Letters to the Editor
To the Editor:
Taking an interdis ciplinary angle to address the growing problem of burnout among medical students, Pathipati and Cassel1 provide three succinct, yet insightful approaches inspired by business school curricula—namely, (1) increasing learning opportu nities that foster innovation, creativity, and problem solving; (2) providing more resiliency training that explicitly introduces interpersonal communication and self-reflective methods for navigating high-stress work and learning environments; and (3) making available more thorough career counseling that critically analyzes the socioeconomic and personal implications of diverse career choices. I suggest adding a fourth approach, drawing upon a robust body of research in the field of cognitive psychology: teaching self-regulated learning strategies, which have shown to be negatively correlated with depression, and positively correlated with academic and clinical performance among medical students.2,3
For well-defined tasks across learning environments (e.g., reading, studying, test taking, clinical reasoning, clinical procedures), self-regulated learning can be integrated into medical education curricula through problem-based learning activities, academic coaching, peer mentoring, or faculty development programs. Specifically, the following key strategies most commonly used in the three-phase assessment-to-intervention method referred to as “self-regulated learning microanalysis” could serve as a framework for implementation4,5: goal setting and strategic planning (forethought phase—prior to task); metacognitive monitoring (performance phase—during task); and self-evaluation and causal attribution (self-reflection phase—after task). To facilitate their implementation, these strategies could be introduced in combination with strategies from the learning sciences such as retrieval practice, spaced repetition, interleaving, and elaboration.6
Resolving the burnout crisis in medical education requires a multidisciplinary approach that taps into theoretical frameworks and intervention strategies not traditionally located in the literature on student burnout. The learning sciences, being multidisciplinary in nature, offer a wealth of theoretical frameworks and methods that may serve as starting points for further exploration of the correlation between burnout and learners’ utilization of study strategies across learning environments.
Adrian K. Reynolds, PhD
Academic enhancement specialist and assistant professor of professional practice, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; firstname.lastname@example.org; ORCID: https://orcid.org/0000-0002-0130-794X.
1. Pathipati AS, Cassel CK. Addressing student burnout: What medical schools can learn from business schools. Acad Med. 2018;93:1607–1609.
2. Cho KK, Marjadi B, Langendyk V, Hu W. The self-regulated learning of medical students in the clinical environment—A scoping review. BMC Med Educ. 2017;17:112.
3. Van Nguyen H, Laohasiriwong W, Saengsuwan J, Thinkhamrop B, Wright P. The relationships between the use of self-regulated learning strategies and depression among medical students: An accelerated prospective cohort study. Psychol Health Med. 2015;20:59–70.
4. Cleary TJ, Callan GL, Zimmerman BJ. 2012. Assessing self-regulation as a cyclical, context-specific phenomenon: Overview and analysis of SRL microanalytic protocols. Educ Res Int. 2012;2012:428639.
5. Cleary TJ, Durning SJ, Artino AR Jr.. Microanalytic assessment of self-regulated learning during clinical reasoning tasks: Recent developments and next steps. Acad Med. 2016;91:1516–1521.
6. Brown PC, Roediger HL III, McDaniel MA. Make It Stick: The Science of Successful Learning. 2014.Cambridge, MA: Belknap Press.