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Table 2 Motivations for resident SDL with supporting quotations

From: A model of self-directed learning in internal medicine residency: a qualitative study using grounded theory

Motivation

Participant quotationsa

Personal interest

“It’s unlikely to come up on the board exam, but I still think it’s interesting so I’ll read about it, but that [is one of the] main things I consider as SDL” (group 1).

Curiosity

“I find that a lot of my SDL is a result of curiosity. It’s usually triggered by a patient encounter that makes me raise a question, and I keep probing until there comes a point when it gets uninteresting and I don’t have questions anymore” (group 6).

Enjoyment of learning

“The true essence of SDL is enjoyment. If you’re learning something without knowing that you’re learning it, then it’s probably SDL because you’re doing it without even thinking about it” (group 7).

Patient care

“Am I here because I like to be called a doctor or am I here because I want to know how to take care of patients the best I possibly can? I think that makes the biggest difference between SDL and doing the bare minimum” (group 6).

Competence

“At the end of the day, when you sit in a room with a patient, how competent are you” (group 6)?

“It’s important to demonstrate competence in areas that you may not be so interested in so that you can still provide excellent care” (group 4).

Personal responsibility

“Being in the position where I had no safety net, I realized that only I could help in the situation, and so immediately I became more resourceful than I typically would have been in a situation like that, in how I perused resources and created an initial therapy plan. That was very instructional because when you’re put in that position you become more resourceful than you think you’re capable of, and to me that was like the crux of SDL” (group 6).

Identity formation

“Once you start figuring out your specific niche, you become more interested in that pathology and literature, and it’s interesting because your peers will come to you and ask about specific cases. It motivates you to really be on top of the area in which you’re going” (group 3).

Fear of looking stupid

“I’m afraid of looking dumb in front of the med students…patients…yeah, including yourself…there’s a constant fear of looking dumb” (group 5).

Emotional connection

“SDL is important when we’re emotionally tied to a specific topic. If we have a family member who is struggling from a specific illness, we might have a self-directed drive to learn more about that, or if we have an emotional connection to a patient we might go deeper just because there’s an emotional connection” (group 2).

Self-preservation

“When I have a rough day, I go back at the end of the day and I’m like, ‘Man why was I slogging through everything, why was it such a pain?’ Then I go, ‘Well, I didn’t know this.’ I should look that up so that next time I can have that discussion much more easily, and that’s one of the ways in which I drive myself to do SDL” (group 1).

Faculty inspiration

“In terms of motivation from consultants, you meet so many world-famous leaders in fields on a daily basis, and that’s really inspirational for me. Like the people around me really motivate me, and [faculty members] are a big part of that” (group 3).

Social pressure

“To be honest with you, for me it’s a lot of [my peers]. I mean, these guys are always learning, and I feel like if I don’t, I’ll be left behind” (group 3).

Examinations

“All the residents care about is, ‘Is this coming up on my boards, is this coming up on Step 3?’ I feel that is really big” (group 4).

Mistakes

“I find that I learn the best from my own mistakes. If I did something and I was like, ‘Oh crap, I screwed up,’ that stays with me and I become the unofficial expert in that thing because I messed it up” (group 4).

Previous success

“The moments are fleeting, but when they do occur it’s fun, but when you see a patient and you think about it more and you’re like, ‘I’ve seen this before and I know this,’ and you figure it out. That’s what makes it enjoyable—the aha moments” (group 1).

  1. Abbreviation: SDL self-directed learning
  2. aQuotations given are followed by the group number of the participant