What do you need to be a scholar? And why?

Medicine is both an art and science. For both aspects, it is crucial that doctors stay on top of recent advances. Medicine is advancing rapidly, not only in our understanding of causation but also in investigations and therapeutic interventions. In order to stay up-to-date, doctors need to study, evaluate, and accept or reject hypotheses in both clinical settings and research, which informs service planning, design and delivery.

One of the key competencies that CanMEDS proposes in its framework is a scholar. ¹ So, what is a scholar? Or rather who is a scholar and what do they do or what do they have to do?

A scholar is defined and identified as someone who is well educated and has an aptitude for study: someone who is good at learning and by virtue of such learning becomes an expert in the field they have selected. They have three enabling competencies that are about understanding and interpreting data and following the implications of data analysis through both planned and opportunistic learning, and then integrating these into routine clinical work. The aim is to employ these in improving patient care and services, which will enable patients to seek help and will lead to better therapeutic outcomes. Continuous learning is a key part of personal professional development. Some Royal Colleges in the UK as well other institutions and universities encourage peer groups who meet regularly, and these meetings inform personal professional development. This is very strongly directed by and in consultation with peers. These peer groups can help identify gaps in knowledge or training and monitor individual progress and make suggestions for future development.

Scholarly abilities include an awareness of recent research and developments not only in their own field but also in broader developments in medicine, in order to improve quality and safety of services, which can help improve therapeutic engagement and outcomes. Physicians should be cognisant of research evidence, consider whether it is generalisable and determine where it is applicable. They ought to be able to evaluate the evidence and apply it to their own clinical practice as well as service planning and design. Throughout medical school and training, the acquisition of knowledge is an important skill set.

For physicians, learning is about improving services through better knowledge of treatments and interventions, including public mental health. Learning is also focused on improving skill sets in other competencies. They can learn about service development, teaching activities (including how to teach), carrying out research, how to advocate and so on. They identify pertinent evidence and as clinicians synthesise the research evidence to apply it to therapeutic settings. For doctors, learning is lifelong and must include not only individual learning but also team learning where members of the team get together to learn. This relies on the functions and the aim of the team. Whether there is a formal assessment after sessions or only informal assessment depends on a number of factors, including local or national policies devised by regulatory bodies as well as employers. Lifelong learning has varying aspects from individual to collaborative learning based on personal development plans. The assessment of knowledge may not need formal procedures, but the appraiser during annual appraisal or Annual Review of Competence Progression may informally carry out such an assessment. The assessments are likely to be informal. Self-reflection is increasingly encouraged, and in peer groups, Balint groups or Schwartz rounds, this can be carried out in a supportive way.

For continuing professional development, the physician must have a personal learning plan that may depend on personal reflection, group advice and suggestions or other factors. Individuals must look out for opportunities for learning – be it by attending conferences, academic meetings, grand rounds or online learning at a personal individual level or at a collaborative team level. Any learning or personal development plans must be monitored and revised as needed according to changing needs and monitoring. Scholars are also likely to be in a position to teach either at an individual level through supervision and mentoring or through lectures, seminars and case-based discussion and other means. A scholar is a learned individual and it is expected that they will share their learning with others, again formally or informally. As part of the teaching responsibility, the individual can be a role model and also provide a safe learning environment. The physician should be able to plan, deliver and evaluate any learning activity. In addition, they should be able to assess and evaluate teaching style, content and its impact on individual learners. They should be able to access suitable learning materials after identifying these and be able to evaluate their contents and impact on personal development but perhaps more importantly on patient care or research development.

Scholars learn from various sources, such as books and journals, increasingly available online. In addition, journal clubs, grand rounds and the like provide a very helpful forum for learning where ideas and findings can be shared and discussed. When teaching students or other professionals, individuals can learn new materials. Additionally, presentations and the questions that follow can lead to mutual learning. In teaching, involving others in learning activities can also enhance individual learning. Using tests and feedback can help individuals learn new information and improve retention. Identifying integrity and reliability of research and its application into clinical practice can enable the individual clinician to learn about ethics of research and contribute to understanding and sharing of new information, knowledge and practices applicable to health.

Attending scientific meetings and congresses can be very helpful, as research findings are often presented before they are published. This can offer both advantages and disadvantages. Conferences can help enhance skills, particularly through workshops. Ideally, these should have a small number of individuals, where every attendee is encouraged to participate actively. Conferences are also very helpful in understanding, developing and maintaining professional standards, as well as acquiring new information on healthcare delivery. Such awareness can lead to improved patient safety and quality of care. All learning needs to be accompanied by regular periods of reflection. Using a range of methods and opportunities, such as lectures, panel discussion, workshop, symposia and posters, can help in learning. Post pandemic, webinars, blog posts and online meetings or hybrid models have become more important and relevant in many places for both lecturers and delegates. There is little doubt that actual learning occurs in personal, social, experimental, cognitive and experiential methods. Each method carries with it certain advantages and uses differing models of learning.

Learning itself can be bite sized, with knowledge delivered in easily understandable and digestible chunks. Manning et al. ² confirm its effectiveness related to acquisition of knowledge. Another model extensively used in medicine is simulation training, where specific skills are taught in a virtual environment, sometimes using actors to create real-life situations. These are especially useful for learning practical skills and being engaged. ³ Anecdotally, sometimes students have complained that simulation does not enthuse them due to the ‘artificiality’ of the setting. Because they know that the actors are being paid, students often find it difficult to generate empathy. A third model of learning is the pecha-kucha approach, where presentations consist of 20 slides, each shown for 20 seconds (totalling 6 minutes and 40 seconds). This fast-paced but concise method of sharing ideas has been shown to be an effective learning tool in medical education. ⁴

There are thus multiple sources and methods of learning that can help learn and retain new information. In learning, increasingly diverse methods of decolonization are being employed, leading to textbooks and teaching that reflect both inclusivity and diversity.

Scholars can acquire new information either consciously or subconsciously. To maintain standards and support continuing professional development, targets are often discussed and agreed upon in peer groups and then built upon accordingly. Personal reflections and learning points should follow attendance at events and may need to be shared with the peer group. Additionally, a clear balance between online and face-to-face meetings is necessary for sustainability, financial reasons and building personal relationships.