How much time do internal medicine residents spend on self-directed learning and on which resources: a multi-center study

Shreya P. Trivedi, Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Anthony R. Artino, School of Medicine and Health Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Adam Rodman, Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
R Logan Jones, Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
Jafar Al-Mondhiry, Inova Schar Cancer Institute, Fairfax, VA, USA.
Timothy Rowe, Division of Pulmonary and Critical Care Medicine, McGaw Medical Center of Northwestern University, Chicago, IL, USA.
Tyler Larsen, Department of Medicine, VA Greater Los Angeles, Los Angeles, CA, USA.
Sarai Ambert-Pompey, Department of Medicine, Boise VA Medical Center, Boise, ID, USA.
Devesh Rai, Department of Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
Ahmed Ghoneem, Department of Cardiovascular Medicine, University of Pittsburgh Medical Center, Harrisburg, PA, USA.
Nicholas Gowen, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Melina Manolas, Department of Medicine, New York Presbyterian-Weill Cornell Medical Center, New York, NY, USA.
Martin Fried, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA.
Shrunjal Trivedi, Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Kelly L. Graham, Division of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Document Type

Journal Article

Publication Date

12-1-2025

Journal

Medical education online

Volume

30

Issue

1

DOI

10.1080/10872981.2025.2501259

Keywords

Self-directed learning; clinical learning environment; graduate medical education; learning resources; survey design; technology in teaching

Abstract

Increased clinical demands and newer means of self-directed learning (SDL) necessitate an understanding of how medical residents are supporting their learning. To examine the patterns of SDL engagement among internal medicine residents, their attitudes and behaviors with various resources, and evaluate the relationship between the clinical learning environment (CLE) and the time residents allocate to SDL and types of resources. This cross-sectional study used a systematic questionnaire informed by previous qualitative research on SDL among internal medicine residents. Internal medicine (IM) residents from 10 residency programs across the United States participated, providing a diverse representation of geographical and institutional contexts. Residents were asked to estimate weekly hours spent on SDL during their last clinical rotation, on which resources, and then to rank the usefulness of each resource. The survey also measured several variables, including attitudes and behaviors after using the resource they perceived to be the most useful, and the influence of training level, residency program type, clinical rotation, and number of hours worked clinically per week on reported time spent on SDL and types of resources. The response rate was 69.5% (783/1,126). Residents dedicated a mean of 18.2 (SD 18.6) hours per week (median of 10.5 hours per week) to SDL. Community-based programs reported more hours of SDL. There was no difference in hours spent on SDL based on the last clinical rotation, number of hours worked clinically, or PGY level. Senior residents favored digital resources, like podcasts, and were less likely to use traditional resources, like textbooks than interns. Our findings underscore the substantial time residents devote to SDL. In light of these results, educators and healthcare systems will need to work together to better support residents in optimizing the complex clinical learning environment.

Department

Health, Human Function, and Rehabilitation Sciences

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