Master adaptive learner

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The Master Adaptive Learner (MAL) concept in American medical education refers to a framework designed to prepare U.S. medical students, residents, and medical practitioners to continually adapt and respond to the rapidly evolving landscape of medical knowledge and practice. [1] This metacognitive approach to learning or “learning to learn” [2] is based on self-regulation that fosters the development and use of adaptive expertise in practice. [3] This concept emphasizes the importance of lifelong learning, self-regulation, and adaptability, enabling health professionals to provide high-quality care in an ever-changing environment. [3]

Contents

The MAL concept aligns with competency-based medical education, [4] [5] which is becoming more common and focuses on defining specific competencies or skills required for effective practice, assessing learners based on these competencies, and allowing progression based on demonstrated proficiency rather than time-based criteria. [6] [7] [8] MAL also aligns to the newer concept of precision education which is being proposed as a model for lifelong learning for medical students, residents, fellows, and physicians. Precision education is an educational approach that tailors learning experiences and interventions based on individual student needs, strengths, and learning styles. [9] Precision education utilizes data-driven insights and personalized strategies to optimize educational outcomes, fostering greater student engagement, understanding, and achievement. [10]

History

The MAL framework was first outlined in the scientific literature in 2017. [3] The concept emerged from the recognition that medical knowledge is expanding at an unprecedented rate. [3] Traditional frameworks for medical education, which often focus on the acquisition of static knowledge, are insufficient to prepare health professionals for the dynamic nature of medical practice. [3] The MAL framework aims to cultivate skills that help learners not only acquire new knowledge but also adapt and apply this knowledge effectively in diverse and unpredictable clinical settings. [3]

Core principles

The Master Adaptive Learner framework is built on four key principles:

1. Self-regulated learning [11]

Self-regulated learning involves the ability to set goals, monitor progress, and adjust learning strategies as needed. [12] This includes self-assessment, reflection, and the ability to seek feedback. [12] The MAL framework encourages learners to take an active role in their education, fostering independence and self-efficacy. [13]

2. Adaptive expertise [3] [14]

Adaptive expertise is the ability to apply knowledge and skills flexibly and innovatively in different situations. [15] [16] Unlike routine experts, who rely on well-practiced routines, [17] [18] adaptive experts can think critically and creatively, making them more effective in novel or complex scenarios. [19]

3. Lifelong learning

Lifelong learning is the continuous pursuit of knowledge and skills throughout a professional's career. The MAL framework promotes a culture of ongoing education and professional development, recognizing that medical knowledge and best practices are constantly evolving. [20]

4. Reflection and Feedback [21]

Reflection and feedback are crucial components of the MAL framework. [3] Reflective practice involves regularly analyzing one's own experiences and performance to identify strengths and areas for improvement. [22] Constructive feedback from peers, mentors, and patients helps learners refine their skills and knowledge. [23]

Implementation in medical education

Implementing the MAL framework in medical education requires a multifaceted approach.

Curriculum design

When designing medical curricula, opportunities for self-directed learning, critical thinking, and problem-solving should be incorporated. [24] This includes case-based learning, simulations, and other active learning strategies that encourage students to apply knowledge in practical settings. [25]

Assessment methods

Assessments should evaluate not only factual knowledge but also the ability to apply knowledge adaptively. [13] This may involve formative assessments, reflective exercises, and performance-based evaluations that provide meaningful feedback and guide further learning. [13] [26]

Faculty development

Faculty members play a crucial role in fostering the skills associated with the MAL framework. [27] Training programs for educators should focus on mentoring, providing effective feedback, and creating an environment that supports adaptive learning. [28]

Learning environment

Creating a supportive learning environment is essential. [28] This includes access to resources, opportunities for collaboration, and a culture that values continuous improvement and innovation. [28]

Coaching

Coaching is frequently a part of medical school curricula that incorporates the MAL framework. [26] This coaching helps learners take appropriate action in response to feedback and assessment. [26] [29]

Informatics

A learning environment focused on the MAL framework requires a robust informatics infrastructure to identify learning needs [30] and assist in guiding learners on individualized paths. [8]

Benefits

Limited evidence indicates that the MAL framework can reduce burnout and increase resiliency, although the mechanism of this is unclear. [31]

Challenges

While the MAL framework holds promise, its implementation faces challenges. Implementing the MAL framework is resource intensive, requires a cultural shift, and new assessment methods. [1]

Implementation into physical therapy education

The MAL framework is increasingly spreading from medical schools to physical therapy education. [32] The MAL framework has been proposed as a strategy to address the physical therapy needs of those with COVID-19 as well as address systemic racism and other injustices. [33]

Future directions

The Master Adaptive Learner concept represents a paradigm shift in medical education, focusing on developing health care professionals who are equipped to navigate and excel in an ever-changing medical landscape. [1] By fostering self-regulation, adaptive expertise, and lifelong learning, the MAL framework aims to enhance the quality of health care and ensure that practitioners remain competent and innovative throughout their careers. [1] It will most likely have a significant role as medical education increasingly incorporates competency-based medical education and precision education modalities.

Related Research Articles

A teaching method is a set of principles and methods used by teachers to enable student learning. These strategies are determined partly by the subject matter to be taught, partly by the relative expertise of the learners, and partly by constraints caused by the learning environment. For a particular teaching method to be appropriate and efficient it has to take into account the learner, the nature of the subject matter, and the type of learning it is supposed to bring about.

<span class="mw-page-title-main">Adult education</span> Any form of learning adults engage in beyond traditional schooling

Adult education, distinct from child education, is a practice in which adults engage in systematic and sustained self-educating activities in order to gain new forms of knowledge, skills, attitudes, or values. It can mean any form of learning adults engage in beyond traditional schooling, encompassing basic literacy to personal fulfillment as a lifelong learner, and to ensure the fulfillment of an individual.

Instructional scaffolding is the support given to a student by an instructor throughout the learning process. This support is specifically tailored to each student; this instructional approach allows students to experience student-centered learning, which tends to facilitate more efficient learning than teacher-centered learning. This learning process promotes a deeper level of learning than many other common teaching strategies.

<span class="mw-page-title-main">Problem-based learning</span> Learner centric pedagogy

Problem-based learning (PBL) is a teaching method in which students learn about a subject through the experience of solving an open-ended problem found in trigger material. The PBL process does not focus on problem solving with a defined solution, but it allows for the development of other desirable skills and attributes. This includes knowledge acquisition, enhanced group collaboration and communication.

Motor learning refers broadly to changes in an organism's movements that reflect changes in the structure and function of the nervous system. Motor learning occurs over varying timescales and degrees of complexity: humans learn to walk or talk over the course of years, but continue to adjust to changes in height, weight, strength etc. over their lifetimes. Motor learning enables animals to gain new skills, and improves the smoothness and accuracy of movements, in some cases by calibrating simple movements like reflexes. Motor learning research often considers variables that contribute to motor program formation, sensitivity of error-detection processes, and strength of movement schemas. Motor learning is "relatively permanent", as the capability to respond appropriately is acquired and retained. Temporary gains in performance during practice or in response to some perturbation are often termed motor adaptation, a transient form of learning. Neuroscience research on motor learning is concerned with which parts of the brain and spinal cord represent movements and motor programs and how the nervous system processes feedback to change the connectivity and synaptic strengths. At the behavioral level, research focuses on the design and effect of the main components driving motor learning, i.e. the structure of practice and the feedback. The timing and organization of practice can influence information retention, e.g. how tasks can be subdivided and practiced, and the precise form of feedback can influence preparation, anticipation, and guidance of movement.

<span class="mw-page-title-main">Royal College of Physicians and Surgeons of Canada</span> Canadian regulatory authority

The Royal College of Physicians and Surgeons of Canada is a regulatory college which acts as a national, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada.

Lifelong learning is the "ongoing, voluntary, and self-motivated" pursuit of learning for either personal or professional reasons.

<span class="mw-page-title-main">Metacognition</span> Self-awareness about thinking, higher-order thinking skills

Metacognition is an awareness of one's thought processes and an understanding of the patterns behind them. The term comes from the root word meta, meaning "beyond", or "on top of". Metacognition can take many forms, such as reflecting on one's ways of thinking, and knowing when and how oneself and others use particular strategies for problem-solving. There are generally two components of metacognition: (1) cognitive conceptions and (2) cognitive regulation system. Research has shown that both components of metacognition play key roles in metaconceptual knowledge and learning. Metamemory, defined as knowing about memory and mnemonic strategies, is an important aspect of metacognition.

Cognitive apprenticeship is a theory that emphasizes the importance of the process in which a master of a skill teaches that skill to an apprentice.

Employability refers to the attributes of a person that make that person able to gain and maintain employment.

<span class="mw-page-title-main">Medical education</span> Education related to the practice of being a medical practitioner

Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician and additional training thereafter.

An objective structured clinical examination(OSCE) is an approach to the assessment of clinical competence in which the components are assessed in a planned or structured way with attention being paid to the objectivity of the examination which is basically an organization framework consisting of multiple stations around which students rotate and at which students perform and are assessed on specific tasks. OSCE is a modern type of examination often used for assessment in health care disciplines.

Mastery learning is an instructional strategy and educational philosophy, first formally proposed by Benjamin Bloom in 1968. Mastery learning maintains that students must achieve a level of mastery in prerequisite knowledge before moving forward to learn subsequent information. If a student does not achieve mastery on the test, they are given additional support in learning and reviewing the information and then tested again. This cycle continues until the learner accomplishes mastery, and they may then move on to the next stage. In a self-paced online learning environment, students study the material and take assessments. If they make mistakes, the system provides insightful explanations and directs them to revisit the relevant sections. They then answer different questions on the same material, and this cycle repeats until they reach the established mastery threshold. Only then can they move on to subsequent learning modules, assessments, or certifications.

<span class="mw-page-title-main">Medical education in the United States</span> Educational activities training physicians in the United States

Medical education in the United States includes educational activities involved in the education and training of physicians in the country, with the overall process going from entry-level training efforts through to the continuing education of qualified specialists in the context of American colleges and universities.

Practice is the act of rehearsing a behavior repeatedly, to help learn and eventually master a skill. The word derives from the Greek "πρακτική" (praktike), feminine of "πρακτικός" (praktikos), "fit for or concerned with action, practical", and that from the verb "πράσσω" (prasso), "to achieve, bring about, effect, accomplish".

<span class="mw-page-title-main">Medical simulation</span> Medical training and evaluation technique

Medical simulation, or more broadly, healthcare simulation, is a branch of simulation related to education and training in medical fields of various industries. Simulations can be held in the classroom, in situational environments, or in spaces built specifically for simulation practice. It can involve simulated human patients, educational documents with detailed simulated animations, casualty assessment in homeland security and military situations, emergency response, and support for virtual health functions with holographic simulation. In the past, its main purpose was to train medical professionals to reduce errors during surgery, prescription, crisis interventions, and general practice. Combined with methods in debriefing, it is now also used to train students in anatomy, physiology, and communication during their schooling.

Competency-based learning or competency-based education is a framework for teaching and assessment of learning. It is also described as a type of education based on predetermined "competencies," which focuses on outcomes and real-world performance. Competency-based learning is sometimes presented as an alternative to traditional methods of assessment in education.

A desirable difficulty is a learning task that requires a considerable but desirable amount of effort, thereby improving long-term performance. It is also described as a learning level achieved through a sequence of learning tasks and feedback that lead to enhanced learning and transfer.

Entrustable professional activity (EPA) refers to a framework within medical education where trainees are evaluated on their ability to perform certain critical clinical tasks without direct supervision. Originating from the medical education domain, the success of EPAs has sparked interest in its application across other professional sectors.

Health systems science (HSS) is a foundational platform and framework for the study and understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care delivery. It is one of the three pillars of medical education along with the basic and clinical sciences. HSS includes the following core foundational domains: health care structure and process; health system improvement; value in health care; population, public, and social determinants of health; clinical informatics and health technology; and health care policy and economics. It also includes four functional domains: ethics and legal; change agency, management, and advocacy; teaming; and leadership. Systems thinking links all of these domains together. Patient, family, and community are at the center of HSS.

References

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  2. ↑ Regan, Linda; Hopson, Laura R.; Gisondi, Michael A.; Branzetti, Jeremy (November 2019). "Learning to learn: A qualitative study to uncover strategies used by Master Adaptive Learners in the planning of learning". Medical Teacher. 41 (11): 1252–1262. doi:10.1080/0142159X.2019.1630729. ISSN   1466-187X. PMID   31287741.
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