Background: The transition from a traditional lecture-based curriculum to a competencybased curriculum poses significant challenges to both students and faculty in medical schools, especially when the curriculum is implemented in a flipped learning environment. Self-regulated learning (SRL) has been proven to be beneficial for competency-based learning and flipped classroom learning, but medical educators cannot expect our entering medical students to bring in these learning skills automatically. Methods: This study took place in the Michigan State University College of Human Medicine. A new competency-based curriculum was implemented in the fall 2016, focusing on the integration of basic science and clinical experience. Participants in this study were 26 firstand second-year students. By interviewing each student about the learning strategies they use in independent learning before class, we investigated how students use SRL strategies in different phases of learning, and how their adoption of SRL strategies differ across selfperceived achievement groups and years. Results: We found that students frequently use strategies in the stages of planning and reflection, but less frequently during the learning or monitoring phase. Students who perceive themselves as high achieving, and students in their second year of medical school do use more learning strategies during the monitoring stage than their counterparts. Conclusions: Students who lack self-regulation strategies may fail to comprehend or connect ideas in their pre-class learning, which could lead to ineffective learning outcomes during inclass activities. Our study indicated that while medical students, who tend to be successful learners in their undergraduate study, were able to use learning strategies to plan and reflect on their learning, they need more explicit instruction in how to monitor their own learning.
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