Beyond the self: The role of co‐regulation in medical students’ self‐regulated learning

Abstract

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.

Resident learning trajectories in the workplace: A self‐regulated learning analysis

“…These interpretations expand on emerging research on how SRL unfolds in the clinical workplace, where residents, peers, nearpeers (e.g. fellows) and their supervisors have been shown to help learners set goals relatively well, 46 but not necessarily to appraise why their progress might falter and how they can adapt their plans accordingly. 18,19 Given this state of the evidence, we suggest that future research on self-regulation and co-regulation of workplace learning moves beyond studying how learners describe factors influencing their experiences of SRL, and expands toward studying how their experiences aggregate over time to build into personal learning trajectories.…”

“…45 Instead, the authors of many recent studies of workplace learning choose to use grounded theory methods without integrating SRL theories and principles into their sensitising concepts. 17,46 Our findings demonstrate that a transition to using theories that emphasise the social and co-constructed nature of learning need not occur at the expense of social-cognitivist models, such as triadic reciprocality. Instead, we argue that researchers must continue to capitalise on the many pre-existing theories for studying SRL from cognitivist 10 to sociocultural perspectives.…”

Limited effects from professional identity formation-oriented mentoring on self-regulated learning in a preclinical setting: a randomized-controlled study in Japan

“…Professional identity formation as a promoting factor of SRL Recent research has focused on professional identity formation (PIF) as a factor promoting SRL [4,[16][17][18][19][20][21][22][24][25]. According to Cruess et al professional identity is de ned as "a representation of self, achieved in stages over time during which the characteristics, values, and norms of the medical profession are internalized" [16, p1447].…”

The regulation of learning in clinical environments: A comment on ‘Beyond the self’

“…If so, is it regulated by others or by the self? In this issue of Medical Education , Bransen et al report on a study in which they interviewed clinical students about their perceptions of learning . The authors demonstrate that students progress through three interrelated shifts during their clerkships in an intricate interplay between self‐regulated learning (SRL) and co‐regulated learning (CRL).…”

“…The authors demonstrate that students progress through three interrelated shifts during their clerkships in an intricate interplay between self‐regulated learning (SRL) and co‐regulated learning (CRL). They conclude that: ‘workplace learning, including development of SRL, always occurs in interaction with others, and that student SRL always involves engagement in CRL.’ As a result, they stress that educators need to: ‘focus on facilitating and organising learners' engagement in co‐regulated learning from the start of the curriculum.’…”