Context Medical students are expected to self‐regulate their learning within complex and unpredictable clinical learning environments. Research increasingly focuses on the effects of social interactions on the development of self‐regulation in workplace settings, a notion embodied within the concept of co‐regulated learning (CRL). Creating workplace learning environments that effectively foster lifelong self‐regulated learning (SRL) requires a deeper understanding of the relationship between CRL and SRL. The aim of this study was therefore to explore medical students’ perceptions of CRL in clinical clerkships and its perceived impact on the development of their SRL. Methods We conducted semi‐structured interviews with 11 purposively sampled medical students enrolled in clinical clerkships at one undergraduate competency‐based medical school. Data collection and analysis were conducted iteratively, informed by principles of constructivist grounded theory. Data analysis followed stages of open, axial and selective coding, which enabled us to conceptualise how co‐regulation influences the development of students’ self‐regulation. Results Data revealed three interrelated shifts in CRL and SRL as students progressed through clerkships. First, students’ CRL shifted from a focus on peers to co‐regulation with clinician role models. Second, self‐regulated behaviour shifted from being externally driven to being internally driven. Last, self‐regulation shifted from a task‐oriented approach towards a more comprehensive approach focusing on professional competence and identity formation. Students indicated that if they felt able to confidently and proactively self‐regulate their learning, the threshold for engaging others in meaningful CRL seemed to be lowered, enhancing further development of SRL skills. Conclusions Findings from the current study emphasise the notion that SRL and its development are grounded in CRL in clinical settings. To optimally support the development of students’ SRL, we need to focus on facilitating and organising learners’ engagement in CRL from the start of the medical curriculum.

The necessity for healthcare professionals to regulate their learning is widely acknowledged due to positive associations with highquality healthcare and lifelong learning. 1,2 For example, safeguarding high standards in healthcare requires physicians to monitor relevant developments in continuously and rapidly changing healthcare practices and to align appropriate learning opportunities with personal learning needs and learning goals. 3 Hence, physicians have to engage in self-regulated learning (SRL) to develop and maintain competence. 4 Generally, self-regulated learners are considered to be "meta-cognitively, motivationally, and behaviourally active participants in their own learning". 5 In pursuit of and committed to their goals, they design and implement strategies aligned with these goals, monitor progression towards these goals, followed by reflection and -when applicable -formulation of new learning goals. 6,7 Because of its relevance for education and practice, and as SRL skills can be learnt and therefore taught, health professions curricula build in elements to support and facilitate the development of students' SRL. [8][9][10] For example, many curricula implement portfolio systems that stimulate or require students to reflect on progress and formulate personal learning plans, 11 or include problem-based learning principles to stimulate students' self-directedness. 12,13

Introduction Recent conceptualizations of self-regulated learning acknowledge the importance of co-regulation, i.e., students’ interactions with others in their networks to support self-regulation. Using a social network approach, the aim of this study is to explore relationships between characteristics of medical students’ co-regulatory networks, perceived learning opportunities, and self-regulated learning. Methods The authors surveyed 403 undergraduate medical students during their clinical clerkships (response rate 65.5%). Using multiple regression analysis, structural equation modelling techniques, and analysis of variance, the authors explored relationships between co-regulatory network characteristics (network size, network diversity, and interaction frequency), students’ perceptions of learning opportunities in the workplace setting, and self-reported self-regulated learning. Results Across all clerkships, data showed positive relationships between tie strength and self-regulated learning (β = 0.095, p < 0.05) and between network size and tie strength (β = 0.530, p < 0.001), and a negative relationship between network diversity and tie strength (β = −0.474, p < 0.001). Students’ perceptions of learning opportunities showed positive relationships with both self-regulated learning (β = 0.295, p < 0.001) and co-regulatory network size (β = 0.134, p < 0.01). Characteristics of clerkship contexts influenced both co-regulatory network characteristics (size and tie strength) and relationships between network characteristics, self-regulated learning, and students’ perceptions of learning opportunities. Discussion The present study reinforces the importance of co-regulatory networks for medical students’ self-regulated learning during clinical clerkships. Findings imply that supporting development of strong networks aimed at frequent co-regulatory interactions may enhance medical students’ self-regulated learning in challenging clinical learning environments. Social network approaches offer promising ways of further understanding and conceptualising self- and co-regulated learning in clinical workplaces.

When is self‐regulated learning not entirely self‐regulated? The authors argue SRL is socially embedded and we need better measurement of its reciprocal relationship with co‐regulated learning.

Background Self-regulated learning is a key competence to engage in lifelong learning. Research increasingly acknowledges that medical students in clerkships need others to regulate their learning. The concept of “co-regulated learning” captures this act of regulating one’s learning by interacting with others. To effectively cultivate such skills in students, we need to increase our understanding of co-regulated learning. This study aimed to identify the purposes for which students in different phases of clinical training engage others in their networks to regulate their learning. Methods In this social network study, we administered a questionnaire to 403 medical students during clinical clerkships (65.5% response rate). The questionnaire probed into the composition of students’ co-regulatory networks and the purpose for which they engaged others in specified self-regulated learning activities. We calculated the proportion of students that engaged others in their networks for each regulatory activity. Additionally, we conducted ANOVAs to examine whether first-, second-, and third-year students differed in how they used their networks to support self-regulation. Results Students used others within their co-regulatory networks to support a range of self-regulated learning activities. Whom students engaged, and the purpose of engagement, seemed to shift as students progressed through clinical training. Over time, the proportion of students engaging workplace supervisors to discuss learning goals, learning strategies, self-reflections and self-evaluations increased, whereas the proportion of students engaging peers to discuss learning strategies and how to work on learning goals in the workplace decreased. Of all purposes for which students engaged others measured, discussing self-reflections and self-evaluations were consistently among the ones most frequently mentioned. Conclusions Results reinforce the notion that medical students’ regulation of learning is grounded in social interactions within co-regulatory networks students construct during clerkships. Findings elucidate the extent to which students enact self-regulatory learning within their co-regulatory networks and how their co-regulatory learning behaviors develop over time. Explicating the relevance of interactions within co-regulatory networks might help students and supervisors to purposefully engage in meaningful co-regulatory interactions. Additionally, co-regulatory interactions may assist students in regulating their learning in clinical workplaces as well as in honing their self-regulated learning skills.