Individualized Learning Plans: Who, What, When, Where, Why, and How?

What is an ILP?

An ILP is a learner-centered tool that customizes learning opportunities throughout residency training and supports the attainment of professional goals preparatory for post-graduate practice. An ILP considers a resident’s interests, learning needs, supports, electives, and other learning experiences through training. ILPs often use I-SMART (important, specific, measurable, attainable, relevant, and timely) goals that are remedial, aspirational, or both.^2-4

Why are ILPs Important?

Individualized learning plans foster development in master adaptive learning (MAL) through the cycle of planning-learning-assessing-adjusting.⁵ ILPs allow residents reflective practice, a critical component of adult learning theory, and offer faculty structure to discuss learning needs, both the needs that excite the resident and those that do not. Importantly, ILPs structure elective experiences in which residents can bolster weaknesses or explore new or in-depth learning.

When and Where are ILPs Relevant?

Resident creation of ILPs relate to the ACGME Family Medicine Milestones 2.0 Practice-Based Learning and Improvement Sub-Competency 2 “Reflective Practice and Commitment to Personal Growth” and to Professionalism Sub-Competency 3 “Self-Awareness and Help-Seeking Behaviors.”⁶ When used thoughtfully and continuously throughout residency, residents may focus on their paths both professionally and personally. When required for everyone, the ILP process acknowledges that all residents have areas of strength and areas of opportunity—not just those who on the surface need additional support. This approach focuses attention on areas where challenged learners may benefit from concrete goal-directed plans. This way, ILPs allow for specific assessment for each resident, assuming everyone progresses at different paces.

The ACGME requires development and monitoring of ILPs at least annually. Because ILPs can accommodate short, intermediate, and long-term goal planning, programs may choose to do so more frequently, perhaps on a semi-annual or quarterly basis. Particularly in situations with challenged learners, plans may require more frequent assessment and revision.

Who Creates an ILP?

ILPs should ideally be created by the resident, with assistance from faculty and input from the program CCC and PD. Creation by the resident allows critical self-analysis of progress for both personal and professional goals. Residents and faculty should be allowed protected time to create, use, and monitor ILPs. The current focus on ILPs comes at a time when some educators have noted that residents want a checklist of what must be accomplished and an ILP is not a checklist. Rather, it can be used to provide guidance on strategically homing in on the experiences a resident will need for their future practice.

How is an ILP Created, Used, and Monitored?

ILPs are iterative. The basic elements of an ILP are (1) reflection on long-term career goals and self-assessment of strengths and opportunities, (2) goal generation, (3) development of strategies to achieve the goals, (4) tracking or progress toward the goals, and (5) revision of goals/strategies or generation of new goals.⁷ Though templates for ILPs exist, some programs may prefer to adapt these or devise their own for their local use. ILPs can be recorded on paper, electronically, or in web-based format using word processing, spreadsheet, or forms applications. Regardless of format, ILPs should flex to allow for residents at various levels and with distinct learning styles or needs with a plan for regular evaluation with a faculty coach or advisor. Simply having a method to track progress toward achieving learning goals is a prime characteristic associated with successful use of an ILP.⁸

Self-directed, lifelong learning is critical for medical professionalism and ILPs are one way to teach MAL for family medicine residents. The Association of Family Medicine Residency Directors is developing resources for PDs around ILPs. Other resources for PDs have been provided by the Society for Teacher of Family Medicine in the CBME Toolkit⁹ and The American Association of Medical Colleges faculty development module.¹⁰

Although the ILP may seem initially to be daunting to undertake, it is a wonderful opportunity. The ILP provides residents, faculty, and PDs an opportunity to ensure reflection, guidance, and growth.