Page 14 - Medical students’ self-regulated learning in clinical contexts

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Being responsible for one’s learning is closely related to becoming an e ec ve life- long learner because in life-long learning doctors also need to be able to monitor their performance, decide on areas for improvement, and set goals for themselves. Competencies that are important for life-long learning, such as re ec ng, have been integrated in competency frameworks such as the CanMEDS,11 the ACGME core com- petencies,12 and Tomorrow’s Doctors13 in one way or another. Because doctors need to master the competencies necessary to control one’s own learning, these compe- tencies should be taught, assessed and fostered in (under)graduate medical educa on.
Various theories have been used to describe how people may direct their own learn- ing, including experien al learning theories, re ec ve learning theories, and life-long learning theories.14 Many of these theories are closely aligned to construc vism and topics discussed in adult learning.15 As learning in clinical contexts takes place in a context with many compe ng tasks and curricular requirements, learners need to take responsibility for their learning within these contexts in a way that works best for them. Self-regulated learning (SRL) theories focus on learning within a given task, in a certain context and its boundaries.16
The self-regulated learning theore cal framework
The various processes of SRL have been theorized by scholars from di erent elds of research. This includes self-regula on theories17,18 from educa onal psychology, but also control theory from cyberne c engineering,19 self-e cacy theory from clinical psychology,20 and goal-se ng,21,22 ac on regula on,23,24 and resource alloca on theo- ries25 origina ng from industrial and organiza onal psychology. As a result, SRL theo- ries describe a broad variety of processes that are ac vely regulated by students in order to strive towards achieving personally set goals. A widely used de ni on of SRL overarching the di erent theories is that: “Self-regulated learning is the modula on of a ec ve, cogni ve, and behavioral processes throughout a learning experience to reach a desired level of achievement”.26 All SRL theories also entail that learning is an ac ve process which originates from a goal, rather than from a task in self-directed learning theories,16 and from feedback in re ec ve learning theories.14
Sitzmann and Ely performed a literature review and meta-analysis of SRL. They con- cluded that di erent theories on SRL describe processes that can be categorized as: regulatory agents (goal se ng), regulatory mechanisms (planning, monitoring, metacogni on, a en on, learning strategies, persistence, me management, envi- ronmental structuring, help-seeking, mo va on, emo on control, and e ort) or reg- ulatory appraisals (self-evalua on, a ribu ons, and self-e cacy).26 They also noted