Page 59 - Medical students’ self-regulated learning in clinical contexts

to rely on. Especially important for many experienced students’ SRL was a feeling of autonomy, ge ng increasing responsibili es in line with their goals, and being surrounded by s mula ng people.
Maggie: “In my nal clerkship it was the rst me I told pa ents the diagnosis and treatment plan. Of course that’s pre y strange. It is a real part of..., but un l the nal clerkship you don’t do that yourself, discussing the diagnosis and treatment plan. You may take a history and physical examina on, but then you return [to the consultant], explain your ndings and discuss: “well what do you think it is and how should we proceed?” “Well” says the consultant, “I would do the same thing”, but then he ends up delivering the message [...] but really I think: “well, if you agree, let the student deliver the message”.
The in uence of others such as nurses and the people in charge of making the planning, on experienced students’ SRL in a clinical context is large in comparison to novice students. Experienced students felt more a part of a clinical team and knew how to involve others in their SRL strategies. Exemplary was how experienced students would share their goals with many others, including peers, consultants and nurses, using their knowledge to discuss which strategy to use to achieve their goals.
Amy: “During my last clerkship, I discussed with one of the nurses whether an elec ve on the neonatal intensive care unit would be a smart move. Yes you talk about that [...] I nd teamwork very important so maybe that is resembled in this.”
Transi oning from novice into an experienced student
Looking back on their clerkships, many of the experienced students explained how they had changed because they gradually realized they needed to take control of their learning. Taking control of one’s learning led to more focused learning goals, using more e cient learning strategies, and asking for feedback on achieving the competencies students felt they needed. There were mul ple ways students described this process. Many experienced students explained this happened a er 3-6 months in the clerkships.
At that point they started to realize what doctor they wanted to become and set learning goals accordingly. They felt more comfortable in a clinical context and
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How clinical medical students perceive others to in uence their self-regulated learning
Chapter 3