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Development and initial validation of a practical instrument supporting clinical reasoning and self-directed learning
Nicholas R Nelson1, Madison Ricco2, Robert Hubal3
1Wingate University School of Pharmacy, Wingate, NC, USA.
Medical Teacher
|July 22, 2026
Summary
This study developed a new 27-item Learner Mindset Instrument (LMI) to measure characteristics supporting clinical reasoning and self-regulated learning (SRL). The LMI offers a unified tool for educators to assess and coach learners in health professions.
Area of Science:
- Health Professions Education
- Educational Psychology
- Assessment and Evaluation
Background:
- Clinical reasoning is crucial in health professions education.
- Self-regulated learning (SRL) and the Master Adaptive Learner (MAL) framework support clinical reasoning.
- Existing instruments lack validation for clinical reasoning contexts.
Purpose of the Study:
- To develop and validate a unified instrument measuring the four MAL characteristics.
- To generate items reflecting curiosity, motivation, growth mindset, and resilience.
- To pilot and refine a new instrument for assessing learner mindset.
Main Methods:
- A multi-phase, mixed-methods approach was used for scale development.
- Systematic literature searches, modified Delphi process, and focus groups were employed.
- Exploratory factor analysis and reliability testing were performed on data from student pharmacists.
Main Results:
- A 27-item Learner Mindset Instrument (LMI) was developed, incorporating self-directedness as a fifth construct.
- The LMI demonstrated strong internal reliability (Cronbach's α = 0.893).
- The instrument showed acceptable factorability (Kaiser-Meyer-Olkin = 0.77).
Conclusions:
- The 27-item LMI provides initial construct validity for measuring characteristics vital to SRL and clinical reasoning.
- This unified tool can aid formative assessment and targeted learner coaching.
- The LMI can evaluate educational interventions aligned with the Master Adaptive Learner framework.
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