Independent learning has real advantages in the long term One of the latest educational crazes has been to encourage "self directed" (also known as "independent" or "autonomous") learning for students. Is this based on sound educational theory? Or is it, as some students perceive, a case of lecturers neglecting their duty by expecting students to do it all themselves?

The main characteristic of such learning is that "students take some significant responsibility for their own learning over and above responding to instruction."¹ The approach stems from an inspiring book by the humanist Carl Rogers, who argued that learners should be encouraged to develop their own interests and learning free from fear or external direction.² Of course this approach has to be modified in a medical school, where graduates will be licensed to practise medicine.

An important benefit of the self directed approach is that it can tackle one of the most enduring problems in medical education: the exponential growth in knowledge. It has long been recognised that the course cannot teach everything that doctors consider relevant, and continued additions can lead to what Abrahamson describes as "curriculum hypertrophy."³ Various strategies have been tried to accommodate the extra knowledge, including lengthening the course and introducing postgraduate and continuing medical education, but none has solved the problem. In addition, the obsolescence of knowledge means that much of what is important today may be irrelevant tomorrow. Given this, teaching today's facts seems less important than ensuring that students have the skills to learn and relearn as knowledge develops. This has led to an emphasis on "lifelong learning skills." These include the ability to analyse problems, define what needs to be learnt, know how and where to access information, evaluate information, and be aware of the one's own limitations. The rationale is that students who develop such skills will be equipped for whatever the future holds and will keep up to date when they are no longer on formal training programmes.

Innovations such as problem based learning, group projects, and learning contracts are all designed to encourage the learning of such skills. When introduced appropriately, these methods have been shown to promote understanding rather than rote learning.¹ They can also be empowering and enjoyable. Amid the debate about what problem based learning does or does not achieve, the one consistent finding has been that students find the learning environment more stimulating and humane.⁴

If such approaches can be popular and educational, why does self directed learning sometimes have a bad name? The main reason seems to be that sometimes it is seen as cheap education, as its introduction in some universities was an attempt to deal with increased student numbers. Also, if introduced without sufficient resources and staff support and understanding, it may have poor results. To make self directed learning successful, both students and teachers need a clear understanding of the rationale and process and a commitment to making it work. Both may find the transition from traditional methods difficult. For teachers, facilitating self directed learning is a very different skill from lecturing or other forms of instruction in which the teacher dominates. They need to be able to assess students' readiness for such learning and guide them from a position of dependence to independence. They should provide a structure, in terms of offering guidance, checking plans, suggesting resources, and clarifying the basis on which work will be judged.

Moving from clearly structured and defined teach. ing in school or in the early years of the medical course can also be difficult for students. They may feel anxious about the uncertainty of not being told what to do. They may feel isolated. They may lack the skills to find and evaluate information for themselves. Or they may feel that it is all too much effort and would be quicker just to be "told the facts."

The most successful students are rarely the cleverest, but are those who feel motivated by the subject they have chosen and who persist. Ultimately, all doctors have to rely on their own self directed learning. Developing these skills early will help ensure success in later careers.

Further reading

Marshall LA, Rowland F. A guide to learning independently, 3rd edn. Buckingham: Open University Press, 1998.
Murdoch A, Davies B. An introduction to self.directed study. London: Scutari Press, 1994.

1. Boud F. Developing student autonomy in learning. London: Kogan Page, 1981, pp 23, 35.
2. Rogers CR. Freedom to learn in the 80s. Ohio: Charles E Merrill, 1983.
3. Abrahamson S. Diseases of the curriculum. J Med Educ 1978;53:951.7.
4. Bligh J. Problem based, small group learning. BMJ 1995;311:342.3.