A Systematic Review of Assessment Practices for Self-Directed Learning in Health Professions Education

INTRODUCTION: This systematic review aimed to describe the assessment practices related to self-directed learning (SDL) in undergraduate health professions education. There were three main objectives of the review: 1) evaluating the different types of assessment used to determine the effectiveness of SDL; 2) assessing the effectiveness of SDL methods on student learning; and 3) exploring how readiness for SDL is assessed. METHODS: The PRISMA standards were followed for this systematic review. A total of seven electronic databases were searched: CINAHL, Embase, ERIC, PsycINFO, PubMed, Scopus, and Web of Science. Articles published in English between 2015 and March 2020 were retrieved for further evaluation. Two independent investigators screened abstracts and full-text articles using the inclusion and exclusion criteria. The same investigators independently extracted data from included articles: the type of participant, sample size, study design, SDL activities, and assessment methods used to evaluate effectiveness of SDL. In addition, two independent investigators evaluated study quality using the validated Medical Education Research Study Quality Instrument (MERSQI). A third investigator resolved discrepancies and disagreements. RESULTS: A total of 65 studies from nineteen different countries were included in the analysis. Most study participants were medical (N=33) or nursing (N=20) students. Overall, there were wide variations in the definition of SDL, SDL activities used, and in the assessments developed to evaluate the effectiveness of SDL activities. The most common type of assessment used was a student perception survey, unrelated to a SDL readiness assessment. Internally-developed knowledge exams were also commonly used. A total of 38 studies concluded that the SDL had a positive outcome, measured by the assessment instrument, whereas 21 studies reported a mixed or neutral outcome and six studies reported a negative outcome. CONCLUSIONS: This systematic review demonstrates the wide variations in both the SDL activities used as well as the assessment methods developed to determine SDL effectiveness. Since SDL is a necessary skill for lifelong learning and success as a healthcare professional, it must be used and assessed appropriately. It may be valuable to standardize SDL activities and assessment methods across healthcare professions education. In addition, future research should be conducted to help establish the most accurate and effective assessment methods for SDL. © FASEB.