Page 138 - Medical students’ self-regulated learning in clinical contexts

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chapter 2 showed us, highly specialized departments, long procedures, high me pressure, and a large propor on of follow-up pa ents, limit students’ perceived learning opportuni es. Many students discussed how they perceived their clerk- ships in peripheral hospitals to be much more bene cial for their learning. In these hospitals, students more easily integrated in the clinical teams because these were generally smaller, pa ent care was overall less complex allowing them to work more independently, and lastly the number of peers was generally smaller. As students expounded on in chapter 3, large numbers of peers simultaneously enrolled in a clerkship was usually a barrier to students’ self-regulated learning. It o en meant there was a limited amount of possibili es for learning and it promoted compe on between students. Compe on between students was destruc ve for peer-learning, could be detrimental for students’ mo va on and helped fuel unwanted unsupport- ive behavior. Smaller numbers of students (or at least clearly separate responsibili- es for each student) could help solve compe on issues.
Lastly, faculty development programs could be improved by including how to individ- ually support students’ self-regulated learning in clinical contexts. As we have shown in chapter 3, novice students are most suscep ble to the didac c quali es of a single supervisor. These students describe learning in a small social network in which the most prominent roles are usually ful lled by peers and residents. Therefore, it is very important to train residents in how to supervise and support students learning in the clinical context. Faculty development ini a ves focusing on student learning in clini- cal contexts should not only be catering to consultants and other faculty, but also, perhaps more importantly, to residents. Addi onally, it is important to support peer learning by having students collaborate, giving and receiving meaningful feedback, asking for advice or providing help when necessary, giving emo onal support etc. For this it is impera ve to have a safe environment for peer learning. It is therefore advisable that students have an ‘own room’ in which they can learn from each other without having anyone around who is assessing them.
Sugges ons for future research
My thesis has given us an insight in students’ self-regulated learning in clinical con- texts. However, there are s ll many ques ons that are le unanswered and even more ques ons that arose a er performing the studies presented in this thesis. Naturally, I am unable to present all possibili es for future research regarding SRL in clinical contexts. Therefore, I will present what I believe are the most promising ap- proaches for future research on this topic.