Page 134 - Medical students’ self-regulated learning in clinical contexts

132
therefore used a broad focus of a department in chapter 2, studied students’ self- reported SRL behavior in clerkships in general in chapters 3 and 5, and narrowed chapter 4 to describe SRL in a single day of a student.
The studies reported in this thesis have limita ons and cau on must be used when interpre ng the ndings. First of all, the studies have taken place in one western European country. Therefore the ndings may not be easily transferrable to other contexts. It is for instance likely that the major factors in uencing SRL reported in chapter 4, such as autonomy, may not present in the same way in other cultures with stronger hierarchy. Similarly, I believe that pa erns in SRL behavior will exist everywhere, however the content of these pa erns might be very di erent in other se ngs and cultures than the pa erns reported in chapter 5. The same is true for how rou nes in clinical departments and social interac ons in uence students’ SRL. Moreover, our results should also not be generalized directly to other stages of clini- cal training (e.g. early clinical experience, postgraduate, or sta ’s lifelong learning). It is also unknown whether our results are transferrable for other health professions learning in clinical contexts such as nursing students and physiotherapy students. Addi onally, we know the pedagogy used in a bachelor curriculum in uences SRL. We included students from two universi es using di erent preclinical pedagogical approaches in chapter 4 but not in the other studies reported in this thesis. None of the par cipants in the studies presented in chapter 2, 3, and 5 were trained to self- regulate their learning. Therefore, it is likely that students who are, such as those ed- ucated in a problem-based learning pedagogy, would have responded di erently to the ques ons we asked. These students might not have a similar need for structure in their environment as some of the students in chapter 2 had, but bene t from more autonomy. Another clear limita on is that our studies are solely based on self-report. This is insuperable because SRL also entails mental processes, but is a limita on as many studies have shown self-report and self-assessment may be unreliable.33–37As we have only used students as par cipants we do not know whether faculty and oth- ers view students’ SRL similarly. It might be that sta do not recognize students’ SRL at all. Because this is s ll unclear, we have to be cau ous with making sugges ons about how students’ SRL could be supported by others. Lastly, we have iden ed many ways in which students’ SRL can be in uenced. However, we did not study which of these in uences’ e ect is largest or should be addressed most urgently.