Self-regulated learning in medical education

Self-regulated learning is about cognitive and metacognitive parts of learning as well as about motivational and emotional parts. Medical students need high competences in self-regulated learning, not only in the academic setting, e.g. while learning for exams, but also in the clinical practical setting when facing real-life situations. Many students struggle to transition from an academic setting to a clinical practical setting and some struggle even later when they are already familiar with the clinical practical setting. While there is a considerable body of research on students self-regulated learning with the focus on knowledge acquisition in an academic setting, little attention has been paid to medical students self-regulated learning in the clinical practical setting. We aim to fill the gap in our understanding of self-regulated learning in the clinical practical setting by following a comprehensive theoretical and methodological approach. The project will go beyond the state-of-the-art by (a) specifying an model for self-regulated learning in the clinical practical setting, (b) developing a diary, which is a novel data collection approach in research on self-regulated learning, and (c) applying a quantitative longitudinal study to learn more about the state and developmental components of self-regulated learning in addition to the trait component in the clinical practical setting. We will develop the model and the diary together with students and teachers by using a citizen- science approach. To analyse the trait, state, and developmental component of self-regulated learning we will use quantitative longitudinal diary data. Our work will provide a solid foundation for accurate interventions for students transitioning from the academic setting to the clinical practical setting. If the trait component of self-regulated learning is the most important, research should focus on individual differences and address interventions suitable for different types of learners. If the state component is the most important in the clinical practical setting, more situation-specific intervention elements should be investigated and implemented. If the developmental component is the most important, research should focus on stages of self-regulated learning in the clinical practical setting and on appropriate intervention elements. If there is no single dominant component but two, or if all three components are relevant, a mixture of intervention elements could be most effective.

Health sciences students need to be able to learn well on their own, not only in the classroom or in preparing for exams but also in the workplace where they encounter real-life situations. Our project focused on self-regulated learning (SRL) for acquiring competences in real-world settings. We (a) created a model of SRL at the workplace, (b) came up with a new way of collecting SRL data using a diary, and (c) looked at how SRL changed over time. What's more, the students and teachers involved in the project said that stress was important for learning at work. We added studies, where we (d) identified different types of students based on how stressed they felt at the workplace, and (e) investigated the relationship between stress and SRL. The most important results are: (1) A new model for SRL at the workplace including cognitive, motivational, emotional and contextual aspects at both the learning process level (acquiring knowledge and skills) and the metalevel (reflecting about the learning process). (2) We have developed new scales and single items to assess the SRL aspects. (3) A step-by-step plan for doing diary studies in educational setting. (4) How well students regulate learning depends mostly on the situation but also on stable characteristics of the person or workplace and on development over time. (5) There is a gradual decline in the cognitive, motivational and emotional aspects of learning over the course of the week. This decline can be counteracted by a positive learning environment. (6) Four different stress-groups were found among the students. Most students felt stressed by high workloads. (7) Stress and SRL are interrelated. High stress in one week impairs SRL at the workplace in the following week. Thinking and reflecting about learning in one week reduces stress in the following week. Our project advanced health sciences education research by including a psychological point of view. The results can help disentangling the sub-processes of learning at the workplace. What's more, we expanded the theory and research on SRL from learning in academic settings to learning in real-life settings. We focused on competence, which means we looked at knowledge as well as practical/motor skills. Finally, our project also brought together two research areas that were previously separate: SRL and stress. We were able to understand how SRL and stress interact in more detail by doing a study that looked at how things change over time. This project followed an interdisciplinary approach by integrating educational psychology research and health sciences education research. The project was transdisciplinary because it integrated not only a researcher perspective on SRL at the workplace but also a teacher- and student perspective.