMA 304(24):2732–2737.
Promoting self-directed learning through portfolios in undergraduate medical education: the mentors'perspective.
Author information
- 1University of California San Francisco, San Francisco, CA 94143-0106, USA. vanschaiks@peds.ucsf.edu
Abstract
BACKGROUND:
AIMS:
METHODS:
RESULTS:
CONCLUSIONS:
- PMID:
- 23102105
- [PubMed - indexed for MEDLINE]
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