Page 96 - Medical students’ self-regulated learning in clinical contexts

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Methods
Se ng
We conducted this study in the Academic Medical Center in Amsterdam, the Neth- erlands, between December 2014 and April 2015. Students in the clinical phase of undergraduate medical educa on were eligible to par cipate (year four to six in an undergraduate-entry program). The preclinical curriculum is a block-based curricu- lum, with ver cal integra on of preclinical and clinical sciences and horizontal inte- gra on of basic knowledge and skills into a clinical context. Clerkships consist of 13 discipline-based rota ons in clinical departments, outpa ent clinics and community se ngs, las ng for two to ten weeks.
Par cipants
Considering the importance of the interac on between individual and context for self-regulated learning behavior, we aimed for maximum variability by including stu- dents who were enrolled in various stages of the clerkships in either the academic hospital, its a liated regional hospitals or in a community se ng.13 We only included students who had par cipated in more than three di erent clerkships, because we assumed it takes me and experience for students to gain insight in their own SRL behavior in the clinic. We set no speci c exclusion criteria. Eligible students were approached in groups to par cipate. These groups were based on date of ini al en- rolment in the clerkships, represen ng varying stages of advancement through the clerkships to ensure diversity in experience, and on current enrollment in di erent clerkship special es to ensure diversity in the current learning context. There is no de nite number of par cipants required in a Q-methodology study. In general, 40 to 60 par cipants is considered to be adequate.20, page 73 However, because we sam- pled groups of students rather than individuals and we wished to minimize the risk of missing a less prevalent behavior pa ern, we aimed for a higher number of ap- proximately 75 par cipants out of a total of approximately 800 eligible par cipants. Groups of students were approached one a er another either by email or in person to invite them to par cipate in the study un l we had reached our aim of approxi- mately 75 par cipants. As an incen ve, a lo ery decided which two students won a gi cer cate.
Q-methodology
The Q-methodology has been used before in the context of medical educa on.22–25 It uses features of both qualita ve and quan ta ve methods for the systema c in- ves ga on of subjec ve issues.20,21,26 It is important to include par cipants who rep-