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The Royal College of Psychiatrists Improving the lives of people with mental illness

Methods of Learning

Discipline

The overwhelming reason for developing a discipline in learning is to improve our knowledge, skills and performance for the benefit of our patients. How we learn is very much an individual preference, or even a habit, though the present emphasis on self-directed, self-assessment and self-regulation is not suited to all individuals. An ineffective self-assessment by some can result in an overestimation of self-competence thus leading to poor recognition of clinical skills and knowledge. At best this results in a failure to improve clinical practice, at worst it may result in serious consequences to patients.

 

Traditional ways in which psychiatrists gain knowledge and skills have changed over the years. Lecture based learning or sitting in libraries poring over text books have been superseded by learning in groups and a number of different ways of internet learning. Each method has its own supporters and critics; didactic lectures are more likely to add to knowledge and effect an attitudinal change but may be less likely to enhance performance. On the other hand, case based discussions, role play and hands-on practice sessions are regarded as more effective in influencing clinical practice.

 

Figure 1. Factors Affecting CPD

Factors Affecting CPD

 

Two pillars

Whatever style of learning one adopts, it has to be underpinned by two main pillars: it has to be engaging and there has to be a subsequent event which reinforces what has been learnt. In practice, psychiatry is as much about acquiring skills and maintaining knowledge as it is about learning from mistakes. In the prevailing compensation culture the latter is stress provoking, but a demonstration of personal attitude and an ability to adopt corrective methods might go some way to mitigate against such clinical errors. There are both positive and negative factors that affect our performance (Fig 1).

 

Some very practical work-related issues can act as impediments to continuing professional development, such as pressures of work, inability to take study leave for an appropriate course, and limited study leave budget. On the other hand, there are some who might regularly not turn up at local teaching meetings and case conferences because they have a negative attitude to learning.

 

It is not necessarily true that psychiatrists become more competent with maturing age. There is some evidence that age and performance have a concave relationship so that in some respects clinical skills and personal attitudes might actually worsen with time. It is important then to be aware, whatever the age, what factors contribute positively to our clinical abilities. These are:

 

  • Setting clear objectives for your professional development.
  • Taking time to reflect on your practice and obtaining constructive feedback both formal and informal from peers and patients.
  • Carrying out periodic audits.
  • Ensuring that there is a practice of reviewing any serious untoward incidents in the department.
  • And perhaps most important of all, having the motivation and commitment to learn and teach.

 

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