Page 83 - Medical students’ self-regulated learning in clinical contexts

an cipate on posi ve outcomes when a ending these procedures. At the end of the procedure he autonomously created a learning opportunity for himself by asking the gynaecologist if he could close the opera ng wound, expec ng a posi ve outcome from asking this because the gynaecologist knew him and knew Rick was capable of doing this. Finally, he explains his self-regula ng strategy of always being ac ve in the OR to become an engaged member of team, an cipa ng posi ve outcomes by doing this, because it would enable more learning opportuni es for him in the near future.
Discussion
Our study determined the personal, contextual and social a ributes and the four factors: perceived goals, opportunity, experienced autonomy and the an cipated outcomes, that support or hamper self-regulated learning by students in the clinical workplace. Self-regulated learning in the clinical workplace is a complex process in which many di erent in uences interact, making it a highly individual, context- speci c process. This has to be taken into account both in research on self-regulated learning in a clinical context and in educa onal strategies to try and support students’ self-regulated learning. We used the three-phase model of Zimmerman as sensi zing concept for our analysis of the factors in uencing students’ self-regulated learning in the clinic. These three phases could all be retrieved in our data, though we found li le evidence for the dis nct stages as portrayed in Zimmerman’s model. Our results be er align with Butler, Car er and colleagues’ descrip on that the process is recursive, dynamic, mul direc onal and complex.36
The personal a ributes that a ect self-regulated learning were largely the same as those found in other studies, including students’ skills pertaining to regulatory mechanisms to self-regulate learning , their self-e cacy, their a tude towards learning, their previous experiences, and the task demands perceived and the a ec ve reac on to this.11,18,19,21 Contextual and social a ributes pertaining to the teacher, curriculum pedagogy, me and di erent elements pertaining to the learning climate, have already been described in literature to in uence self-regulated learning in the classroom.18,22 However, based on our ndings we emphasize that a clinical context also contains several unique a ributes in uencing the opportunity to self- regulate learning, such as: the facili es available, the interac on with pa ents, the pa ents present, social a ributes pertaining to peers and other hospital sta , the complexi es of hierarchical departments, and the engagement in a team. These contextual a ributes have not been described similarly in a classroom se ng.
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Chapter 4
Exploring the factors in uencing
clinical students’ self-regulated learning