Lifelong Learning M. Andrew Greganti, MD

Key Observations What you know as the standard of practice at any given point in time is likely to be outdated within a short interval. Physicians have to commit to lifelong learning or “education for life” to provide timely, efficient, and state-of-the-art patient care. Your patients deserve nothing less - basically, you owe it to your patients Your peer physicians who refer their patients to you also deserve nothing less.

Basically … Self-directed learning is an integral component of medical professionalism.

Other Key Observations The peer respect and recognition that you receive are, in large part, based on: Your command of the knowledge base Your ongoing commitment to maintain a very high level of competency Your interpersonal/interactional skills in dealing with both your peers and your patients

Also of Note It is certainly acceptable to say that “I don’t know” but doing so should always serve as a motivating factor to learn more.

So, how do you do it? You have to first accept that you will be a lifelong student who will never complete the course hours required. You will also have to accept the fact that your motivation must be nurtured and sustained by the “fire within.” What will it take to succeed? You have to compulsively set aside a sacrosanct time for regular reading – preferably daily. Sustained, unwavering commitment and hard, at times meticulous, work Each person has to develop an individualized approach.

Some Practical Examples How do you decide what to read when confronted with the following tables of content? In answering, consider the dangers of “selective reading.”

So, how do you do it? Electronic databases like UptoDate are okay for an initial perusal of a topic but reading the background literature helps avoid “reviewer bias.” Read about your patients in detail. What you learn is more likely to become part of your “permanent memory.” Early on, select the major common diseases and read about these in detail, including the background articles that have led to the current standard of care.

So, how do you do it? See a large volume of patients that can serve as the basis of reading and learning – that will generate questions that you can research. “Think out-loud” about what you have read and learned and teach others. As you have been told many times: to teach is to learn

What are the Barriers to Success? How do you address these?

Barriers to Success Competing demands Attitude that self-directed learning activities lack urgency Difficulty with goal generation and developing and implementing a personal plan to achieve these Difficulty with self assessment underlies this. The importance of mentoring in this process External environmental factors that create stress, exhaustion, or limited time to complete learning goals Failure to develop an individualized learning plan to reach goals Failure to set aside dedicated and rigidly allocated time to work on goals