Using self-determination theory to improve residency training: Learning to make omelets without breaking eggs

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

An inherent tension exists in clinical training between supervising learners to ensure quality and patient safety, and allowing learners to practice independently to gain experience. In this issue of Academic Medicine, Biondi and colleagues discuss this tension, highlighting the disconnect between faculty and resident perceptions of autonomous practice for housestaff. They report that each group perceives itself as more competent in its role than does the other group. Their work leads us to consider how medical educators might safely and effectively transform the learning process. Self-determination theory (SDT) holds that there is a human tendency to develop toward self-directed and autonomous regulation of behavior. This development of intrinsic motivation is governed by the complex relationships among autonomy, competence, and relatedness as well as educational content and the learning milieu. Applying an SDT framework to their findings, Biondi and colleagues report that faculty desire from residents the evidence of internal motivation and demonstration of competence and self-confidence that will allow faculty to entrust learners with autonomy. They conclude, however, that these are qualities that faculty find lacking in many residents. To optimize the balance between autonomy and supervision, this Commentary's author proposes the use of "scaffolding," a construct from developmental psychology. In the scaffolding model, the role of teachers is to support the learner's development and to provide support structures to help the learner get to the next stage of entrustment and competence. Achieving a balance is essential to providing the best patient care now and in the future.

Original languageEnglish (US)
Pages (from-to)408-410
Number of pages3
JournalAcademic Medicine
Volume90
Issue number4
DOIs
StatePublished - Apr 1 2015

Fingerprint

Personal Autonomy
Internship and Residency
self-determination
Eggs
Learning
Mental Competency
autonomy
resident
learning
Motivation
educational content
developmental psychology
intrinsic motivation
self-confidence
Patient Safety
patient care
supervision
learning process
Patient Care
Group

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Using self-determination theory to improve residency training : Learning to make omelets without breaking eggs. / Hoffman, Benjamin.

In: Academic Medicine, Vol. 90, No. 4, 01.04.2015, p. 408-410.

Research output: Contribution to journalArticle

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