Page 112 - Medical students’ self-regulated learning in clinical contexts

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tern, where students are characterized by trying to make sure learning is maximized at every moment and is deemed favorable. In the study of Woods et al. self-re ec on and a pa ern of behavior dominated by uncertainty (pa ern 3 in our study) were not prominently addressed by the students. Our study adds to this knowledge by includ- ing pa erns in behavior regarding re ec on and feedback, and gives an insight in addi onal ways how students self-regulate their learning in a clinical context.
The pa erns we have found in SRL behavior in a clinical context also show similari- es with the “stances” in rst-year undergraduate medical educa on described by Evensen et al.29 The six separate stances they found served to govern percep ons of the students themselves and their context. The interac ve stance, which is described as being mo va onally, metacogni ve and behaviorally in charge of one’s own learn- ing, shows many similari es with the engaged pa ern. The proac ve stance, in which a student is highly mo vated and inven ve, but ina en ve to the certain a ordances of a context that could relieve burdens, shows many similari es with the cri cally op- portunis c pa ern. The retroac ve stance is closely related to the proac ve stance, but involves the use of ine ec ve learning strategies from a di erent context. This shows many similari es with the e ort pa ern where students solely rely on very high e ort to support their learning. The reac ve stance, where the students en rely relies on a context to guide their learning, has some similari es with the uncertain pa ern, however the importance of low self-e cacy and not wan ng to be a burden are emphasized even more in the pa ern we found. The transac ve stance, which is similar to the interac ve stance but includes the student wan ng to be a full and legi mate member of the team, did not clearly emerge from our data. This might be because in a clinical context students are frequently relocated, not allowing them to really become legi mate members of a clinical team. Contrarily, the stances de- scribed did not include a stance similar to the restrained pa ern. This is again likely due to context. The stances theory was developed studying undergraduate students in a PBL curriculum. These students do not yet face the challenges of hierarchy and busy schedules of a clinical context and therefore do not show a clearly restrained learning pa ern. These di erences again highlight the importance of studying SRL in context.13
Evensen et al also no ced how their stances could be related to iden ty develop- ment.29 Whilst interpre ng the pa erns resul ng from our study, we also noted a resemblance between the pa erns and theories on iden ty development. A resem- blance between iden ty development in a clinical context and our resul ng pa erns is understandable, because what students want to learn and what they nd impor-