Perceived drivers and barriers to implementing self-directed learning among faculty and students of a private medical and dental institute: a convergent mixed-methods study

Given the rapid expansion of the medical knowledge base, self-directed learning (SDL) helps health professionals remain accountable for their own learning, and accrediting bodies increasingly require institutes to allocate SDL hours within the weekly schedule. This study aimed to explore the perception of SDL and to compare the enablers and barriers to its implementation among medical and dental faculty and students, and to identify recommendations for implementation. A convergent (parallel) mixed-methods study was conducted on medical and dental faculty and students of a private medical and dental college, Karachi, between August 2021 and January 2022. A comparative cross-sectional study design was used for the quantitative component. Questionnaires were administered online. Descriptive Qualitative design was used for second strand of the study where nine in-depth interviews were conducted with students and ten with faculty, principals and educationists. The chi-square test, with Fisher’s exact test where expected counts were small, was used to determine the association of academic programme/background with barriers and drivers of SDL; the Benjamini–Hochberg procedure was applied to correct for multiple comparisons. Qualitative data were thematically analyzed using an inductive approach. Questionnaires were completed by 331 students (MBBS n = 187, BDS n = 144) and 111 faculty members (medical n = 50, dental n = 61). The response rate was 74.0% for faculty (111 of 150 invited) but 41.4% for students (331 of 800), a limitation considered below. The main barrier reported by students was lack of adequate space for studying or group discussion (73.4%, n = 243) and, for faculty, the dependency of students on teachers for content (73.9%, n = 82). The major enabler identified by students was the availability of discussion rooms (74.9%, n = 248), while faculty most often endorsed awareness regarding lifelong learning and use of modern teaching strategies (each 90.1%, n = 100). Of 78 subgroup comparisons, 14 reached nominal significance and one survived Benjamini–Hochberg correction: faculty development workshops were endorsed by all medical faculty compared with 78.7% of dental faculty ( p = 0.0005, q = 0.040). Qualitative analysis yielded four themes: “To each their own”, “Facilitators”, “Challenges” and “Magic formula for success”. Integrating the strands, both groups converged on the lack of study and group-discussion space as a leading barrier and on the availability of discussion rooms as a leading enabler, each corroborated by the corresponding qualitative theme. The groups diverged on students’ dependency on teachers, which faculty ranked first among barriers but students ninth of thirteen. Although Knowles’s definition was endorsed on the questionnaire, understanding of SDL in practice was largely confined to identifying learning resources and to guided sessions. The barriers participants described were predominantly structural — an assessment-driven curriculum, fixed syllabi, limited study space and the absence of clear ownership of SDL — rather than individual. These findings indicate that allocating timetabled hours is not sufficient for implementation where SDL is introduced by mandate, and that curricular placement, assigned responsibility, assessment alignment and teacher preparation are the conditions institutions and regulators can address. Specific session formats and frequencies proposed by participants were not evaluated here and require prospective study.