Page 111 - Medical students’ self-regulated learning in clinical contexts

Discussion
We iden ed ve dis nct pa erns in students’ self-assessed self-regulated learning behavior to learn in a clinical context. The pa erns varied widely regarding goals, metacogni on, communica on, e ort, and dependence on external guidance for learning and resulted from a complex interac on between individuals and the con- text they learn in. A clinical context is one in which it may be di cult to learn because students have a hard me knowing what they can expect and a hard me dealing with the unpredictability of a clinical context.4 This is re ected to a varying extent in all SRL pa erns by the poorly planned SRL behavior in general and limited goal set- ng speci cally.
Sitzmann and Ely concluded that SRL constructs regarding goals and self-e cacy have the largest impact on the e ect of SRL in a workplace and that metacogni ve strategies (a combina on of planning, monitoring, metacogni on and learning strat- egies), a ribu ons, e ort, me management, mo va on and environment structur- ing have a weak to moderate e ect on SRL.7 In our study, the goal se ng and high self-e cacy were most prominently notable in the engaged pa ern and largely ab- sent the uncertain pa ern. Both the engaged and the cri cally opportunis c pa erns prominently involved using metacogni ve strategies. Using a ribu ons for learning is prominent in the restrained pa ern. However by wan ng to perform, rather than learn, the e ect of SRL may be impaired. Time management and e ort on learning most prominently showed in the e ort pa ern. If the results from Sitzmann and Ely’s meta-analysis are also valid for clinical contexts, this might mean the engaged pat- tern would lead to the best learning outcomes and the use of this behavior pa ern should be encouraged.
Woods et al. have also looked at the self-regulated learning in a clinical context, speci cally the informal aspects of SRL in a surgical clerkship, and discovered three separate “approaches” to SRL.19 The rst approach: acquiescing to a lack of learning opportuni es, relates to cri cally opportunis c pa ern that we found. This approach also features a focus on contextual barriers on learning and subsequent frustra on and loss in mo va on. The second approach they found: choosing learning oppor- tuni es, covers important aspects of the restrained and e or ul pa erns we found. This approach also emphasizes how students believe a lot of e ort is required to learn in a clinical context and how they try to balance the demands their learning forms for a context and maintaining a good rela onship with residents and sta . The third approach: crea ng learning opportuni es, closely resembles the engaged pat-
109
Chapter 5 Pa erns in clinical students’ self-regulated learning behavior: a Q-methodology study