Preparation for future learning: a missing competency in health professions education?

Abstract

Evidence suggests that clinicians may not be learning effectively from all facets of their practice, potentially because their training has not fully prepared them to do so. To address this gap, we argue that there is a need to identify systems of instruction and assessment that enhance clinicians' 'preparation for future learning'. Preparation for future learning (PFL) is understood to be the capacity to learn new information, to use resources effectively and innovatively, and to invent new strategies for learning and problem solving in practice. Education researchers have developed study designs that use dynamic assessments to measure what trainees have acquired in the past, as well as what they are able to learn in the present. More recently, researchers have also started to emphasise and measure whether and how trainees take action to gain the information they need to learn. Knowing that there are study designs and emerging metrics for assessing PFL, the next question is how to design instruction that helps trainees develop PFL capacities. Although research evidence is still accumulating, the current evidence base suggests training that encourages 'productive failure' through guided discovery learning (i.e. where trainees solve problems and perform tasks without direct instruction, though often with some form of feedback) creates challenging conditions that enhance learning and equip trainees with PFL-related behaviours. Preparation for future learning and the associated capacity of being adaptive as one learns in and from training and clinical practice have been missed in most contemporary training and assessment systems. We propose a research agenda that (i) explores how real-world adaptive expert activity unfolds in the health care workplace to inform the design of instruction for developing PFL, (ii) identifies measures of behaviours that relate to PFL, and (iii) addresses potential sociocultural barriers that limit clinicians' opportunities to learn from their daily practice.