What Do Pediatric Sub-Interns Say about Their Learning and Assessment? A Qualitative Analysis of Individual Learning Plans

To perform a qualitative content analysis of learning and assessment strategies that pediatric sub-interns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning.We analyzed ILPs from medical students enrolled in pediatric sub-internships at 10 U.S. medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record three or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes.204 ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in five categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students' ability to make and assess progress on their selected learning objectives.Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessments strategies. The strategies that students identified in this study provide a menu of learning and assessment options for sub-interns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment.