Changes to Master Adaptive Learning in the Pre-Clerkship Phase of Medical School.

Introduction: Adaptive expertise or the ability to self-assess, create a learning plan, incorporate self-assessment and feedback, adjust practices with newly learned skills, and address gaps is a core skill in medicine. The Master Adaptive Learner model (MAL) describes a framework to develop adaptive expertise, but studies have not measured adaptive learning during medical school, which limits our ability to design curricular strategies. This study investigated changes in master adaptive learning during the pre-clerkship phase of medical school. Materials and Methods: This study was a single-cohort within-subject design. Medical students were administered the MAL Instrument at matriculation, end of M1 year and end of M2 year. The MAL instrument included 16 items measured on a 5-point Likert agreement scale measuring 4 factors representing adaptive learning, resilience, curiosity, and motivation. Across and within-subjects ANOVA was used to detect changes in MAL. Results: There were 174 respondents at matriculation, 81 at the end of M1, and 150 at the end of M2 survey (response rates respectively 94%,41%,89%). 65 students had matched data across all three time points. MAL mean scores increased during the M2 phase for MAL overall and each subfactor. Adaptive learning decreased during the M1 phase but resilience, motivation, and curiosity factors were stable. Discussion: Medical students MAL scores increased in the M2 phase of the curriculum. The transition into medical school may challenge students' ability to apply adaptive learning strategies, particularly as they continue developing the metacognitive skills needed to navigate a more complex learning environment.