Answer to "How can student difficulties with learning be supported?"
A complex range of factors are associated with students presenting with difficulties in learning. Learning difficulties cannot be simply addressed by specific training in study skills. Co-existing personal, psychological, social or professional issues also have to be addressed.
Students with psychological disorders, such as anxiety or depression, should be supported to manage or obtain appropriate treatment before attending to difficulties with their learning.
Students with difficulties in learning may have an undiagnosed specific learning disabilities,such as dyslexia, and late presentation may only become apparent after a transition, such as progressing from one part of the course to another. Supporting students with these disabilities usually requires referral for additional specialist support.
Many students who experience difficulty across the continuum of medical education have poor self-regulated learning behaviours, causing problems with their ability to learn or study as well as to effectively perform at assessments. Specific support to develop effective self-regulated learning behaviours may be required.
The instructional design of educational activities for students with difficulties in learning should be based on principles of deliberate practice, with a specific focus on developing accurate mental models for what good performance ‘looks like’ in the student’s mind before, during and after completing the task.
Student support of students with difficulties in learning should move beyond only a facilitated recall about the level of performance towards addressing the essential components required for the development of lifelong learning : the repertoire of learning skills for academic and clinical performance, the effective use of self-regulated learning behaviours and the motivational aspects related to learning. Many students in difficulty have lowered motivation due to repeated lowered performance and a strengths –based approach to support is advised to build self-confidence in their abilities.
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Hauer, K. E., Ciccone, A., Henzel, T. R., Katsufrakis, P., Miller, S. H., Norcross, W. A. & Irby, D. M. (2009). Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature. Academic Medicine, 84(12), 1822-1832.
Patel, R., Tarrant, C., Bonas, S., Yates, J., & Sandars, J. (2015). The struggling student: a thematic analysis from the self-regulated learning perspective. Medical Education, 49(4), 417-426