Page 125 - Medical students’ self-regulated learning in clinical contexts

sequently, they knew what to do in pa ent care and how to learn from that. More experienced students were therefore more resilient in subop mal learning contexts and could be er cope with transi ons across rota ons.
Another signi cant nding in this thesis was how students perceived rou nes of clini- cal departments to support or hinder their possibili es to form rela onships with others in the workplace, as is remarked in chapter 2. Therefore, to support students’ SRL, it is essen al to s mulate the forma on of professional rela onships to facilitate interac ons. Forming these rela onships requires me and the possibility to collabo- rate (in pa ent care). This explains why students valued longer clinical placements to support their SRL and wanted to feel like a legi mate part of a team, for instance by including them in informal moments such as lunch and giving them responsibili- es, for instance in handovers. This gives them the opportunity to start to feel and act like a professional. Addi onally, students regarded some rou nes exercised by the people in a clinical department to indicate a lack of e ort that was invested in their learning. This lack of e ort was frequently followed by a loss in mo va on for learning by the student because of a need for a feeling of reciprocity. In other words, if students felt the people in a clinical department invested me and e ort in them, they would invest me and e ort in the clerkship. If students did not feel reciprocity of the e ort they invested in a clinical department, they were more likely to decrease the e ort they put into the clerkship. This is likely to have had a nega ve impact on learning, and not be bene cial for supervisors’ well-being and mo va on for teach- ing,3,4 resul ng in a downwards spiral.
Combining these two signi cant ndings results in the realiza on that especially nov- ice students are very suscep ble to rou nes of departments in uencing their pos- sibili es to create rela onships with others and perceiving reciprocity of e ort. For these students’ SRL, it is therefore highly important to foster a safe learning environ- ment, without rota ng them between departments too o en to enable them to de- velop themselves in a certain context. Having departmental rou nes that s mulate the crea on of professional rela onships may also facilitate students se ling into a clinical context and the transi on towards SRL like an experienced student.
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Chapter 6 General Discussion