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Self‐directed learning of clinical skills

Ever since Knowles described so clearly the theories that explain how and why adults may prefer to learn, at least in adult education classes, medical educators have frequently used the terms adult learning and self-directed learning to describe both the process and outcomes of many education programmes. Although their relevance to medical education has been challenged, these concepts fit well because the pace of change in knowledge, understanding, technology and management options makes it imperative that medical graduates never stop learning, but instead almost continuously assimilate new information in order to maintain currency of practice. After completion of the more prescribed curricula of basic medical education and specialty training, maintaining currency of practice requires individuals to take responsibility for determining their own learning needs, addressing those needs and then monitoring their effect on their personal clinical practice. These responsibilities have been recognised as the keys to successful continuing professional development, although they are difficult to incorporate into the ‘standard’ update courses offered to experienced clinicians. By contrast, experienced clinicians may select courses that address their personal learning needs and achieve more effective professional development by applying the other steps before and after the selected interventions. Thus, the transition from trainee to doctor requires not just clinical competence, but sufficient educational competence to understand and apply the principles underlying the maintenance of currency of practice.