Page 150 - Medical students’ self-regulated learning in clinical contexts

teen semi-structured interviews with students we discovered there were large dif- ferences between students. ‘Novice students’ o en had a small social network that a ected their SRL, mainly consis ng of residents and peers. More ‘experienced stu- dents’ on the other hand had a larger social network and were able to engage more people in their SRL. Experienced students generally re ected on transi oning from a novice student to an experienced student a er three to six months into their clerk- ships. However, not all students appeared to make this transi on, and some students learned like an experienced student from the onset of the clerkships.
In chapter 4 we wanted to gain more insight in how a person and a clinical context in- teracted to in uence a students’ SRL. We analyzed data of 17 semi-structured inter- views with students of two Dutch medical schools, aided by the “Day Reconstruc on Method”. We found that students’ SRL was a ected di erently in every individual. SRL was in uenced by four major factors: the speci c goals students perceived, the autonomy they experienced, the learning opportuni es they were given or created themselves, and the an cipated outcomes of an ac vity. All of these factors were in turn a ected by personal, contextual and social a ributes in a complex and inter- twined fashion. Students’ SRL did not only follow a planned cyclical pa ern as des- cribed in many SRL theories, but also a reac ve, opportunis c, chao c pa ern not necessarily ini ated by goal se ng. This likely resulted from learning opportuni es which could suddenly present themselves at any given me in a clinical context.
A er gaining an insight in how students’ SRL happens in a clinical context, we wanted to improve our understanding of what a ect this has on students’ actual SRL behav- ior. Therefore, in chapter 5 we presented a study using Q-methodology to see wheth- er we could iden fy pa erns in students SRL’ behavior in clinical contexts. We had 74 par cipants sort 52 statements about SRL behavior to represent which behav- iors best described their SRL. A er analyzing the Q-sorts of the 74 par cipants we were able to iden fy ve characteris c pa erns in SRL behavior, which we named: engaged, cri cally opportunis c, uncertain, restrained and e or ul. These pa erns described how students approached SRL and helped iden fy strengths and poten al pi alls for students who’s SRL followed a certain pa ern. This provided us with the insight that students who portray di erent pa erns of SRL behavior require di erent types of contextual support to maximize learning.
Finally, in chapter 6 I provided a general discussion about the ndings presented in this thesis. In this chapter I interpreted our ndings by combing results of the studies presented in the other chapters, placed them within a larger theore cal framework,
148