Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 154 No. 7 (2024)

Self-directed learning among general practitioners in the German-speaking part of Switzerland: a qualitative study using semi-structured interviews: Did habits change under recent technological shifts?

DOI
https://doi.org/10.57187/s.3436
Cite this as:
Swiss Med Wkly. 2024;154:3436
Published
24.07.2024

Summary

AIMS OF THE STUDY: This research aimed to investigate the self-directed learning (SDL) habits of Swiss general practitioners from the German-speaking part of Switzerland, understanding how they acquire new knowledge, exploring the impact of the COVID-19 pandemic on these habits and identifying optimisation strategies for their future self-directed learning.

METHODS: We employed a qualitative study design, conducting semi-structured interviews with 16 general practitioners from 30 May 2022 to 06 July 2022. Thematic analysis based on a mixed deductive/inductive approach was used to gain insight into the learning activities and self-directed learning practices of the practitioners.

RESULTS: The interviewed general practitioners demonstrated a versatile approach to self-directed learning, where peer communication emerged as the most predominant learning method. It is noteworthy that the younger generation in particular showed a strong inclination for peer learning and is well prepared for the integration of advanced digital solutions for peer communication. Furthermore, a significant shift was observed in media-based self-directed learning, especially since the COVID-19 pandemic. Digital platforms and repositories for practical learning were mentioned as educational mainstays by many interviewees, reflecting a profound technological shift observed over the past 25 years and especially since the pandemic. The primary motivation for pursuing new knowledge remains patient care, although personal development and staying up-to-date with medical and technological advancements are also key motivators. Although the pandemic has undeniably accelerated the transition towards digital learning, it has also brought with it challenges such as information overload and technical difficulties. There was an evident decline in formal learning venues and physical presence during the pandemic, yet the reported value of in-person interactions remains high. Suggestions for optimising self-directed learning included enhancing digital offerings, fostering stronger peer networks and integrating more practical content.

CONCLUSIONS: The COVID-19 pandemic has catalysed a transformation in the self-directed learning practices of general practitioners in the German-speaking part of Switzerland, underlining the importance of a balanced approach between digital and traditional learning methods. As the digital realm of self-directed learning grows, it is essential to address existing challenges and capitalise on potential advantages. Both individual networking efforts like general practitioner quality circles and initiatives from official authorities like informal self-test opportunities can play pivotal roles in refining self-directed learning practices. The findings from this study offer valuable insights for enhancing learning resources and environments that align with general practitioners’ needs and preferences. Future research should investigate the ongoing impact of advanced digital technologies on self-directed learning to understand the evolving landscape in a post-pandemic world.

References

  1. Knowles M. Self-directed learning: a guide for learners and teachers. New York: Association Press, 1975.
  2. Hill JR, Song L, West RE. Social Learning Theory and Web-Based Learning Environments: A Review of Research and Discussion of Implications. Am J Distance Educ. 2009 May;23(2):88–103. 10.1080/08923640902857713 DOI: https://doi.org/10.1080/08923640902857713
  3. Bate E, Hommes J, Duvivier R, Taylor DC. Problem-based learning (PBL): getting the most out of your students - their roles and responsibilities: AMEE Guide No. 84. Med Teach. 2014 Jan;36(1):1–12. 10.3109/0142159X.2014.848269 DOI: https://doi.org/10.3109/0142159X.2014.848269
  4. Kauffman DM, Mann KV. Teaching and learning in medical education. in Understanding Medical Education, 2013, pp. 7–29. doi: https://doi.org/10.1002/9781118472361.ch2 DOI: https://doi.org/10.1002/9781118472361.ch2
  5. Bundesgesetz über die universitären Medizinalberufe (Medizinalberufegesetz, MedBG). Internet: https://www.fedlex.admin.ch/eli/cc/2007/537/de.
  6. Slotnick HB. How doctors learn: physicians’ self-directed learning episodes. Academic Medicine, vol. 74, no. 10, 1999. https://journals.lww.com/academicmedicine/Fulltext/1999/10000/How_doctors_learn__physicians__self_directed.14.aspx DOI: https://doi.org/10.1097/00001888-199910000-00014
  7. Cervero RM. Place matters in physician practice and learning. Journal of Continuing Education in the Health Professions, vol. 23, 2003. https://journals.lww.com/jcehp/Fulltext/2003/23011/Place_matters_in_physician_practice_and_learning.4.aspx 10.1002/chp.1340230405 DOI: https://doi.org/10.1002/chp.1340230405
  8. Westberg EE, Miller RA. The basis for using the Internet to support the information needs of primary care. J Am Med Inform Assoc. 1999;6(1):6–25. 10.1136/jamia.1999.0060006 DOI: https://doi.org/10.1136/jamia.1999.0060006
  9. Verhoeven AA, Boerma EJ, Meyboom-de Jong B. Use of information sources by family physicians: a literature survey. Bull Med Libr Assoc. 1995 Jan;83(1):85–90.
  10. Coumou HC, Meijman FJ. How do primary care physicians seek answers to clinical questions? A literature review. J Med Libr Assoc. 2006 Jan;94(1):55–60.
  11. Dorsch JL. Information needs of rural health professionals: a review of the literature. Bull Med Libr Assoc. 2000 Oct;88(4):346–54.
  12. Owen PA, Allery LA, Harding KG, Hayes TM. General practitioners’ continuing medical education within and outside their practice. BMJ. 1989 Jul;299(6693):238–40. 10.1136/bmj.299.6693.238 DOI: https://doi.org/10.1136/bmj.299.6693.238
  13. Stanley I, al-Shehri A, Thomas P. Continuing education for general practice. 1. Experience, competence and the media of self-directed learning for established general practitioners. Br J Gen Pract. 1993 May;43(370):210–4.
  14. Clarke MA, Belden JL, Koopman RJ, Steege LM, Moore JL, Canfield SM, et al. Information needs and information-seeking behaviour analysis of primary care physicians and nurses: a literature review. Health Info Libr J. 2013 Sep;30(3):178–90. 10.1111/hir.12036 DOI: https://doi.org/10.1111/hir.12036
  15. Vollmar HC, Rieger MA, Butzlaff ME, Ostermann T. General Practitioners’ preferences and use of educational media: a German perspective. BMC Health Serv Res. 2009 Feb;9(1):31. 10.1186/1472-6963-9-31 DOI: https://doi.org/10.1186/1472-6963-9-31
  16. M. S. Knowles, E. F. Holton III, R. A. Swanson, and P. A. Robinson, The Adult Learner. Routledge, 2020. doi: 10.4324/9780429299612. DOI: https://doi.org/10.4324/9780429299612
  17. Verspoor K. The Evolution of Clinical Knowledge During COVID-19: Towards a Global Learning Health System. Yearb Med Inform. 2021 Aug;30(1):176–84. 10.1055/s-0041-1726503 DOI: https://doi.org/10.1055/s-0041-1726503
  18. Lewnard JA, Lo NC. Scientific and ethical basis for social-distancing interventions against COVID-19. Lancet Infect Dis. 2020 Jun;20(6):631–3. 10.1016/S1473-3099(20)30190-0 DOI: https://doi.org/10.1016/S1473-3099(20)30190-0
  19. Williams SN, Armitage CJ, Tampe T, Dienes KA. Public perceptions of non-adherence to pandemic protection measures by self and others: A study of COVID-19 in the United Kingdom. PLoS One. 2021 Oct;16(10):e0258781. 10.1371/journal.pone.0258781 DOI: https://doi.org/10.1371/journal.pone.0258781
  20. Chhablani N, Choudhari SG. Behind the Frontline: A Review on the Impact of COVID-19 Pandemic on Healthcare Workers. Cureus. 2022 Sep;14(9):e29349. 10.7759/cureus.29349 DOI: https://doi.org/10.7759/cureus.29349
  21. Wohlfarth B, Gloor B, Hautz WE. Challenges of students and residents of human medicine in the first four months of the fight against the Covid-19 pandemic - Implications for future waves and scenarios. BMC Med Educ. 2021 Oct;21(1):554. 10.1186/s12909-021-02962-8 DOI: https://doi.org/10.1186/s12909-021-02962-8
  22. Bogner A, Littig B, Menz W. Introduction: Expert Interviews — An Introduction to a New Methodological Debate. Interviewing Experts. London: Palgrave Macmillan UK; 2009. pp. 1–13. 10.1057/9780230244276_1 DOI: https://doi.org/10.1057/9780230244276_1
  23. Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspect Med Educ. 2019 Apr;8(2):90–7. 10.1007/S40037-019-0509-2 DOI: https://doi.org/10.1007/S40037-019-0509-2
  24. Philipp Mayring. Einführung in die qualitative Sozialforschung. 7th ed. Beltz; 2023.
  25. Wagemann C, Goerres A, Siewert MB, Meuser M, Nagel U. Handbuch Methoden der Politikwissenschaft. Wiesbaden: Springer Fachmedien Wiesbaden; 2020. 10.1007/978-3-658-16936-7 DOI: https://doi.org/10.1007/978-3-658-16936-7
  26. L. Gideon, Handbook of Survey Methodology for the Social Sciences. New York (NY): Springer New York; 2012. 10.1007/978-1-4614-3876-2 DOI: https://doi.org/10.1007/978-1-4614-3876-2
  27. Hiemstra R, Brockett R. Reframing the Meaning of Self-Directed Learning: An Updated Model. New Prairie Press, 2012. Accessed: Apr. 27, 2023. [Online]. Available: https://newprairiepress.org/aerc/2012/papers/22/
  28. Candy P. Self-Direction for Lifelong Learning. Jossey-Bass; 1991.
  29. Murad MH, Coto-Yglesias F, Varkey P, Prokop LJ, Murad AL. The effectiveness of self-directed learning in health professions education: a systematic review. Med Educ. 2010 Nov;44(11):1057–68. 10.1111/j.1365-2923.2010.03750.x DOI: https://doi.org/10.1111/j.1365-2923.2010.03750.x
  30. Sawatsky AP, Ratelle JT, Bonnes SL, Egginton JS, Beckman TJ. A model of self-directed learning in internal medicine residency: a qualitative study using grounded theory. BMC Med Educ. 2017 Feb;17(1):31. 10.1186/s12909-017-0869-4 DOI: https://doi.org/10.1186/s12909-017-0869-4
  31. Kuckartz U, Raediker S. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung. 5th ed. Beltz; 2022.
  32. Trachsel S, Schaufelberger M, Feller S, Küng L, Frey P, Guttormsen Schär S. Evaluation eines neuen Mentoring-Programms für Medizinstudierende in der hausärztlichen Grundversorgung: Erfahrungen von Studierenden und Lehrärzten. GMS Z Med Ausbild., vol. 27(3):Doc42, 2010, [Online]. Available: 10.3205/zma000679
  33. Dresing T, Pehl T. Praxisbuch Interview, Transkription & Analyse. Anleitungen und Regelsysteme für qualitativ Forschende., vol. 8. Marburg, 2018.
  34. Cunningham DE, Ward C, Kyle J, Yeoman L. Learning needs, preferred learning methods and learning challenges of first five general practitioners in NHS Scotland: a qualitative study. BMJ Open. 2021 May;11(5):e044859. 10.1136/bmjopen-2020-044859 DOI: https://doi.org/10.1136/bmjopen-2020-044859
  35. Taylor DC, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach. 2013 Nov;35(11):e1561–72. 10.3109/0142159X.2013.828153 DOI: https://doi.org/10.3109/0142159X.2013.828153
  36. Gattrell WT, Barraux A, Comley S, Whaley M, Lander N. The Carbon Costs of In-Person Versus Virtual Medical Conferences for the Pharmaceutical Industry: Lessons from the Coronavirus Pandemic. Pharmaceut Med. 2022 Apr;36(2):131–42. 10.1007/s40290-022-00421-3 DOI: https://doi.org/10.1007/s40290-022-00421-3
  37. Yee M, Simpson-Young V, Paton R, Zuo Y. How do GPs want to learn in the digital era? Australian Journal for General Practitioners, vol. 43, pp. 399–402, 2014. https://www.racgp.org.au/afp/2014/june/learning-in-the-digital-era
  38. How do GPs want to learn in the digital era? Australian Journal for General Practitioners, vol. 43, pp. 399–402, 2014. https://www.racgp.org.au/afp/2014/june/learning-in-the-digital-era
  39. Wald HS, Dube CE, Anthony DC. Untangling the Web—the impact of Internet use on health care and the physician-patient relationship. Patient Educ Couns. 2007 Nov;68(3):218–24. 10.1016/j.pec.2007.05.016 DOI: https://doi.org/10.1016/j.pec.2007.05.016
  40. Marstedt G. Das Internet: Auch Ihr Ratgeber für Gesundheitsfragen? Bertelsmann Stiftung; 2021.
  41. Gu A, Willis K, Kay M, Hutt K, Smallwood N. ‘We are largely left out’: workplace and psychosocial experiences of Australian general practitioners during the initial months of the COVID-19 pandemic. Aust J Prim Health. 2023 Feb;29(1):47–55. 10.1071/PY22103 DOI: https://doi.org/10.1071/PY22103
  42. Cohidon C, El Hakmaoui F, Senn N. The role of general practitioners in managing the COVID-19 pandemic in a private healthcare system. Fam Pract. 2022 Jul;39(4):586–91. 10.1093/fampra/cmab112 DOI: https://doi.org/10.1093/fampra/cmab112
  43. Makowski L, Schrader H, Parisi S, Ehlers-Mondorf J, Joos S, Kaduszkiewicz H, et al. German general practitioners’ experiences during the COVID-19 pandemic and how it affected their patient care: A qualitative study. Eur J Gen Pract. 2023 Dec;29(2):2156498. 10.1080/13814788.2022.2156498 DOI: https://doi.org/10.1080/13814788.2022.2156498
  44. Schrimpf A, Bleckwenn M, Braesigk A. COVID-19 Continues to Burden General Practitioners: Impact on Workload, Provision of Care, and Intention to Leave. Healthcare (Basel). 2023 Jan;11(3):320. 10.3390/healthcare11030320 DOI: https://doi.org/10.3390/healthcare11030320
  45. Taylor C, Parsons J, Sparrow N, Gerada C. The first5 concept. Br J Gen Pract. 2011 Jan;61(582):72–3. 10.3399/bjgp11X549135 DOI: https://doi.org/10.3399/bjgp11X549135
  46. Verhoeven V, Tsakitzidis G, Philips H, Van Royen P. Impact of the COVID-19 pandemic on the core functions of primary care: will the cure be worse than the disease? A qualitative interview study in Flemish GPs. BMJ Open. 2020 Jun;10(6):e039674. 10.1136/bmjopen-2020-039674 DOI: https://doi.org/10.1136/bmjopen-2020-039674
  47. Rohrbasser A, Harris J, Mickan S, Tal K, Wong G. Quality circles for quality improvement in primary health care: their origins, spread, effectiveness and lacunae- A scoping review. PLoS One. 2018 Dec;13(12):e0202616. 10.1371/journal.pone.0202616 DOI: https://doi.org/10.1371/journal.pone.0202616
  48. Beyer M, Gerlach FM, Flies U, Grol R, Król Z, Munck A, et al. The development of quality circles/peer review groups as a method of quality improvement in Europe. Results of a survey in 26 European countries. Fam Pract. 2003 Aug;20(4):443–51. 10.1093/fampra/cmg420 DOI: https://doi.org/10.1093/fampra/cmg420
  49. Eliasson G, Mattsson B. From teaching to learning. Experiences of small CME group work in general practice in Sweden. Scand J Prim Health Care. 1999 Dec;17(4):196–200. 10.1080/028134399750002403 DOI: https://doi.org/10.1080/028134399750002403
  50. de Villiers M, Bresick G, Mash B. The value of small group learning: an evaluation of an innovative CPD programme for primary care medical practitioners. Med Educ. 2003 Sep;37(9):815–21. 10.1046/j.1365-2923.2003.01595.x DOI: https://doi.org/10.1046/j.1365-2923.2003.01595.x
  51. Rohrbasser A, Wong G, Mickan S, Harris J. Understanding how and why quality circles improve standards of practice, enhance professional development and increase psychological well-being of general practitioners: a realist synthesis. BMJ Open. 2022 May;12(5):e058453. 10.1136/bmjopen-2021-058453 DOI: https://doi.org/10.1136/bmjopen-2021-058453
  52. Shaw T, Long A, Chopra S, Kerfoot BP. Impact on clinical behavior of face-to-face continuing medical education blended with online spaced education: a randomized controlled trial. J Contin Educ Health Prof. 2011;31(2):103–8. 10.1002/chp.20113 DOI: https://doi.org/10.1002/chp.20113

Most read articles by the same author(s)