How clinical medical students perceive others to influence their self-regulated learning

Abstract

ObjectivesUndergraduate medical students are prone to struggle with learning in clinical environments. One of the reasons may be that they are expected to self‐regulate their learning, which often turns out to be difficult. Students’ self‐regulated learning is an interactive process between person and context, making a supportive context imperative. From a socio‐cultural perspective, learning takes place in social practice, and therefore teachers and other hospital staff present are vital for students’ self‐regulated learning in a given context. Therefore, in this study we were interested in how others in a clinical environment influence clinical students’ self‐regulated learning.MethodsWe conducted a qualitative study borrowing methods from grounded theory methodology, using semi‐structured interviews facilitated by the visual Pictor technique. Fourteen medical students were purposively sampled based on age, gender, experience and current clerkship to ensure maximum variety in the data. The interviews were transcribed verbatim and were, together with the Pictor charts, analysed iteratively, using constant comparison and open, axial and interpretive coding.ResultsOthers could influence students’ self‐regulated learning through role clarification, goal setting, learning opportunities, self‐reflection and coping with emotions. We found large differences in students’ self‐regulated learning and their perceptions of the roles of peers, supervisors and other hospital staff. Novice students require others, mainly residents and peers, to actively help them to navigate and understand their new learning environment. Experienced students who feel settled in a clinical environment are less susceptible to the influence of others and are better able to use others to their advantage.ConclusionsUndergraduate medical students’ self‐regulated learning requires context‐specific support. This is especially important for more novice students learning in a clinical environment. Their learning is influenced most heavily by peers and residents. Supporting novice students’ self‐regulated learning may be improved by better equipping residents and peers for this role.

Context matters when striving to promote active and lifelong learning in medical education

“…Such a need for relatedness has never been described in SRL theories, but makes sense when combined with self‐determination theory. In one of our studies on SRL in clinical contexts, the importance of relatedness and relationships for SRL was also evident . Just like SRL, relatedness is inextricably linked to context, because to have a sense of relatedness other people need to be present.…”

“…Therefore context includes what people do in a context, the roles that people have in a context, interpersonal relationships, and the physical context in which learners learn. This results in a context that is not static but rather flexible, emergent, dynamic and changing, and can be interpreted differently by individuals . This explains why learners in different contexts may engage in active learning very differently.…”

Tying knots: an activity theory analysis of student learning goals in clinical education

“…Typically, learning goal programmes or individualised learning plans are examined in relation to how they help trainees develop into more self‐regulated lifelong learners, sometimes termed ‘master learners’ . Previous analyses of SRL have shown that the social environment provides important feedback and support for learners . However, these studies have not demonstrated how both learners’ and supervisors’ actions can change as they collaboratively seek to reconcile the challenges of work with learning goals.…”

Expanding the definition of learning: from self to social to system

“…Indeed, several investigations have found collaborative dialogue to be essential for successful implementation of ostensibly SRL educational interventions whether they be clerkship student learning goals or resident individualised learning plans . Berkhout et al . showed that as learners became more experienced in workplace learning, their pursuit of SRL became increasingly collaborative with supervisors.…”