Background/rationale

Medical education is quickly changing from teacher-centered to student-centered education [1]. As medical education shifts from teacher-centered to student-centered, self-directed learning capabilities that enable students to acquire medical knowledge are strengthening. A good learning strategy is also a learning skill that learners use to promote self-learning. If a learner fails to develop or use an effective learning strategy, his or her self-directed learning ability for self-learning is low. Therefore, medical colleges should develop appropriate learning strategies for students with low levels of self-directed learning and those who cannot use effective learning strategies.

Objectives

It aimed to find the self-directed learning quotient and common learning types of pre-medical students through the confirmation of 4 characteristics related to self-learning strategies. Precisely, characteristics scales were measured. After that, the self-directed learning index and common learning types were calculated.

Ethics statement

This study was approved by the Institutional Review Board (IRB) of Songeui Medical Campus, the Catholic University of Korea (IRB approval no., MC22EADI0106). Obtainment of the informed consent was waived by the IRB.

Study design

This is a survey-based descriptive study.

Setting and participants

The Catholic University of Korea College of Medicine has conducted the Multi-Dimensional Learning Strategy Test, 2nd edition (MLST-II) every year in the “Self-Development and Portfolio II” course in the second semester of the first year [2]. The data used in this study were collected for 3 years, from 2019 to 2021. The target subjects were 294 first-year pre-medical students in 3 years (97 in 2019, 102 in 2020, and 95 in 2021). Seventeen students not participating in the test were excluded. So, the data used for the analysis were the results of 277 students (94 in 2019, 97 in 2020, and 86 in 2021). Survey questionnaires were distributed through an online tool provided by the company.

Measurement tool

This measurement tool, MLST-II, was developed by Park [2] and owned by the INPSYT (Supplement 1). It provides information about characteristics scales related to self-directed learning strategy.

First, the levels of personality (academic self-efficacy, performance expectation, conscientiousness), emotional (depression, anxiety, irritation), motivational (academic, competence, avoid motivation), and behavioral (time management, listening, note taking, learning environment, concentration, book reading, memory skill, examination preparation) characteristics were tested. Since the score of each sub-variable is a standardized test, it is expressed as a T-score obtained (average=50, standard deviation=10). Scores below 30T or above 70T are interpreted as statistically significant weaknesses and strengths that can be observed only in 2.5% of the total collection. A higher score corresponds to more positive personality, motivation, and behavioral characteristics, but a higher score for emotional characteristics indicates difficulties.

Second, the self-directed learning quotient shows the current level of self-directed learning as a single indicator based on the total score of the three variables (personality, behavior, and learning motivation). Those variables are the most related to self-directed learning among the MLST-II measurement variables. It is a score obtained by standardizing and summing the values and then converting the average of the values into 100 and a standard deviation of 15.

Thirds, learning strategy marks the 4 types (self-directed type, conscientious type, latent type, and stagnant type). It is based on the levels of strategies (behavior characteristics), and input (learning motivation, amount of study time, conscientiousness). The self-directed type is a type in which concrete learning efforts are appropriately invested, and the learning strategy is sound. The latent type has a reasonable learning strategy but needs more will to make an effort and the amount of study time. The conscientious type works harder than others but has a weak learning strategy and is the type that does not achieve the desired results compared to the effort. The stagnant type is weak in the willingness to make an effort, the actual study time, and the study strategy. A total of 185 test items consisted of a 4-point Likert scale: 1 point for “disagree,” 2 points for “somewhat agree,” 3 points for “agree,” and 4 points for “strongly agree.”

The reliability coefficient (Cronbach’s α) for each characteristic in this test was 0.910 for personality characteristics, 0.830 for academic motivation, 0.840 for competence motivation, 0.730 for avoiding motivation, 0.915 for emotional characteristics, and 0.952 for behavioral characteristics. The components and interpretation standard of the scale is presented in Supplement 1 in Korean.

Statistical methods

Analysis was performed using the MLST-II standardized scoring program of Insight Psychological Testing Lab. Descriptive statistics were used.

Main results

The distribution of the levels of 4 characteristics scores is shown in Table 1 (Supplement 2). The distribution of the self-directed learning quotient of participants is presented in Table 2 (Supplement 2). The most common learning type was the self-directed type (n=122, 44.0%), followed in descending order by the stagnant type (n=94, 33.9%), latent type (n=40, 14.4%), and conscientiousness type (n=21, 7.6%)

Interpretation

This study provided the background information for developing a program to help students increase learning efficiency by identifying the variables, learning types, and self-directed learning quotient. The following recommendations are suggested.

First, the average score of personality, motivation, emotion, and behavior characteristics was generally high. However, looking at the distribution, many students needed help. Students with low personality characteristics (36.8%) lack interest in and confidence in their studies, so a program is needed to help them develop good, goal-oriented learning habits by recovering their academic self-efficacy and expectations for learning. Students with high emotional characteristics (22.4%) feel uncomfortable emotionally, so it may be difficult to concentrate on learning due to high stress and sensitivity to emotional changes. Therefore, a program including counseling and stress is needed to help them focus on learning by becoming emotionally stable. Students with low behavioral characteristics (37.6%) often have bad habits related to learning, which reduces the efficiency of learning. For these students, there is a need for a program that can help to cultivate specific learning strategies, such as time management and memory skills. Since motivational characteristics cannot be comprehensively interpreted, it is necessary to analyze the sub-variables. Low academic motivation (40.4%) and competence motivation (44.4%) indicated that students had strong negative attitudes toward learning, showed no spontaneity and had low achievement desire, and high avoid motivation (22.4%). Thus, there is a need for a program that can help positively reinforce motivational characteristics for students who are afraid of academic failure and worry about criticism.

Second, there are 4 types of learning; among them, the type that requires special attention and management is the stagnant type. This type lacks willpower and practical learning time, and is characterized by weak learning strategies. In this study, 33.9% of students displayed the stagnant type. Therefore, there is a need for a program to help set goals and compensate for weaknesses in learning actively.

Third, students with a low self-directed learning quotient (24.6%) lack the time for self-learning and have a passive attitude, and even if they learn, they often do not achieve results corresponding to their efforts due to their lack of strategies. As a result, their self-confidence and motivation to learn are low. Therefore, a program is needed to help students form proactive learning attitudes based on a clear sense of purpose.

Comparison with previous studies

A previous study reported that when a learning support program was introduced, students’ use of learning strategies increased, and this program was effective in improving academic achievement [3]. In another study, students’ self-directed learning competency was enhanced through an academic coaching program. The program’s effectiveness was verified by assisting students in setting goals and acquire effective learning strategies [4].

Limitations and generalizability

The generalizability of results is limited because it was conducted among pre-medical students of one medical college. However, it is meaningful that characteristics, learning types, and self-directed learning quotient were found to determine the difficulties pre-medical students experience in the learning process.

Conclusion

The results show that many students lacked self-directed learning capabilities and strategies. In addition, the difficulties experienced by each student were different, and the characteristics resulting in difficulties in self-directed learning were also variable. Therefore, based on the results of this study, it is necessary to develop a coaching program tailored to each student's results and a group coaching program for each type of learning. So, students can strengthen their self-directed learning capability.

Article information

Conflict of interest

A Ra Cho is an associate editor, and Sun Kim is a senior consultant of the Journal of Educational Evaluation for Health Professions; however, they were not involved in this article’s peer reviewer selection, evaluation, or decision process. Otherwise, no potential conflict of interest relevant to this article was reported.

Funding

None.

Data availability

Raw data cannot be provided since it is a survey based on a commercial measurement tool.

Acknowledgments

Supplementary materials

References

• 1. Kim S, Cho AR, Chung CW. Newly appointed medical faculty members’ self-evaluation of their educational roles at the Catholic University of Korea College of Medicine in 2020 and 2021: a cross-sectional survey-based study. J Educ Eval Health Prof 2021;18:28. https://doi.org/10.3352/jeehp.2021.18.28 ArticlePubMedPMC
• 2. Park DH. Multi-dimensional learning strategy test. 2nd ed. Seoul: Insight of Psychology Inc; 2019.
• 3. Noh HS. Effectiveness of learning support program for underachievers of university. J Soc Sci 2019;38:73-108. https://doi.org/10.18284/jss.2019.12.38.3.73 Article
• 4. Lim IR. The development and effectiveness verification of the academic coaching program to improve the self-directedness of university students. Korean J Gen Educ 2020;14:297-309. https://doi.org/10.46392/kjks.2020.14.2.297 Article

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