Page 136 - Medical students’ self-regulated learning in clinical contexts

134
To aid iden ty development in medical educa on it is also vital to make it an explicit part of a curriculum.5 Students need to be engaged in discussions about what it is to be a doctor and about their clinical experiences, to facilitate students’ own under- standing of who they are.12 Lastly, students’ iden ty as a doctor-to-be is mainly de- veloped in clinical contexts. As iden ty development happens through interac ons with others, it is important for clinical contexts to iden fy and be aware of the mes- sages they portray through their daily rou nes. These are o en shaped by underlying uno cial rules, implicit values, beliefs and a tudes.12
Enhancing individual support in a clinical context
Suppor ng students’ SRL requires individual support because all students are di er- ent and have di erent needs. I would therefore like to advocate for individualized support for students’ SRL in a clinical context. Especially students new to a context may experience di culty with self-regulated learning. Novice, insecure students may require help with se ng learning goals for their SRL naviga ng the context, and plan- ning learning in a clinical context as showed in chapter 5 because they are unsure of what to expect. Addi onally, it seems plausible that especially novice students and other students, who feel insecure about their role in a clinical team, require more emo onal and metacogni ve support than others. Providing students with some sort of sca olding using a form of co-regulated learning from the onset of clinical learning, with generally decreasing support over me (both within a single clerkship and throughout the curriculum) as suggested by Brydges et al. seems a promising strategy to achieve more individualized support for SRL.1,48
Mul ple approaches can be taken when individualizing support for students’ SRL in a clinical context by co-regulated learning. A sta member can aid in a students’ SRL by engaging in discussions about a students’ learning goals, engaging in discussions about learning strategies, and by frequently asking re ec ve ques ons regarding whether set goals are met.39
Many clinical students ul mately work towards the goal of being able to func on independently as a resident. Therefore, it is important that students are able to take responsibili es similar to those of a resident, under close observa on. This allows them to self-assess performance and monitor their progress towards their goal of func oning as a resident, and ac vely self-regulate their learning whilst ge ng there. Implemen ng Entrustable Professional Ac vi es (EPA’s) in undergraduate medical educa on may support such an increase in responsibili es for students, whilst ensur- ing pa ent safety and high quality care.49