Self-directed learning (Miszmasz/Dreamstime.com)
In his Agenda (PJ, 11 July 2009, p47), Barry Jubraj discusses the need for pharmacy to develop a definition of self-directed learning (SDL) that “allows students to learn what they need to learn, with support for their development through provision of the necessary experience, guidance and assessment”.
He writes with experience of supporting newly registered pharmacists and suggests that, for these learners, the “what to learn” should be defined and fixed for them in the form of learning objectives.
We have considerable experience supporting pharmacists further on in their careers and argue that the “what to learn” for experienced pharmacists relates to an individual’s needs and should be negotiable, flexible and relate directly to the individual’s practice and aspirations for further development.
We agree that, on the whole, it is appropriate to define the “what to learn” for newly registered pharmacists embarking on a postgraduate diploma. In this context, SDL is about providing the student with the skills and support to become a self-directed and confident adult learner.
This transition, from the arguably more didactic and tutor-led approach to learning and teaching that they may have experienced as undergraduate students, may be difficult for many, but it can be successfully achieved through the medium of a written reflective portfolio that engenders a systematic approach to reflective learning.1,2
The definition of SDL in Mr Jubraj’s article, developed in the context of the Joint Programmes Board diploma, that “SDL is about pharmacy practitioners being personally responsible for achieving the required competencies in the workplace to achieve fitness to practise, supported by the infrastructure of an accredited training centre” is, we agree, appropriate for this group of pharmacists. The required competencies are usually specified by the Higher Education Institute in the form of learning outcomes.
At Keele University, we use a similar approach through the integration of structured portfolios throughout our postgraduate diploma courses. These provide students with a model of learning that they can subsequently use in their professional practice to develop knowledge and understanding through reflection on learning and to improve and advance professional practice through reflection on practice.
There are, however, other groups of pharmacists who embark on formal postgraduate education courses for whom this definition of SDL may not be appropriate because they require more individual flexibility in the learning outcomes and, therefore, the concept of a “traditional” course with a common syllabus for all may not be appropriate. These pharmacists then become responsible for achieving the learning outcomes that they have had a role in defining.
They include, for example, experienced pharmacists who have achieved a postgraduate diploma that has engaged them with a model of learning that developed them to be effective self-directed learners, and who are now seeking to advance their practice further to focus on an area in which they wish to specialise.
Also, there are perhaps some experienced pharmacists who have had little formal education since qualifying but who have, over time and through experiential learning in the workplace where there has been little or no support for their learning, developed the skills to be effective self-directing learners. In this regard, we go on to discuss further the concept of SDL and how it might apply to pharmacists such as these.
These pharmacists are likely to display the characteristics of adult learners as described by Knowles3 (see Panel below), more so than those who enrol on a diploma course straight from qualifying, including taking control of, and responsibility for, their learning. Learning is most likely to be entirely intrinsically driven.4
They are pharmacists who are likely to identify their learning needs, not through looking at course learning outcomes, but by looking at what they need to know or be able to do to fulfil the requirements of their jobs or to advance their practice and their careers. Learning is centred on real-life experience.
Many of these pharmacists may want to develop advanced level competencies or knowledge and skills in a specialist area of practice with the support that an academic award pathway can offer.
Pharmacists such as those described may have already learnt to self-evaluate through a reflective learning model that has supported them to identify their strengths, weaknesses and continuing learning needs in order to define their learning activities. They are used to taking responsibility for their learning. These pharmacists are, we would argue, ready to engage with an “advanced” model of SDL.
One example is the advanced practice development (APD) model that we have developed and use at Keele. It was designed bearing in mind that the learners will have individual learning needs depending on prior experience and their chosen area of practice.
We recognised the need for a course that can be tailored to suit individual learning needs and took the view that, for learners who are already self-directing, such a course should be designed so that teaching and learning remains within the learner’s control to the greater extent. This is the first definition of SDL proposed by Kaufman5 and fits with the principles of adult learning.
The APD course, which can be studied as a stand-alone 15-credit module or as part of a MSc academic award, including the advanced professional practice award route, was developed with this notion of SDL and the principles of adult learning as central considerations.
With the support of a tutor, the learner is expected to define his or her own specific learning outcomes in the area that he or she has chosen for advanced practice development. The support of an academic tutor enables the learner to define appropriate learning outcomes without superimposing a pre-existing set.
The specific learning outcomes are linked to competencies from recognised competency frameworks relevant to the learner’s area of practice, thereby providing professional accountability and ensuring the learning outcomes are appropriate for the learner’s level of practice. At present, these are usually the Advanced and Consultant Level Framework (ACLF) or the Pharmacist with a Special Interest Framework.
Competency frameworks are potent tools for adult learning since they help learners to discover the gaps between where they are now and where they want to be. Using competency frameworks involves learners diagnosing their own learning needs and triggers internal motivation.4
Encouraging learners to formulate their own learning outcomes gives them control over their learning. They then identify, with support from their tutor, resources and strategies that they will use to achieve their learning outcomes. The learners and their tutors agree a learning plan and the tutors support the learners to carry out their learning plan.
The role of the tutor in the APD course is, as Mr Jubraj describes, appropriate for SDL: to listen and ask questions rather than to tell and advise, to facilitate problem identification and help them identify what they need to learn, and to provide feedback. The academic infrastructure that supports the course ensures that the learning outcomes and the learning resources and strategies are appropriate for the development of practice to the level sought and attainment of the academic award.
The APD course is assessed using a structured reflective portfolio in which learners must provide evidence that they have achieved their learning outcomes and reflect on their learning experiences, so developing further their skills of critical reflection. Thus the APD module is an SDL course designed for the self-directing learner and based on the principles of adult learning.
In their recent review of the literature, Kostrzewski6 et al concluded that evidence is limited in relation to the contribution that portfolios can make to practice development. However, the supporting structure of the portfolio design created by Keele has been shown to develop practitioners’ skills in using reflection on learning and professional practice that can make a powerful contribution to professional learning and development.
Our evidence comes from research that provides theory that is grounded in reality as perceived by pharmacists who have used our unique portfolio design to develop their skills in reflection on learning and practice.1,2
In conclusion, we agree with Mr Jubraj that pharmacy needs to define and appropriately apply SDL to post-registration education, and argue that there is more than one way of defining self-direction that is dependent on the pharmacist’s previous experience and level of attainment. The required competencies in our definition relate to individual need, not an academic one-size-fits-all model.
It may be appropriate for newly registered pharmacists embarking on postgraduate education that the “what to learn” is, on the whole, defined for them. But experienced pharmacists can reasonably decide, with support from an academic tutor to ensure academic rigour, what is to be learnt and how it should be learnt.
Courses such as the APD course support pharmacists to develop as advanced and specialist practitioners and, therefore, offer one model to meet future needs in line with the current development work of the new professional body in this area.
Elizabeth Mills is postgraduate academic course manager, and Patricia Black is director of postgraduate studies, both at Keele University
References
1. Black PE, Plowright D. How postgraduate pharmacy students develop professional understanding: re-conceptualising deep, reflective learning. Pharmacy Education 2008;8:29–35.
2. Black PE, Plowright D. Exploring pharmacists’ views about the contribution that reflective learning can make to the development of professional practice. International Journal of Pharmacy Practice 2007;15:149–55.
3. Knowles M, Holton III E, Swanson R. The adult learner. Burlington: Elsevier; 1998.
4. Schmidt H. Assumptions underlying self-directed learning may be false. Medical Education 2000;34:243–5.
5. Kaufman D. ABC of learning and teaching in medical practice. Applying educational theory in practice. BMJ 2003;326:213–6.
6. Kostrzewski AJ, Dhillon S, Goodsman D, Taylor K. The impact of portfolios on health professionals’ practice: a literature review. International Journal of Pharmacy Practice 2008;16:339–45.
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