1.Growing Changes
Continuous changes in the health care delivery system and growing differences in patient populations demand, more than ever, the ability to address and manage complexity. Managing complexity in clinical practice (and learning) requires the capability to understand the patient’s situation, recognize one’s limitations, address individual differences, and monitor one’s thinking in action
2.Medical Expertise
Competencies and expected learning outcomes identified by the Accreditation Council of Graduate Medical Education (ACGME), such as “communicating effectively,” “using information technology,” and “appraising evidence from scientific studies,” must be viewed as a lifetime rather than medical school achievements. The ephemeral nature of knowledge and skills, combined with the unending opportunities for new experiences from which to learn, expands the time frame and context for gaining competency in medicine. There is a growing demand for expert thinking in clinical practice that makes learners to be updated on to date. So it requires lifelong learning in their field.
Required Competencies
Medical students must develop the ability to
- define and prioritize their goals
- anticipate and assess their specific needs concerning the goals
- organize (and reorganize) their experiences to meet their unique needs
- define their own and recognize differences in others’ perspectives, and
- continuously monitor their knowledge base, problem-solving, and interactions with others.
Metacognition
Medical educators have focused on the development of problem-based learning which is representative of the shift in the cognitive arena. The long-established call for lifelong learning has not resulted in substantial change. Research demonstrates that learners who are strong and metacognitive are more likely to achieve expertise and are best prepared to learn throughout their lives. Metacognitive capable learners are the most effective in executing functions like budgeting, regulating, visualizing, self-questioning, reflective thinking, and connecting new material to prior knowledge.
Intuition Support
It is proposed here that learners systematically develop and practice metacognitive and intuitive capabilities that will serve their learning and practice needs throughout their lifetimes. Both sets of capabilities rely on learning from experience and are differentiated in practice by the level of consciousness and rapidity of thinking, To develop intuition, it is necessary but not sufficient to practice metacognition. One must also possess self-confidence, tolerance of uncertainty, and other important personal characteristics. These should be fostered in both the formal and the informal curriculum.
Effective experiential learning completes the learning process. As Osler states, “To study medicine without books is like sailing in the uncharted sea, but to study medicine from books alone is like never going to sea at all” By fostering intuitive and metacognitive approaches in clinical education, he or she can be prepared to learn, extract the essential elements from the experience, and evaluate the results.
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