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Letters to the Editor

Program Director as Master Adaptive Learner

Edje, Louito C. MD, MHPE

Author Information
doi: 10.1097/ACM.0000000000002825
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To the Editor:

The term “master adaptive learner” (MAL) has historically applied to medical students and residents. When MALs encounter gaps in their knowledge, they feel a cognitive dissonance described by Schön as a “surprise,” a sudden intuitive realization.1,2 This is the optimal time for learning to occur since MALs start to make plans to fill their gaps. They decide on the best learning strategy and resources to reduce their feeling of discomfort. Subsequently, MALs engage in the processes of learning, assessing their learning, and receiving feedback. Finally, they adjust their practices to incorporate the newly learned information.1 Having been a learner in a master of health professions education (MHPE) program during a portion of my time as a program director (PD), it occurred to me that the term “MAL” may have broader applications than those currently in the literature.

The definition of “MAL” could be expanded in two ways: (1) to be inclusive of other learners, such as PDs; and (2) to be inclusive of broader aspects of our environment than clinical medicine, namely the other domains of a PD’s job description.

I experienced some cognitive dissonance as I first led faculty development for my team. This may have been in large part because I became PD at a program in which some of our faculty had been in medical education for longer than me. Like a MAL, I started planning how to reduce the dissonance. After researching a variety of MHPE programs, I selected one that best fit my busy life as a PD. Through my MHPE program, I engaged in the process of learning and assessment. Subsequently, I incorporated what I learned into our faculty development curriculum, adjusting my role as PD.

If we apply the concept of “MAL” to PDs and balance our expertise of adhering to accreditation requirements with creative exploration, we will be better able to accommodate our traditional MALs and move closer to becoming adaptive expert PDs.


The author thanks Larry Gruppen, PhD, and Monica Lypson, MD, MHPE, for their tutelage during her master of health professions education training.

Louito C. Edje, MD, MHPE
Program director, St. Luke’s Hospital Family Medicine Residency, Perrysburg, Ohio; [email protected]; ORCID:


1. Cutrer WB, Miller B, Pusic MV, et al. Fostering the development of master adaptive learners: A conceptual model to guide skill acquisition in medical education. Acad Med. 2017;92:70–75.
2. Schön D. The Reflective Practitioner: How Professionals Think in Action. 1983.New York, NY: Basic Books.
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