Early medical school education consisted of learner observations of medical procedures and observations of medical personnel, but this approach was not found to be effective nor was it comprehensive. In modern medical education, characteristics, experiences, and modeling are integrated. With the shift of medical institutions to support learner-centered learning and the use of more modern teaching methodologies, post-medical school education must follow in the shift from CME to CPE. Medical students and physicians alike can reflect on learning styles and current skills to address ongoing development and education. This chapter will first outline learning styles and their relevance to CPE; this allows self-directed learning and development based on personal reflection. Furthermore, the authors discuss reflection, its role in learning, and how it can be used to guide CPE. Finally, the role of peer feedback in learning and the importance of physician competence on peer feedback will be discussed.
TopLearning Styles
Learning styles has been defined as “characteristic cognitive, effective, and psychosocial behaviors that serve as relatively stable indicators of how learners perceive, interact with, and respond to the learning environment” (Curry, 1981; Romanelli et al., 2009). Recognition of learning styles has been cited as a key determinant for success in education. Furthermore knowledge of learning styles should be used by both educators and students (Curry, 1981). The importance of accounting for learning styles in medical education and specifically CME has been reported as early as 1981 in a report that stated that although little is known about learning, it should be used to guide education (Curry, 1981). This report calls for planning CME programs that are more consistent with learning preferences and learning styles (Curry, 1981). This section seeks to outline several learning styles to provide the information needed to guide students and practitioners alike in a journey of CPE.
Two different learning styles are deep processing and surface processing (Dinsmore & Alexander, 2012). Individuals with deep processing, approach learning to understand an underlying concept. They tend to learn for the sake of learning. Individuals with a surface processing approach focus on memorization, tend to be motivated by external standards and tend to desire a positive evaluation by others (Zhang & Sternberg, 2000). Understanding one’s own learning styles is important to understand a new broader model of continuing professional development (CPD) within physicians’ professional advancement (Jeong et al., 2018). Best practices include classrooms which can accommodate a variety of learning styles which build self-efficacy in students reflecting on what works best for them to learn (Romanelli et al., 2009). The way in which this can be applied to CPE is that health care providers should reflect on their own learning style to guide their continued education and development.
Further research into learning styles has revealed that learning styles represent not an innate ability an individual has but a way in which a learner prefers to use their abilities (Hatami, 2013). These different preferences are proposed to stem from different motivations of acquiring information (Hatami, 2013), as mentioned above in the example of deep and surface processing. Again, these different motivations and ways in which learners benefit from processing information supports the shift in education to a more learner centered approach. An approach which allows the learners to guide their own learning based on reflection and self-assessment.
The learning style inventory was derived from various theories and presents a model to conceptualize learning styles and allow learners to take the inventory (The Learning Style Inventory, n.d.). The interpretation allows users to see a relative measure of each learning style, and later Kolb 1984 describes characteristics of each style (The Learning Style Inventory, n.d.).
The learning style inventory identified four types of learning “modes” and four learning styles. An individual’s score presents them with the relative emphasis of each learning mode and then later a dominant learning style (Campos et al., 2022; The Learning Style Inventory, n.d.)
Learning modes (The Learning Style Inventory, n.d.):