Page 47 - Medical students’ self-regulated learning in clinical contexts

introduc on
Students are prone to struggle with learning in clinical contexts, especially when transi oning from preclinical to clinical medical educa on. 1–3 Students may have a hard me understanding what they can expect and what is expected of them, resul ng in high levels of uncertainty.4 In a clinical context which is not primarily designed for teaching and learning, students are no longer told what exactly to learn, and are expected to take control of their own learning.3 Being expected to engage in so-called self-regulated learning (SRL), poses a large challenge to undergraduate medical students.5
In SRL, an individual proac vely modulates a ec ve, cogni ve and behavioral processes, to direct learning in order to achieve a desired level of competence.6 This includes goal se ng, emo on control, environment structuring, gathering feedback and self-re ec on.6,7 Many educators and researchers agree on SRL being bene cial for learning.8,9 Following Brydges and Butler’s situated model of SRL, SRL results from a complex process that happens in the interac on between an individual and the context in which learning takes place.9 Consequently, both individual and context in uence the process and outcome of SRL.10 Therefore, SRL is known to be di cult in a hec c, ever changing context, such as a hospital.11
A broad variety of contextual factors, including historical, cultural, pedagogical, physical and social factors, have been described to in uence students’ SRL.6,11–15 From a socio-cultural perspec ve, workplace based learning is a social process and consequently social factors are essen al.16 Social factors that have been described to in uence students’ SRL include other people in a workplace, students’ rela onships with them, students’ familiarity with them, the feedback they give to students, the willingness of other people to create possibili es for students to engage in SRL and prac ce independently, these peoples’ experience and mo va on for teaching, the engagement of students in the team and the social support students receive from the team.9,11,13 Previous research has focused on speci c aspects of social factors in uencing student learning in a clinic, such as how students use peers to compare their performance and build on others to develop an iden ty in a clinical context.17–19 However, to our knowledge there have not been any studies on how others in uence the process of self-regulated learning in clinical contexts, including goal se ng, various regulatory mechanisms and regulatory appraisals.6
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How clinical medical students perceive others to in uence their self-regulated learning
Chapter 3