This study examines the role of regulatory processes in medical students as they learn to deliver bad news to patients in the context of an international web-based problem based learning environment (PBL). In the PBL a medical facilitator and students work together to examine video cases on giving bad news and share their perspectives on what was done effectively and what could be done differently. We examine how regulation occurs within this collaboration. A synchronous computer-supported collaborative learning environment (CSCL) facilitated peer discussion at a distance using a combination of tools that included video-conferencing, chat boxes, and a shared whiteboard to support collaborative engagement. We examine regulation along a continuum, spanning from self- to co-regulation, in situations where medical students learn how to manage their own emotions and adapt their responses to patient reactions. We examine the nature of the discourse between medical students and facilitators to illustrate the conditions in which metacognitive, co-regulation and social emotional activities occur to enhance learning about how to communicate bad news to patients

Learning to monitor and regulate one's learning in an academic setting is a task that all students must engage in. Learning in "group" situations requires both selfand co-regulation. This research examines a case study of a small group of medical student interactions during an on-line problem based learning activity (PBL) where students learn to co-regulate their performance as they construct their understanding of how best to communicate bad news to patients. This paper introduces an approach for analyzing the group discourse to understand how collective knowledge building facilitates co-regulation. A mixed method analysis was used to analyze the case study data. A qualitative data analysis of verbal interactions was conducted to examine coregulatory episodes. Collective knowledge building was examined by analyzing the group discourse for indicators of co-regulatory processes. The study follows two quantitative analyses: a frequency count analysis of types of questions asked by facilitators and students; and a sequential pattern mining for patterns of cooccurrences of learners' discourse and co-regulation.

No abstract