What Do Pediatric Sub-Interns Say about Their Learning and Assessment? A Qualitative Analysis of Individual Learning Plans


Janice L. Hanson, Department of Medicine, Uniformed Services University of the Health Sciences, 430l Jones Bridge Road, Bethesda MD 20814. Electronic address: janicehanson@wustl.edu.
Cynthia Christy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642. Electronic address: christy.cynthia@gmail.com.
Daxa Clarke, Department of Pediatrics, The University of Arizona College of Medicine - Phoenix, 475 N. 5th Street, Phoenix, AZ 85004. Electronic address: dclarke@phoenixchildrens.com.
Cori M. Green, Department of Pediatrics, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065. Electronic address: cmg9004@med.cornell.edu.
T J. Jirasevijinda, Department of Pediatrics, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065. Electronic address: thj2002@med.cornell.edu.
Amal Khidir, Department of Medical Education, Weill Cornell Medicine - Qatar, 8C9R+735، Education City, Al Luqta St, Ar-Rayyan, Qatar. Electronic address: amk2005@qatar-med.cornell.edu.
Terry Kind, Department of Pediatrics, George Washington University, Children's National Hospital, 111 Michigan Avenue, NW, Washington, D.C. 20010. Electronic address: tkind@childrensnational.org.
Leonard Levine, Department of Pediatrics, Drexel University College of Medicine, 2900 W. Queen Lane, Philadelphia, PA 19129. Electronic address: Leonard.Levine@jefferson.edu.
Caroline R. Paul, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 750 Highland Avenue, Madison, WI 53726. Electronic address: Caroline.Paul@nyulangone.org.
Makia Powers, Department of Pediatrics, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310. Electronic address: makiapowers@gmail.com.
Mary Esther Rocha, Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030. Electronic address: mary.rocha@bcm.edu.
Sandra M. Sanguino, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, IL 60611. Electronic address: ssanguino@northwestern.edu.
Jocelyn Schiller, Department of Pediatrics, 1540 E. Hospital Drive, Mott 12-525A/SPC 4280, Ann Arbor, MI 48109. Electronic address: johuang@med.umich.edu.
Rebecca Tenney-Soeiro, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104. Electronic address: tenneysoeiro@chop.edu.
Jennifer L. Trainor, Department of Pediatrics, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, IL 60611. Electronic address: Jtrainor@luriechildrens.org.
Linda R. Tewksbury, Department of Pediatrics, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016. Electronic address: linda.tewksbury@nyulangone.org.

Document Type

Journal Article

Publication Date



Academic pediatrics




individual learning plans; medical students; self-directed learning; sub-internship; undergraduate medical education


OBJECTIVE: To perform a qualitative content analysis of learning and assessment strategies that pediatric sub-interns describe in Individualized Learning Plans (ILPs) and to explore barriers and facilitators to their learning. METHODS: We analyzed ILPs from medical students enrolled in pediatric sub-internships at 10 U.S. medical schools that utilized a standardized curriculum and were recruited to reflect diversity in geographic location, funding, and enrollment. Students used an ILP to record three or more selected learning objectives, rationale for selection, and reflection on learning and assessment strategies. Investigators used the constant comparative method to perform a content analysis of the ILPs, grouping codes into themes, and verifying relationships between codes within themes. RESULTS: 204 ILPs that included student reflections on 850 learning objectives were analyzed. Content was analyzed in five categories: rationale for selecting objectives, learning strategies, assessment strategies, challenges to learning, and facilitators of learning. Students showed strong commitment to individualized, self-directed learning, developed a wide range of creative learning strategies, and relied heavily on self-reflection to assess their progress. The learning environment both helped and hindered students' ability to make and assess progress on their selected learning objectives. CONCLUSIONS: Through ILP-guided reflection and a formal curriculum, students can choose well-justified learning objectives and demonstrate resourcefulness and independence in developing self-directed learning and assessments strategies. The strategies that students identified in this study provide a menu of learning and assessment options for sub-interns. Identified challenges and facilitators of learning provide guidance for educators who seek to enhance the clinical learning environment.