Barriers and Facilitators to the Use of Personal Learning Plans in Internal Medicine Residency Program

Introduction: Personal Learning Plans (PLPs) provide residents opportunities for self-regulated learning. We explored residents’ and academic advisors’ (AAs) experiences with PLPs to identify barriers and facilitators to their use in a competency-based internal medicine (IM) residency program. Methods: Using mixed methods we examined PLPs from three IM cohorts (2017-2019). We evaluated goals set in the PLPs using Lockspeiser’s scoring rubric and alignment with feedback. We conducted semi-structured interviews with residents and AAs to explore their experiences of PLPs. Quantitative data were analyzed within and across training cohorts using descriptive and variance component modeling techniques. Qualitative data were analyzed thematically. Results: Fifty PLPs containing 214 goals were independently scored by two IM medical educators. Completion rate was 47.6%, 73.9%, 95.8% for 2017, 2018 and 2019 cohorts respectively. 47% of goals aligned with faculty feedback. Scores for goals were moderate and varied within resident: goal specificity (x̄ =1.56, range:0-3; ICC =0.46), learning plan quality (x̄ =1.80, range:0-3; ICC =0.53), and the outcome identified (x̄ =1.56, range:0-3; ICC =0.39). Most interviewees thought PLPs developed residents’ self-reflection skills and promoted the use of feedback to identify goals. Barriers included challenges with self-reflection, inexperience with goal setting, challenges with online platforms, limited time, and unclear expectations. Facilitators included a supportive learning environment, coaching by AAs, protected time, and high-quality feedback. Conclusions: This study provides insights into facilitators to effective implementation of PLPs in residency: on-going resident and AA training sessions, coaching residents on writing learning goals and self-reflection, clear expectations and providing dedicated time.