Page 13 - Medical students’ self-regulated learning in clinical contexts

ra onale for this thesis
“The object of educa on is to prepare the young to educate themselves throughout their lives.”
- Robert Maynard Hutchins
Paradigm shi s have been happening in medical educa on in the last century or so, and in the past few decades these have been accelera ng. One prime example is how the teacher-centered approach on educa on has slowly shi ed towards a more student-centered approach to learning. A century ago, philosopher John Dew- ey started to advocate that educa onal processes should build on the interests and knowledge of students, on an individual level, through thinking and doing.1,2 He envi- sioned that teachers should be facilitators in the process of learning, rather than just a source of knowledge in the process of teaching. This call for educa onal change was adopted by many educators and slowly shi ed the educa onal paradigm from teacher- to student-centered learning.3 A call for educa onal change also resulted in new approaches to educa on such as problem-based learning and competency- based learning.4 The paradigm shi towards a student-centered teaching approach is slowly progressing, with recent re ec ons on medical educa on s ll calling for a stronger student-centered approach, in which the curriculum is more exible to cater to students’ individual needs.5 Student-centered educa onal paradigms rely on ac ve learning and on learners taking responsibility for their own learning. In medi- cal educa on, this student-centeredness has also made its way into clinical train- ing. Guidelines stress the importance of tailored objec ves for students learning in a clinical context.6 Naturally, this change also involves great consequences for learners’ and teachers’ daily prac ce.
Nowadays, (future) doctors are trained in hospitals, clinics, and community health centers, by a team of sta members instead of a single preceptor. Consequently, the master-appren ce rela onship has disappeared. Parallel to the decline in the master-appren ce rela onship, the rise of competency-based medical educa on and the subsequent call for more exible educa on have resulted in students and ju- nior physicians increasingly being hold responsible for their own learning process.7–9 To do this, future doctors need to have personal objec ves, be able to monitor their progress, and use assessment and feedback to self-evaluate and take responsibility for their own development.10
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General introduc on Chapter 1