Assessment of first-year medical student perceptions in the development of self-directed learning skills in a single medical school course.

Self-directed learning (SDL) is a form of education in which learners take charge of their own learning process, with an active role in knowledge, skill and attitude acquisition. Developing SDL skills is essential to becoming a lifelong learner, which is necessary in the current climate of rapidly expanding medical knowledge. Students must also develop the ability to reflect on their own strengths and weaknesses in SDL-related skills, allowing them to set appropriate learning goals and identify areas that require further improvement. Critical Reasoning Exercises (CREs), a student-driven, problem-based learning course, was introduced for first year medical students at New York Medical College School of Medicine to ensure all steps of the SDL cycle were covered in a comprehensive and standardized way. As part of the formative assessment process for CREs, we developed and validated a five-item self-reporting rubric of SDL competency to aid students' self-assessment of their acquisition of SDL skills. The increase in student self-assessed total score from midpoint to endpoint of CREs was statistically significant (p < .001), indicating students' perceived increase in SDL competency by the end of the CRE course. In addition to the total score, there was a significant perceived increase in competency for four of the five component skills of SDL (p < .05). Interestingly, there was also a statistically significant difference in student self-assessment total scores among facilitator groups at the midpoint of the CRE course. Integration of CREs into the curriculum demonstrated potential as an effective educational intervention for medical student development of competency in SDL.