Page 139 - Medical students’ self-regulated learning in clinical contexts

First of all, we found that to study learning in a complex context such as a clinical one, it can be very insigh ul to take a holis c approach. Qualita ve research can shed some light on how a large number of in uences plays a role in the process of learning. Besides more tradi onal methodologies such as interviews and focus groups, visual methodologies have been used much too infrequently because for instance they may allow making tacit things explicit.61,62 Longitudinal designs will most likely provide us with some very valuable insights. A longitudinal study on how students develop self- regulated learning throughout clinical training and whether pa erns in self-regulated learning behavior are stable, or more varying over me, seem especially promising. However, also a more quan ta ve approach to studying self-regulated learning in clinical contexts can be taken. For instance, by linking self-regulated learning behav- ior in clinical contexts to learning outcomes or future performance as a physician. Microanalysis protocols for iden fying and quan ca on of self-regulated learning processes seem especially promising.42,43,63,64
Speci cally interes ng study objec ves include all the aspects I described in the prac cal implica ons sec on. It would be interes ng to see if students can be bet- ter prepared for self-regulated learning in clinical contexts, for instance by having a preclinical curriculum put more emphasis on the importance of self-regula on. For advancing individual sca olding of students’ self-regulated learning in clinical con- texts, it would be interes ng to study this from a faculty perspec ve. Do supervisors recognize students’ self-regulated learning? How can they recognize pa erns in stu- dents’ self-regulated learning? And what should supervisors do to best sca old the support needed by individual students? Future research is also required to establish what residents need to best support (novice) student learning because the associ- ated skills will poten ally be bene cial for them throughout their en re career.
I conclude with the issues I believe are most important for students’ SRL in clinical environments and the e ects of which should be studied in closer detail in future research. First of all, star ng o with some longer las ng clerkships, decreasing the number of rota ons, could support students’ SRL.50,55 It would be interes ng to study in what way they are implemented best; for instance, is one long four to six month rota on at the start enough to help students become experienced in SRL in clinical contexts, or do longitudinal integrated clerkships also have a bene cial e ect on stu- dents’ SRL later in clinical undergraduate medical educa on? Secondly, how to use and support legi mate peripheral par cipa on in clinical communi es of prac ce to bene t SRL needs to be studied in more detail. Do longitudinal integrated clerk-
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Chapter 6 General Discussion