1. Goal Setting and Self Assessment: Teaching Lifelong Learning Skills Stacy Potts, MD Allison Hargreaves, MD

2. Objectives By to the end of the session, participants will be able to: • Describe SMART goal setting techniques in clinical education settings • List practical methods for teaching lifelong learning strategies • Formulate a plan to incorporate goal setting and learner self assessment into clinical teaching

3. Background • Self assessment and self-directed lifelong learning are essential to medical practice • Knowledge doubles every 3 to 10 years • Medical trials rose from 500 to 10,000 in the last two decades of the 20th century • Ability to engage in lifelong self-directed learning is the single most important competence

4. Integrated Competency Diagram (H. Bell) Medical Knowledge Patient Care Professionalism Interpersonal and Communication Skills System-based Practice Practice-based Learning

5. Integrated Competency Diagram Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-based Learning Professionalism System-based Practice

6. Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. Practice Based Learning and Improvement

7. Lifelong Learning • Continuous • Supportive • Stimulating and empowering • Incorporating knowledge, values, skills, and understanding • Spanning a lifetime • Applied • Incorporating confidence

8. "The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a college course, not a medical course, but a life course, for which the work of a few years under teachers is but a preparation." - William Osler

9. Experiential Learning Kolb Learning Cycle Observed Behaviors Concrete Experience What? Active Experimentation Reflective Observation So what? Now what? Abstract Conceptualization Private Learning Process

10. Goal Setting Individual + Motivation = Commitment • Active participation includes: • Defining the accomplishment • Determining the specific, measurable outcomes • Creating the timeline • Identifying the necessary resources

11. Collaborative Goal Setting • Discussion • Compromise • Agreement • Bottom Up Goal Setting

12. Goal Creation • Identify opportunities for goals • Write goal statements • Develop goals • Formulate action plans

13. Goal Types • Essential goals • Problem-solving goals • Innovative goals

14. SMARTER Goal Writing • Specific • Measurable • Action-Oriented • Realistic • Time- and resource-constrained • Energizing • Relevant

15. Goal Setting Opportunities • Specific learning interaction • Rotation specific • Advising meetings • Semi Annual Reviews • Portfolio development and review

16. Specific Learning Interaction • Discuss learner’s past experiences • Discuss expectations • Develop goals for interaction • Provide feedback • Develop next steps

17. Rotation Specific • Initial meeting to discuss goals • Include inquiry of past experiences • Co-identify needs • Document goals and action steps • Mid rotation feedback • Review current experiences and progress towards goals • Consider resources • Adjust goals as necessary • End of rotation feedback • Reassess progress towards goals • Develop next steps

18. Advising Meetings • Regular, scheduled meetings with pre-identified agenda • Long(er) term goal setting • Calibration of self assessment • Identifying resources • Develop next steps (for both learner and advisor)

19. Semi Annual Review • Pre-meeting preparation • Self Assessment • Goal setting • Stage of training guided • Calibrate self assessment • Review of goals • Develop into SMARTER goals • Discuss resources to meet goals • Develop next steps

20. Portfolio-based Learning • Values past learning and experience • Recognizes learners ability to learn and act independently • Centrality of reflection to the learning process • Allows meaningful links between experiences Challis 1999

21. Portfolio Spectrum Teacher Centered Teacher Driven Mixed Model Teacher and Learner Collaboration Learner Centered Learner Driven Learner completely in control of design and content Little or no learner involvement

22. Mixed Model Administration Driven • Biographic data* • Test scores • Picture • Evaluations* • Documents • Written evals/OSCEs • Chart reviews • Precepting summaries • Procedure logs* • Conference attendance* Resident Driven • Reflections • Presentations • Community activities • Committee involvement • Projects * Automatic from EValue Data

23. Purpose • Development of Skills in: • Goal Setting • Self Reflection • Self Assessment • Lifelong learning • Development of Advising System which: • Focuses on Whole Learner (Past, Present, and Future) • Accesses Resources (About learner, for learner)

24. Calibrating the Self Assessment • Reviewing self assessment • Strengths • Opportunities for improvement • Reviewing external evaluator’s assessment • Building upon themes • Reconciling incongruence

25. Collaborative Goal Setting • Negotiate priorities • Develop action steps • Develop follow up plan • FOLLOW UP

26. Self Reflection What? So what? Now what?

27. Achieving Goals • Implement the plan • Monitor Progress • Revise Objectives • Restart the cycle

28. Take Home • Set a goal for incorporating goal setting into your home learning environment • Make it: • Specific • Measurable • Action Oriented • Realistic • Time and Resource Constrained • Energizing • Relevant

29. References • Rouillard L. Goals and Goal Setting. 3rd edition. Oklahoma City, OK: Crisp Learning; 2003. • Westberg J and Jason H. Fostering Learner’s Reflection and Self-Assessment. Fam Med 1994; 26:278-82.