Page 62 - Medical students’ self-regulated learning in clinical contexts

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We believe our results are likely to be largely transferable within our Dutch educa onal context. However, as previously described, social rela onships are highly dependent on culture,30 and na onal culture may in uence medical curricula.31 It is therefore likely that our ndings regarding the roles of others and their importance on students SRL would be di erent in other cultures.
Implica ons for prac ce and future research
The ways in which faculty and others in a clinical context can support undergraduate clinical students’ SRL are s ll largely under researched. However, our results do provide an insight in how social in uences a ect students’ SRL. Our ndings hint for possible ways to support undergraduate students’ SRL in a clinical context.
First of all, our ndings strengthen the believe that expec ng novice students to fully self-regulate their learning in a new environment may be very di cult for many. Thus, novice may bene t from sca olding ac ve support by others. Our results also show novice students report rarely interac ng with consultants. In this context, faculty development ini a ves may therefore be er be focused on residents to enable them to e ec vely support students’ SRL. The importance of residents and peers for students’ learning in a clinical context has been described before, regarding role modelling and social comparison.18,32 Our results emphasize this importance even more (especially for novice students) because students reported peers and residents have the largest impact on their goal se ng, opportuni es, SRL strategies and self- re ec on. Perhaps most importantly, a student’s transi on from a novice ‘pinball’ to an experienced ‘snowball’ and subsequent SRL in a clinical context appears to result from feeling comfortable in a clinical context and facilitates working towards personal goals. Therefore suppor ng students’ SRL in a clinical context could be improved by lengthening student placements in a clerkship, following principles of longitudinal integrated clerkships and early clinical encounters. This enables students to nd their way in the culture of the community, including the vocabulary, reduce the stress of transi ons, help novice students’ understand their role, and ul mately help students become part of the health care team.28,33–35
We suggest future research should focus on gaining a be er understanding of how students transi on into clerkships and how they navigate clinical communi es of prac ce of a clinical context, for instance using ethnographic methodologies. This could help us understand how students start to learn like an experienced student even further. A longitudinal study design could increase our understanding of this transi on and may shed some light on how best to support the individual student