A New Concept of Unsupervised Learning: Directed Self-Guided Learning in the Health

Professions. Brydges R, Dubrowski A, Regehr G. Acad Med. 2010; 85:S49–S55.

Goals of review paper:

1. Review strengths and weaknesses of both supervised and self-guided learning
2. Explore how to achieve a blend of supervised and self-guided learning

Asynchronous Learning: “student-centered teaching method that uses online learning resources to
facilitate information sharing outside the constraints of time and place among a network of people”
Examples: Online web-based modules/ lectures, online discussion forums with other
learners, learning environment with virtual patients, self-reflection blogs

Background: On self-guided learning:

Age of asynchronous learning and technology makes self-guided
learning possible without putting patients at risk.
Teaches learners about “life-long learning” skills
Excessive unsupervised learning is problematic.

Directed self-guided learning: Educator is present through the

framework of the self-learning environment

Self-Monitoring: Individual’s awareness of his/her own psychological content

Self-recording details of learning  enhanced learning

Metacognition: Knowledge of one’s own cognitive process

Learners can identify material already learned and sort remaining material into levels of
difficulty. WITHOUT time pressure, they learn “difficult to easy”. WITH time pressure,
they learn “easy to difficult,” placing items of most value first.
Shortcomings
o Learners fail to self-test despite this being a proven way to augment learning
o Learners often overestimate level of learning achieved - “illusions of competence”.

How expert supervision can improve learning outcomes:

1. Educators must identify learner’s skill level and set the level of challenge appropriately
Increase “functional difficulty” as trainee’s learning curve plateaus over time.
2. Educators must challenge the learner in ways in which s/he would not challenge him/herself
(due to metacognitive illusions of competence)

Conclusions:
1. Learning environment should be structured to guide trainees down the path of competence using
“directed self-guided learning” techniques
2. Self-monitoring and self-guided learning should not be individual activities. External resources
and supervision are necessary to maximize these learning opportunities.

Discussion: What asynchronous or self-guided learning modules do you currently use for your
learners? How could they be improved? Should they be more directed?