Wednesday, November 14, 2012

Self-Regulation, Goal Setting and Mastery

I was not at the session, but did talk with Lily afterwards.  She was really impressed with the group's grasp of the concepts.  One concept however that seemed more difficult was the difference between Mastery and Performance Goals.  For what it is worth, this is the way I make the distinction. Excuse my use of sports metaphors but it is in my DNA.  A runner with "Performance Goals" would look at the results of each race individually "a win is a win and a loss is a loss".  To a runner with "Mastery Goals" their personal time would be most important.  A win with a slower time would not be viewed as positively and a loss with a "personal best" time would be viewed more positively.  

Let's see if I can translate this into an educational example....hmm.  OK  The student with Performance Goals would receive a 92 on an exam and be happy for his/her "A".  The student with Mastery Goals receiving the same 92 would want to know what he/she missed so that she could correct mistakes and better understand.  We want to encourage a "Mastery Perspective" because this orientation should lead to a life-long learning habits so vital to the health professions.  I believe "grades" promote a "performance orientation". that is why I really like CCLCM assessment system

Performance Goals are not bad.  They are perfectly appropriate for casual interests or discreet challenges.  It would be exhausting needing to master everything!!!!  Do you know anyone like that?  


R Prayson said...

I know very few people who feel the need to truly master everything- such an approach is not practical, as was pointed out would be exhausting, and would not be generally valued by society (or at least formal education systems). I have known students who I would deem to be "perfectionists". They always have to be the best. Often, these people seem to use performance goals to measure their success. They feel the need to get the 100%, to be the best. Our educational system fosters this mindset. Their letters of recommendation to medical school talk about their fabulous grade in a course and the letter writer often translates the grade into a rank in the class (as if the final course grades were part of a contest or race). Undergraduates rely heavily on grades as the measure for success; if I get a 96% or A on a test, I must have mastered the material that the teacher thought I needed to learn. And, if the student realizes there is a mistake in the grading of the test and they should have received a 97%, many a student is quick to point out the error in grading with the hope of getting the extra point (a bane of many teacher's existence). The concept of using a test to guage mastery is not role modelled or ostensibly valued in most formal education environments. We like our numbers and measures and ranks; they make for easy comparison between individuals. It's much harder to ferret out whether someone is able to learn from their mistakes. It is a much harder task to focus students on the concept of using the test as a tool to assess deficiencies or weakness to the end of improving. In the real world, the performance as measured by grades becomes the final transcript and is the parameter used to measure an individual's success or failure informal education, not whether or not a student has developed the ability to self-regulate their learning or accurately self-assess their performance

Anonymous said...

Maged Argalious
It seems to me that mastery goals put more emphasis on the learner’s intrinsic drive, motivation and confidence rather than on benchmarking against others’ performance. It is then the goal to best oneself that triggers the pursuit towards mastery and perfection with little or no attention to external influences.
The choice of mastery goals in some areas and of performance goals in other areas depends on the individual’s priorities, interest and motivation. Since mastery goals require dedication and a generous investment in time and effort, they cannot be used in all required goals. In my view, the ability to achieve mastery goals even in one area (be it sports or an educational endeavor) shows certain traits (perseverance, confidence, self efficacy and motivation) that are unique to the individuals achieving those mastery goals.

Elias Traboulsi said...

In my (biased of course) mind, mastering everything within one's field of practice or interest is impossible. Aiming at excellence in of as many aspects of one's area of expertise as possible is a good lifetime goal that I like to instill in trainees of graduate medical education. Most of the time, they do not even need to have it instilled in them, it is a necessity for success; a requisite for keeping up expertise and skills; a determinant of their ability to take good care of patients. Most are able to remain experts, and not to become masters. We often sacrifice good knowledge of certain aspects of our training to keep up our expertise in others. Our fields continue to expand in breadth and depth and areas of even narrowing subspecialty continue to emerge. We have to make choices and despite our good intentions, we fall behind. In fact, professionals who seek mastery in too many areas are stressed and may not achieve any. Remember "jack of all trades ... master of none" ? With the increasing demands of modern medical practice, and the expectations of patients, hospitals and licensing organizations, mechanisms such as maintenance of certification, requirements for continuing medical education have been implemented to ensure that practitioners keep up with the necessary knowledge in their field of expertise and satisfy certification criteria. Expert - necessary, Master - if you can.

Brian Burkey said...

I really enjoyed the self-regulation discussion and agree with the thoughts on mastery and performance measures, as related to motivation. I am not sure I have more to offer there--excellent points were made by the three bloggers and Chris.

I do wish that at some point we can dialogue about the issue raised in the associated reading. It suggests that professionals do not self-assess well in areas of weakness, and that even if areas of weakness are defined, that professionals avoid learning in these areas due to extra energy and commitment. I found the article remarkably grounded in reality and concerning for us as medical professionals. It also makes sense that we would rather strengthen areas of strength with our energies than strengthen areas of weakness, due to personal interests. Here mastery may work against us. The problems lie in motivation, but motivating at this level can be difficult. It seemed from the article that multiple motivational strategies have failed in the orthopedic community, and I am sure that similar findings are apparent in other areas of health care. There are no quick fixes but we must be aware of the self-regulation cycle in our areas of education and look to increase the interest in lifelong learning in our students.

Karen George said...

I too enjoyed the frankness of the orthopedic article.Self regulation of the professional in my physician assistant experience has been 30+ years of 100+ hrs of CME every 2 years and a recertification test every 6 years. While these are required and not a product of any self reflection we are allowed the choice of what CME to attend to fulfill the quota. CME choice is usually related to the field we practice in. I do believe this promotes forced self regulation in our profession. If one does not fulfill the basic requirements you will loose the ability to maintain certifcation and your PA license. Self monitoring should occur if the PA is successful. But do we make the effort to learn or relearn
topics that we are not interested in, do not apply to our current job but are flagged on recertification or certification testing with lower scores? I would venture that most would not. The PA student would be motivated to correct any lower scores to succeed on passing the recertification exam but the practicing PA would not have the same motivation. Energy, time and money would be barriers to improving any deficient areas.The NCCPA who regulates the PA's certifications has now developed an additional certification called CAQ or certificate of added qualification. Available in only limited specialties is this an attempt to show mastery in certain areas? Perhaps or is it another fee
obtaining ploy by the NCCPA. I would like to interview those PA's who wish to take on the extra CAQ and examine their motivation. Mastery, more money or something else must drive them to want to exceed.

Anonymous said...

Yes, I know a number of people that feel they need to master any challenge that is put in front of them, and at times that seemed to be me. I was involved in a number of things throughout college and witnessed various events where people would essentially "beat themselves up" because they did not perform to the ability they demanded, while others would look at them as if they were crazy. I played softball in college and getting out on a pop up to shallow left field was better than striking out after 8 foul balls while at bat. Things seem to be expected differently and people held to different calibers at times. I played third base and batted forth or fifth so I was expected to put the bat on the ball, somewhere is play and while on defense stop everything my way, even if it meant practically running over the pitcher to take the ball and get it to first base. Academically I tried to perform my best, but master the material that was being taught. I asked numerous questions and would meet with my professors during office hours at times to make sure I was grasping the material. I performed well on tests and papers, but I was not satisfied with earning an A unless I didn't have any pressing questions about the material. There were times I would enter an exam with questions in my head and not fully understanding something, but still performed well. Trying to master everything would be exhausting, but I know that I am a head-strong individual who will try my best to perform my best, and master the things that I find very interesting or are expected to master in order to further myself. Even if I try to master something and unfortunately fall short, I, like many others refuse to give up and will get up, dust themselves off, and try again. Mastery and performance do go hand in hand to a degree, but there is always going to be room for improvement, or ways to modify. Mastery is not always long lived either because someone will come along and challenge you, whether it be in an intellectual verbal debate, on a written exam, or, if you're Michael Phelps in the pool at the London Olympics this past summer. Phelps was a master of a number of different races, but his mastery was challenged by others, and his performance (he stated after all the swimming events were over) was just fine for the amount of training (or lack there of) he put into it. Therefore, performance seems like it is measurable by others, but mastery is measured and more internalized by ourselves.

Anonymous said...

Sorry, the above post is mine.

Kathy Baker

Brian Johnson said...

As we had discussion in class and now here on-line I continue to see a trend that I find interesting. People are associating mastery goals with becoming a master at a topic. To me they don't mean the same thing. A mastery goal is focused on improving your own performance in a specific arena, getting closer to being a master. The goal itself does not indicate mastery of a topic. The example of the runner mentioned in the original post is appropriate, the person who comes in fourth with a personal best time may not be a master runner but is improving themselves and may over a long time become a master runner. I really like Maged's statement that mastery goals seam to drive toward personal motivations. My question is isn't that what we want out of our students, personal motivation toward mastery?

Heidi Gdovin said...

All posts are very interesting and covered great points! I think what Brian (J.) mentions is similar to my thinking…. If you set a mastery goal for yourself, you may reach that goal but it does not necessarily mean you mastered the concept or activity. There may still be more to learn or ways to improve and others who are better or know more. It is satisfying to reach your goal and it may be more that you expected you could do. However isn’t it possible (and important) to set another, higher goal to try to get even better or know more about a concept or activity? Ideally, after reaching a mastery goal, a learner would continue to set higher goals and implement a plan to continually improve and become better and better at the concept or activity over time. In this case I do not think you can be a master at everything but can set mastery goals toward those most important. Ideally learners would plan and set mastery goals over performance goals however, if they don’t there may be times a teacher’s role can be to help them take the extra steps to look and reach further.

Christine said...

I would agree with Heidi and Brian about setting mastery goals. It may be intimidating to set goals depending upon the nature of what the individual is attempting to accomplish and their level of self-efficacy, however, this is the most effective way for learners to continue to stretch their abilities. I don't think most people feel like they need to master everything, but most people I've found are very critical of their own performance, too critical. Educators can help provide reassurance to learners and encourage them to set the right goals and provide meaningful directed feedback along the way.

Christine said...

ooops... the last one was Shelley

Anonymous said...

David Wheeler
I must begin with the comment that I did not attend the session. I was out of town at a conference and I apologize however, I will comment based on the blogging of my esteemed and learned colleagues. The notion of a highly skilled medical professional performing and authentic self-assessment may be a bit of a stretch for those who have been involved in healthcare education for any time. I believe that people wish to attain the level of mastery that is "expert" in the opinion of their peers and by all objective measures however, may be more practical given the multi-tasking demands of healthcare to strive for mastery in your core area +1. The landscape of medicine and healthcare is changing rapidly and I must say I think that experts are being disincentivized. The highly esteemed, highly sought after expert may be relegated to a rather banal role in the new healthcare delivery system. We are now subject to statutes and regulatory oversight by a new class of non-clinical bureaucrats. However, I digress. The intellectual capital and effort required to attain expert status may be too high a price for many. I do think it is incumbent upon every healthcare professional to gain a mastery of the scope of practice and then invest the time and effort to become an expert. The attainment of expert status becomes more difficult with every evidence-based review. We are living in an era of explosive new knowledge, we are in the knowledge economy and we participate in an endeavor that is producing and consuming knowledge that an incomprehensible rate. To become an expert may be an ephemeral label as our information and evidence is constantly being adapted to new information. Perhaps, the best we can do is to become experts in the moment and remain intellectually curious and active.

Anonymous said...

I am coming late into such a productive discussion and have enjoyed reading your posts. I, like Dr. Taylor have part of my DNA in sports. I spent most of my childhood in a tennis court and believe it or not, in spite of my stature was a champion throughout all those years in Colombia. Every year, I made it to the 'Masters" tournament in my category. Only the best 8 players after a 6 tournament circuit throughout the entire year will classify. The goal of being excellent at my sport as a child meant working hard, enjoying and improving the game. Tennis is a very mental sport, where you have time to analyze the reasons why your game may be at your best or not. I learned a lot from it, the meaning of discipline, effort but more importantly, the idea that improving implied playing better every day, even if that meant not necessarily being number one. Finishing a game having given my best until the very last point, even if I lost meant the world to me.
The idea of self regulation is key in education; one has to reflect on the need for improvement in certain areas. Masters and experts, no matter in which area, continuosly seek improvement Once you have achieved a certain level where you become comfortable if you don't push yourself a little further, you will stagnate and won't improve any further. Hence, the need for those key elements that Maged mentioned (perseverance, confidence, self efficacy and motivation).
I agree with Brian Burkey that is already hard to maintain a high level of expertise in an area but is even more difficult to motivate oneself to put time and effort in something that may not be as interesting and relevant for our practice.

Pilar Castro said...

The prior comment about the "not very tall" child tennis player was mine. Pilar :-)

Anonymous said...

Matt Celmar said…

At risk of sounding like a broken record, I agree with what Maged, Brian, and Heidi said. I have always thought that mastery goals tend to be more intrinsic and performance goals tend to be dictated by others. I guess if you were trying to achieve mastery status you would have to make some sort of checklist of performance goals to accomplish.
Would my interpretation of a master be different than that of another person making a similar list? What I consider to be mastery status in a baseball player (for example) might be different than someone else or even a baseball player. Is it possible to truly reach that master status?

Trying to practically apply this to our learners, we should make lists of performance goals for our students. In the real world you are held up to your performance against your peers. Whether it is by an instructor, institution, or a state board. I guess a compromise is to emphasize the mastery goal buy hold the students up the performance goals. Their intrinsic motivation to achieve their own mastery goals can allow them to perform past our expectations.

Side Question.
Would Aristotle consider himself a master philosopher???

Rachel Steines said...

I am not sure if CCLCM has the same grading system as Case Med, but at Case medical school, there are no grades. They have an exam at the end of each block that is pass/fail, and they only have a couple of these exams a year. For those who are not great self-regulators, I think this is a downfall for them. This is especially problematic for those students who have the “mastery perspective”, which I have to imagine is not terribly uncommon among medical students. I think step 1 scores would be higher if students had more performance goals; basically more exams with real grades. That way, perhaps their mastery goal will be a higher step 1 score.

Anonymous said...


I have to agree with Matt etal., that mastery of goals are intrinsically motivated. A person has to be vested in the task of which he or she wishes to master. Only through self interest would the individual attempt to place the bar of acceptance at a higher level. If an individual loves to play the guitar but presently doesnt play very well, will they be motivated to take the time and effort needed perfect and master the instrument. I have to agree also with Elias that most choose to become experts in their vocation and Masters in areas of self interest.

Miguel A. Morillo said...

Miguel A. Morillo
I pretty much agree with all the previous posts. I think that for the way things are set up in our education system, performance goals seem to be the way to go. The information, due to the complexity, is being broke down into smaller and easier to digest fragments, and then evaluated through performancy goals; but in reallity the mastery goals are not being pushed. I realize that this could also have to do with the fact that mastery goals are more difficult and the human nature always tries to find the easiest way around things. I'd also like to add that personality and the persons social history has a lot to do with sel regulation. Some people are perfectionists and self critizice severely, while other aren't that much. It is a very complex issue.

Shelley Frost said...

testing testing
Shelley Frost

m rana said...

Practices require medical assistants to look after the front office administration
including staff management, appointment scheduling, filing reports, maintaining
patient charts, bookkeeping, billing, tax and insurance processes. With the federal
government incentivizing Meaningful Use of EMR implementations, a majority of
administrative and clinical tasks have been digitized. As the onus of meeting
Meaningful Use objectives lies largely with medical assistants, practices have
started to consider IT skills as indispensable to medical assistant skill
sets and resumes.

medical assistant
medical assistant classes
medical assistant certification
medical assistant programs
medical assistant school
medical assistant courses
medical assistant courses online
medical assistant classes online