Page 137 - Medical students’ self-regulated learning in clinical contexts

Lastly, chapter 2 gave us an insight in how reciprocity of e ort is vital. If students feel e ort is invested in them and into their learning, they will also invest more e ort in a clerkship. That students invest e ort into their learning is important, because as Sitzmann and Ely concluded, e ort is one of the most bene cial factors for learn- ing outcomes resul ng from SRL.19 Having students feel that a en on and e ort is invested in them and their learning can be achieved in mul ple ways. Something simple like knowing students by their name may be highly bene cial. This is also true for involving them in social ac vi es and making them feel appreciated, for instance by a periodical free lunch. Similarly, it is important educa onal sessions are not fre- quently cancelled, and students get adequate resources to learn, including frequent supervision and feedback.
Curricular improvements to enhance contextual support for students’ SRL
Combining the results of the studies presented in this thesis also sheds some light on curricular elements that can support students’ SRL in clinical contexts. The study presented in chapter 2 provided us with the insight that it is highly important for stu- dents to feel recognized as a part of the team. Students also noted how supervisors can best track their progress and grant them adequate entrustment to work inde- pendently, if they work together for a longer period of me. Addi onally, the study in chapter 3 showed how students need to learn like an experienced student who knows and understands the way in which a clinical community works. Our ndings, together with previous research, advocate for the implementa on of longitudinal integrated clerkships.50–55 Longer clerkships and longer placements in the same in- s tu on limit the number of mes students need me to se le and therefore allow more me to be spent and real learning in a clinical se ng. Dubé et al. showed the phases of transi oning into clinical learning usually take four to six months, and end in adop ng a clinical iden ty.56 Par cipants in chapter 3 talked about a similar me- frame before they started to learn like an experienced students. Therefore a long clinical placement of four to six months at the start of clerkships might be especially desirable for students rela vely new to learning in clinical contexts. Addi onally, lon- ger clerkships will result in less frequent transi ons from one department or ins tu- on to another. Literature regarding the need to reduce the number and intensity of transi ons to bene t student learning and reduce stress is abundant.57–60 Lastly, lon- ger clerkships will also make entrus ng students with responsibili es easier, because supervisors get to know what a student is capable of doing on its own.54
Besides longer clinical placements, it is also important where these placements take place and how many students are allocated to each placement simultaneously. As
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Chapter 6 General Discussion