Teaching and Learning Forum 2000 [ Proceedings Contents ]

Self directed learning in first year physiotherapy students: Reflections

Connie Price
School of Physiotherapy
Curtin University of Technology
    In keeping with the University's and the Physiotherapy professions goals of developing life long learners this project aimed to develop a profile of self directed learning in first year Physiotherapy students. Discussions with a focus group of students revealed many of the perceptions held by students that may form barriers to adopting self directed learning approaches. Comparisons between the focus group and a control group also revealed how some of these barriers can be broken down through an education process, and highlighted issues that must be addressed as we assist these students to make the necessary transition from student to professional.
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Self directed learning in the professional context of Physiotherapy

Changes in the health care environment in the last twenty years have seen the physiotherapist's role evolve from technician to independent practitioner with a high degree of autonomy, and a responsibility to rationalise the selection of their treatment approach. In addition to their discipline specific skills the Physiotherapy graduates are expected to possess generic attributes such as critical and creative thinking, oral and written communication skills, and the ability to gather/synthesise/generate information (Hunt et al, 1998).

May and colleagues (1995) surveyed clinical educators and developed a ranked list of generic abilities specific to physiotherapy. These abilities were identified as being critical for the physiotherapy student's successful transition from classroom to clinic. First on the list was commitment to learning, defined as the ability to self assess, self correct, and self direct and the ability to identify their learning needs and sources of information. The other attributes identified included (in descending order) interpersonal skills, communication skills, effective use of time and resources, use of constructive feedback, problem solving, professionalism, responsibility, critical thinking, and stress management. Several of these attributes are also espoused in the literature on self directed learning (Lindner & Harris, 1993).

Becoming a self directed learner

Many universities are now placing specific emphasis on the development of self directed learning or life long learning skills as one of the primary goals of a university education. As self directed learners students should have the ability to: identify and set personally meaningful goals for their own learning; develop and use a wide range of learning strategies appropriate to different learning tasks; work independently and/or with others to achieve their learning goals and persist to overcome obstacles in order to achieve their learning goals (Radloff & de la Harpe, 1999).

It is apparent then that the student's ability to develop learning goals and to monitor their progress towards these goals is a critical element in their ability to be self directed. The questions that must then be asked are: Do students have this important skill when they enter university? If they do not have this skill how can they be supported to develop it?

Previous reviews of learning logs which required students to set weekly learning goals/objectives revealed that, in general, first year students do not set specific and measurable goals nor do they describe specific learning strategies to be used to achieve their goals. It is believed that setting specific learning objectives helps students focus their study efforts (Alderman et al 1993). Consequently a program was developed to assist students to understand the importance of setting meaningful learning objectives and to assist them to write objectives that were specific and measurable. This paper reports some of the findings of this project.

The project

At the end of Semester 1 1999 all students enrolled in first year Physiotherapy were approached to participate in a series of tutorials to be held throughout Semester 2. Fourteen students (5 males and 9 females) volunteered. The tutorials were of one hour duration and were held fortnightly. Initial discussions focussed on what self directed learning was and the importance of being self directed both in the short term as a physiotherapy student and later as a practicing physiotherapist. Subsequent sessions focused on the construction and assessment of appropriate learning goals/objectives and on time management strategies. The distinction between performance goals and mastery goals (Ames, 1992) was also explained.

All students enrolled in first year Physiotherapy for Semester 2 were required to complete a weekly learning log. The learning logs direct the students to set learning objectives, to identify any barriers to learning that they encounter and to identify potential solutions. Students also record the time they spend in various learning activities. These have been divided into three categories: individual study (reading, writing/synthesising, assignments, organising), group study (skills practice, group discussion), and formal contact (lectures, laboratories, tutorials).

At the end of the semester the tutorial group (TG) were asked to fill out a short questionnaire to gain their opinions and feedback about the project. The questionnaire was also administered to a control group (CG) of 20 first year students, who did not participate in the tutorials, for comparison. The questionnaire consisted of 35 statements related to their experiences of self directed learning in the first year Physiotherapy course. Students were instructed to choose the description that most accurately reflected their feelings/perception of the concept expressed in the statement. A five point Likert scale with descriptors of strongly agree, agree, neutral, disagree, and strongly disagree was used. Students were also asked to justify their choice for each question with a written comment.


Although the original intent of the project was for the tutorials to be instructional, and that students would readily receive and apply this guidance it quickly became apparent that there were a number of barriers which made students reluctant to change their approach to study. The tutorials thus became a forum for open discussion about the students' perceptions of self directed learning in a university environment. The questionnaire was designed to capture some of these issues and the discussion which follows highlights selected issues of importance. Issues where the tutorial group responded differently from the control group will also be discussed as they may reflect changes in perception or attitude related to a deeper understanding of what it means to be self directed gained by the tutorial group.

Eighty-six percent of the TG agreed or strongly agreed that a capacity to be a self directed learner is one of the most valued goals of their university career. While this may not initially have been the case (only 60% of the CG responded similarly) group discussions about how physiotherapists are self directed in their practice helped some students to put things into perspective.

S 22:It is now. It has been brought to my attention its value and necessity in becoming a GOOD Physio.
S 26:Now I understand [that] the structure/methods of learning is essential for [my] success.
S 21:I can also see that to be able to continue learning when you finish uni you need to be self directed.

While this may be a goal to be achieved by the time they complete the course how soon do the encounter a need to be self directed?

Seventy-two percent of TG and 60% of CG students agreed or strongly agreed that the methods of teaching and assessment they encountered in their first year at university require that they change their approach to learning. Many, however, are lost as to how to begin the process of change.

S 23:You are no longer spoonfed, and we have NO idea how to change these habits towards self direction.
S 26:I found 'self directed' a new concept and without being self directed, it took a while to figure it out/what was expected [of me]!

However, students do not believe that they have been adequately prepared for the types of learning they encounter at university as 57% of TG students and 15% of the CG strongly agreed with this statement.

S 23:We are spoonfed and taught to learn in order to pass our TEE and be successful. We are allocated set homework and we are NOT prepared for the uni self direction strategies.
S 7:You have to be prepared to find the info, and learn it without being told - if you don't do it you don't get in trouble you just get behind - its your own problem.

It thus falls to the educators to set the students on the path of self direction, gradually developing their skills as they make the transition from secondary to tertiary education. Self directed learning goals must also be made explicit in the course descriptions and in the unit outlines as the majority of students (65% of CG and 57% of TG) agree that these goals will not be attended to by students otherwise.

S 9:I think guidelines about what you should be achieving are essential, especially for those who aren't used to self directed learning.

The extent to which self directed learning should be used in a course of study differed between the TG and the CG. Thirty six percent of the TG strongly agreed and 43% agreed that self directed learning should be used for all aspects of the course not just for isolated units. Comparatively only 35% of the CG agreed and 60% disagreed with this statement. This difference in perspective may be related to a lack of understanding about what self directed learning means. Many students believe that self directed learning means that they will be left to do the work on their own rather than being 'taught'. The TG had many discussions about how they could be self directed in choosing different strategies for different learning situations and about their responsibilities to seek information and deeper learning regardless of the amount or form of instruction given. This is the more commonly accepted definition of self directed learning (Lindner & Harris, 1993).

Through these discussions it was also discovered that many students are locked into a cultural belief that the 'teacher' has all the answers, and indeed that there is only one answer to a given problem. This is far from true in a profession such as physiotherapy where many of the treatment approaches used have not yet been supported through research (Duncan, 1996). If the educator chooses a different approach to the 'traditional' didactic lecture and sets up a learning environment for the students to be active, self directed learners so that they discover their own solutions they often feel that the lecturer is 'with-holding' the answer from them. After a discussion of these issues 75% of the TG agreed that students undervalue themselves and each other as resources for teaching and learning.

S 23:We are unsure of whether or not what we know is correct and as not many of us have learnt such stuff, we don't use each other efficiently.
S 21:We don't believe in each other's ability as we don't really know anything yet.

Metacognitive processes such as reflective journal writing are thought to improve students perceptions of themselves as sources of knowledge, understanding and change (Alderman et al 1993). The main aim of using learning logs in a first year course was to help students identify the relationship between the time they spend doing different types of study and their ability to meet their learning goals. Most, however, saw it as a chore unrelated to the material in the course and only completed the log as it was a required component of the unit. Only 23% of the students in either group felt that using a learning log encouraged them to change their study habits. In the TG, however, 50% found the log useful for helping them understand their learning processes and their ability to be self directed.

Finally, the primary barrier to adopting self directed learning strategies identified by the tutorial group related to how they would be assessed. This was not only on a unit by unit basis but related to how they would be compared once in the job market. As long as students hold the belief that high grades alone will assure them the type of job they aspire to they will continue to set themselves performance related rather than mastery type goals. The study strategies they choose will, therefore, aim to make the most of their limited study time for short term gains. Forty percent of the CG agreed that if they could do well in their exams and assignments they didn't see a need to change their approach to learning. Eighty five percent of the TG (and 40% of the CG) disagreed with this statement and many of the TG students recognised the pitfalls of binge and purge learning.

S 23:Although I do well in my tests and assignments, I often find that I forget half of the stuff later on. Good grades achieved by cramming don't necessarily mean that the content has been learnt.
S 22:One needs to change - I can learn to get a good exam mark, but is this learning the subject or [just] learning to pass an exam!
S 32:The aim of this course is to enable me to perform well as a physio. To do so I need to be "well rounded" and therefore must do more than just for exams and assignments.
S 29:[I] would like to be able to apply the principles rather than just know them through wrote[Sic] learning

In conclusion, this project has revealed some interesting perspectives on first year students' experiences of different types of self directed learning in physiotherapy. These perceptions and the students' comments serve to remind us how important it is for us as educators to be explicit in setting goals which incorporate self directed learning strategies and to provide the framework onto which students gradually graft their own experiences as they become self directed life long learners.


Alderman, M.K., Klein, R., Seeley, S.K. and Sanders, M. (1993). Metacognitive self portraits: Preservice teachers as learners. Readings in Research and Instruction, 32(2), 38-54.

Ames, C. (1992). Classrooms: goals, structures, and student motivation. Journal of Educational Psychology, 84(3), 261-271.

Duncan, P. (1996). Evidence based practice: A new model for Physical Therapy . PT Magazine, December, 44-48.

Hunt, A., Adamson, B., Higgs, J. & Harris, L. (1998). University education and the physiotherapy professional. Physiotherapy, 84(6), 264-273.

Lindner, R. W., & Harris, B. (1992). The development and evaluation of a self regulated learning inventory and its implications for instructor-independent instruction. Paper presented at the Proceedings of selected research and development presentations at the Convention of the Association for Educational Communications and Technology and sponsored by the research and theory division.

May, W.W., Morgan, B.J., Lemke, J.C., Karst, G.M. and Stone, H.L. (1995). Model for ability based assessment in physical therapy education. Journal of Physical Therapy Education, 9(1), 3-6.

Radloff, A & de la Harpe, B. (1999). Characteristics of self directed learners in the context of the Self Directed Learning Project. Self Directed Learning Workshop, Curtin University of Technology, 13 April 1999.

Please cite as: Price, C. (2000). Self directed learning in first year physiotherapy students: Reflections. In A. Herrmann and M.M. Kulski (Eds), Flexible Futures in Tertiary Teaching. Proceedings of the 9th Annual Teaching Learning Forum, 2-4 February 2000. Perth: Curtin University of Technology. http://lsn.curtin.edu.au/tlf/tlf2000/price.html

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