Clearing the confusion about self-directed learning and self-regulated learning

Studying the effectiveness of self-directed education in learning and teaching the otolaryngology module in an integrated-based curriculum

Introduction

Self-learning is a learning process in which students harvest the enterprise, to express their learning goals, choose assets for learning, practice learning strategies, and assess the outcomes achieved. Many forms of self-learning were introduced in integrative medical curricula such as Team-based learning (TBL) and Problem-based learning (PBL). This study aims to evaluate self-learning in the otolaryngology module and determine the type of self-learning that students prefer and which of these types has a stronger impact on achieving the educational objectives of the module.

Material and methods

A cross-sectional study was done on the 270 students of studied the otolaryngology module in three consecutive years representing the whole class of the fifth-year medical students along three consecutive years. A Likert scale questionnaire was distributed to measure the students' satisfaction with the current teaching and learning.

Results

The obtained results revealed higher students 'satisfaction with TBL than other modalities supported by high achievement in TBL-related questions. In addition, there is a significant difference between TBL and PBL (p = .00044). No significant differences were obtained either between TBL and CBL (p = .16570) or between TBL and Seminar presentation (p = .16570). In addition, no significant correlations were obtained between PBL and CBL (p = .34677), between PBL and seminar presentation (p = .46496), and between CBL and seminar (p = .99967).

Conclusion

The results showed that the highest students' satisfaction was towards TBL compared to other educational methods. These results encourage clinical educators to insert and implement TBL in most of the integrative curriculum modules, especially that of the clinical years.

Nurses' self-regulated learning in clinical wards: Important insights for nurse educators from a multi-method research study

Central in nurse education curricula stands the preparation of future nurses to work in quickly evolving, dynamic, clinical wards. Learning in the flow of work plays a pivotal role in initial nurse education, but also during continuous professional development. To drive their ongoing development, nurses need competency in self-regulation of learning (SRL). Despite the importance of SRL in the clinical workplace for all (future) healthcare professionals, research on self-regulated workplace learning (SRwpL) of nurses and future nurses in clinical wards is underdeveloped. This study aims to enhance the conceptual understanding of SRwpL strategies and practices in clinical nursing wards and to offer insights for designing effective educational interventions supporting the facilitation and development of (future) nurses' SRwpL in the clinical ward. A multi-actor, multi-method perspective was adopted to qualitatively investigate SRwpL strategies nurses engaged in. Nurses were observed and interviewed, but also professionals responsible for ongoing development in clinical wards (the ward's head nurses and learning counselors) were interviewed. The data collection took place before the COVID pandemic. Results reveal self-regulatory strategies conditional for SRwpL in addition to strategies initiating, progressing, and evaluating the learning process. Head nurses and learning counselors report a lack of these conditional strategies and little variation, and sporadic engagement in all other self-regulatory strategies. To enhance (future) nurses' SRwpL, we suggest that clinical supervisors from educational institutions could exert a lasting influence by not only educating student nurses, but also fostering further professional development of counselors and head nurses to scaffold the SRwpL processes of future nurses in clinical wards.

In experts' words: Translating theory to practice for teaching self-regulated learning

INTRODUCTION

Health professions education (HPE) should help students to competently self-regulate their learning, preparing them for future challenges. This study explored the perspectives of expert self-regulated learning (SRL) researchers and practitioners on the practical integration of SRL theories into teaching.

METHODS

An exploratory qualitative research study was conducted involving semi-structured interviews with acknowledged research leaders in the field of SRL and/or experienced professionals dedicated to teaching SRL strategies for complex skills in different disciplines. The data were analyzed using an iterative thematic approach guided by a six-step framework.

RESULTS

Fifteen interviews were conducted with experts from six countries representing diverse contexts, cultures, and disciplines. We identified five themes related to translating theory to practice for teaching SRL in HPE: theoretical issues, cultural aspects, stakeholders' participation, teaching complexity, assessment, and feedback.

CONCLUSIONS

This study presents a useful starting point for teaching SRL. The experts suggest a supportive learning environment with the guidance of competent teachers by using general and task-specific teaching and learning strategies, as well as sufficient sources and cycles of feedback, all tailored to the culture and context. These findings call for a shift in faculty development programs to foster teachers to support second-order scaffolding in HPE.

Twelve tips for integrating medical students into specialty clinics

The specialty clinic is an excellent educational environment for medical students. However, preceptors face several challenges as they seek to balance treating complex system-specific conditions with effective teaching, including time constraints, clinical tasks, engaging multi-level learners, and perhaps a lack of guidelines for or training in outpatient medical education. We thus propose twelve tips for integrating medical students into specialty clinics in a feasible and mutually fulfilling way. The first three tips focus on planning the session and setting expectations, the next seven tips detail specific, actionable strategies for enhancing learning while maximizing efficiency, and the final two tips discuss how to optimally close the session with feedback and debriefing.

The potential of structured learning diaries for combining the development and assessment of self-regulated learning

Structured Self-Regulated Learning (SSRL) diaries have the potential for combining the development and assessment of a student's SRL processes over time. The aim of this study was to evaluate the extent to which an SSRL diary can develop SRL and provide a reliable longitudinal assessment of SRL development in academically low-achieving undergraduate medical students. We conducted a quasi-experimental study with low-achieving medical students at Tehran University of Medical Sciences. The intervention was a weekly SSRL diary, with 21 items in two parts (before and after studying) that was integrated with weekly explicit SRL training. A repeated measures ANOVA was performed to assess the participants' SRL development across time. We conducted generalizability theory analysis in two designs; the first was to assess the reliability of the total diary score in assessing low-achieving medical students' SRL and the second was to assess the efficacy of the four-week intervention results in improving the low-achieving medical students' SRL. Each participant (n = 20) completed four SSRL diaries. There were significant positive changes during the intervention in the students' measures of total SRL, time estimation of study, time spent on study, concentration, elaboration, organization, self-monitoring, and self-evaluation. The absolute and relative generalizability coefficients for the first design, which indicates the reliability of the students' SRL scores, were 0.71 and 0.77. The absolute and relative generalizability coefficients for the second design, which presents the reliability of the improvement of students' SRL across time were 0.79 and 0.87. The results of this study suggest that SSRL diaries combined with explicit training can provide an effective and reliable method for combining the development and assessment of SRL in low-achieving medical students' SRL over time.

Self-directed learning assessment practices in undergraduate health professions education: a systematic review

PURPOSE

The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.

METHODS

Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.

RESULTS

Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001).

CONCLUSIONS

The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

Attitudes towards and engagement in self-directed learning among paramedics in New South Wales, Australia: a cross sectional study

BACKGROUND

Australian paramedics must engage in continuing professional development (CPD), including self-directed learning (SDL). This study aimed to examine paramedics' attitudes towards training and learning activities and perceptions about what could increase engagement in self-directed CPD.

METHODS

A cross-sectional survey was conducted with New South Wales Ambulance paramedics. The 48-item survey examined learning attitudes, attitudes towards SDL and socio-demographic and professional characteristics.

RESULTS

Most of the 149 participants (19% consent rate) were male (74.5%) and worked full-time (96.5%). All participants agreed that paramedics should reflect on the quality of their practice (100%) and most were committed to undertaking learning to improve their skills and capability (95.2%). However, 26.3% of participants did not feel motivated to undertake learning and 58.9% did not feel supported. Paramedics reported neutral to modestly positive attitudes towards SDL. Most participants agreed they would be more likely to engage in SDL if they had access to training equipment at their station (91%) and dedicated time during work hours (90.4%).

CONCLUSION

Paramedics are highly committed to undertaking CPD. Increased engagement may be supported by providing SDL materials at work locations and ensuring dedicated time for learning during work hours.

Structured interviews on self-regulated learning strategies of medical students in the final year of medical school

BACKGROUND

In the final year of medical school, the educational focus is on experiences in the clinical environment. This is where students acquire most of their practical knowledge for their future career and need to optimise their Self-Regulated Learning (SRL) strategies. Hence, the current study aims to explore which SRL strategies medical students use during their clerkships in different learning settings.

METHODS

Structured interviews were conducted between May 2019 and December 2020 with 43 medical students during their final year in Munich, Germany. The students were surveyed about their SRL strategies. The transcribed data were thematically analysed using the measurements Strategy Use (SU) and Strategy Frequency (SF).

RESULTS

Interview data were organized into 11 SRL strategy categories. The most used SRL strategy in general was "seeking information in the internet in form of a text" (SU: 1; SF: 2.605), with an e-learning tool; followed by "seeking social assistance from doctors" (SU: 0.977; SF: 1.884), and "seeking information in books" (SU: 0.884; SF: 1.419). There were differences in the usage of SRL in different learning contexts between female and male students. For example, 95.3% of students are "seeking social assistance from doctors" when having difficulties on the ward, but only 55.8% when they need help with written tasks (e.g. medical letter). The results show a difference in SRL usage when preparing for oral-practical (79.1% books) and written (97.7% e-learning tool) exam. However, it also appears that some students do not have SRL strategies for certain situations, mostly due to a lack of time.

CONCLUSION

Medical students in the clinical phase are adapting their SRL strategy to the learning situation. To better support students´ SRL, it is necessary to ensure availability for their preferred resources: e-learning tool and experienced physicians as supervisors. Future research should focus on strategies to handle the limited time during clerkships.

A mixed methods exploration of the emergence of goal orientation in medical students' individualized learning plans

PURPOSE

Goal orientation (GO) describes an individual's approach to different achievement situations. Understanding the motivations and approach to achieving goals of medical students is vital with the increasing emphasis on self-directed learning. The purpose of this study was to identify themes in self-improvement reflections that relate to each GO dimension (learning, performance-prove, and performance-avoid).

METHODS

A sequential explanatory mixed methods design was used. GO data was used to categorize students into groups aligning with the GO dimension identified in the previous stage of quantitative analysis. Individualized learning plans (ILPs) for each GO dimension group were coded inductively to identify emergent themes related to goal setting and achievement.

RESULTS

The learning GO group was the largest of the three GOs. Five themes were identified from inductive analysis: importance of practice, identifying elements that helped, identifying structural barriers, opportunities for improvement, and acknowledging experience. While these themes occur across GO, patterns exist within their ILPs based on GO.

CONCLUSIONS

We identified common themes for motivations of medical students, and these motivations might differ depending on their GO. Further exploration into the themes over the course of their training will provide additional insights on what factors may be involved in student motivations towards learning and achievement. Educators can use this information to individualize feedback and students can better understand their motivations towards achieving goals.

Development of self-regulation amongst dental students in problem-based learning curricula: A qualitative study

AIMS

To explore the value of problem-based learning in the development of self-regulation amongst undergraduate dental students.

MATERIALS AND METHODS

A qualitative approach using focus groups was used to explore the perceptions and experiences of the participants regarding the role of problem-based learning (PBL) in promoting self-regulation in undergraduate dental education. The study was carried out at a newly established dental institution in Qatar. Purposive sampling technique was used to recruit the participants. Invitations to potential participants were sent by e-mail through appropriate professional channels. All focus groups were transcribed verbatim, and data were imported into NVivo 12 and analysed thematically.

RESULTS

A total of five focus groups were conducted with 37 participants which included 27 females and seven males from two different cohorts. Participants expressed their views on a range of issues related to the self-regulation in problem-based learning and also provided recommendations to enhance the learning experiences of students. PBL was perceived to be an appropriate and effective strategy to support student autonomy in construction of knowledge and developing problem-solving and interpersonal skills. However, the workload of the students can impact adversely on their motivation and time management skills.

CONCLUSIONS

This study provides useful insights into the concept of self-regulation in problem-based learning environments as perceived by the stakeholders at a newly established dental institution. The findings of this study may offer clarity on how problem-based learning can be best utilised to promote self-regulation in undergraduate dental education.

Examining pre-service teachers regulation in distance and traditional preschool design and technology education

The significance of adapting to a rapidly changing world is quite evident in the current day; thus, the awareness of how to teach students so that they can be ready to face challenges in the future is very important. Early education has a huge impact on the further development of children, so preschool teachers must be competent and use appropriate teaching and educational methods. In this study, the development of self-directed learning (SDL) of future preschool teachers is investigated by considering two variables, namely the type of study (full-time and part-time students) and the learning modalities caused by the COVID-19 pandemic (pre-, during and post-COVID-19 confinement). We collected data from 418 participants and analysed them using descriptive statistics, 2 × 3 factorial analysis of variance (ANOVA) and a two-step cluster analysis. The results show the status of pre-service preschool teachers' perceptions of their SDL development and how the variables influenced it. There were significant differences in the students' self-reported SDL skills, depending on the learning environment and the type of study. The status indicator helps educators identify and change the curriculum and how they work with students. It allows the faculty to highlight the positive aspects of the different educational modalities encountered, as well as the characteristics of the study types and their impact on the learning process to improve students' SDL skills. The results of the study may help in the design of tailored metacognitive scaffolds that take into account different modalities. Further studies are needed to investigate the effectiveness of digital open learning environments that address both SDL and preschool educational practices.

How does portfolio use affect self-regulated learning in clinical workplace learning: What works, for whom, and in what contexts?

INTRODUCTION

Portfolio use to support self-regulated learning (SRL) during clinical workplace learning is widespread, but much is still unknown regarding its effectiveness. This review aimed to gain insight in the extent to which portfolio use supports SRL and under what circumstances.

METHODS

A realist review was conducted in two phases. First, stakeholder interviews and a scoping search were used to formulate a program theory that explains how portfolio use could support SRL. Second, an in-depth literature search was conducted. The included papers were coded to extract context-mechanism-outcome configurations (CMOs). These were synthesized to answer the research question.

RESULTS

Sixteen papers were included (four fulfilled all qualitative rigor criteria). Two primary portfolio mechanisms were established: documenting as a moment of contemplation (learners analyze experiences while writing portfolio reports) and documentation as a reminder of past events (previous portfolio reports aid recall). These mechanisms may explain the positive relationship between portfolio use and self-assessment, reflection, and feedback. However, other SRL outcomes were only supported to a limited extent: formulation of learning objectives and plans, and monitoring. The partial support of the program theory can be explained by interference of contextual factors (e.g., system of assessment) and portfolio-related mechanisms (e.g., mentoring).

DISCUSSION

Portfolio research is falling short both theoretically-in defining and conceptualizing SRL-and methodologically. Nevertheless, this review indicates that portfolio use has potential to support SRL. However, the working mechanisms of portfolio use are easily disrupted. These disruptions seem to relate to tensions between different portfolio purposes, which may undermine learners' motivation.

Supporting Self-Directed Learning: Development of a Faculty Evaluation Scale

Construct: We sought to assess medical education faculty members' ability to support students in the development of self-regulated learning skills. Background: It is broadly agreed that medical students should become self-directed lifelong learners to succeed as physicians. To that end, many instruments have been developed that measure student attributes of self-directed learning (SDL). By contrast, no such analogous valid instrument is available to assess faculty familiarity in pedagogical strategies to promote SDL among students. Approach: An item bank with 45 items was created and its content-related validity evaluated by a panel of twenty experts. The items were selected and validated in the framework of Item Response Theory (IRT). The unidimensionality of all items within four constructs was assessed by using modified parallel analysis and 2 parameter IRT model calibration. The final version of the Recognition of Learning-Oriented Teaching Strategies (RoLOTS) instrument was validated by using the IRT marginal reliability as well as 2PL model calibrations. Different Item Functioning (DIF) in student-educators and gender was examined. Findings: The final version of RoLOTS included 20 items, with five in each of four subdomains: building content knowledge; the emotional and motivational aspects of learning; leveraging the social nature of the learning process; and metacognitive processes that promote student regulation of the learning process. Construct validity and reliability of each of the four domains were well supported by the results. Significant DIF was not detected in student-educator and gender. Conclusions: The RoLOTS successfully evaluated whether a faculty member is familiar with pedagogical tools to promote medical students' self-directed learning, which can be used as a first step in needs-based professional development. Further research is needed to provide more validity and reliability evidence among groups with diverse SDL experience.

The life raft to keep students afloat: Early detection, supplemental instruction, tutoring, and self-directed remediation

PROBLEM DESCRIPTION

To decrease delayed graduation and student dismissal, we developed a systematic process to identify and intervene with students with academic challenge across the first three years of the curriculum.

QUALITY IMPROVEMENT METHODS

Four strategies were implemented to support student academic success: early identification of academic challenge, supplemental instruction, tutoring, and remediation. Outcomes were tracked through the number of students requiring remediation, academic performance during remediation, and changes in delayed graduation and academic dismissal.

RESULTS OF CQI INQUIRY

The number of students requiring remediation has decreased each year since implementation in 2017 to 2020 (54, 36, 30, and 21, respectively). The rate of successful remediation has ranged from 72% to 87%. Strategies to support student success have resulted in decreased delayed graduation and academic dismissal.

INTERPRETATION AND DISCUSSION

Commitment to academic success was a culmination of resources to support students, including the investment in an academic performance specialist and paid supplemental instructors. A focus on student success has led to awareness of additional strategies that may be employed to enhance the student support program. These include creating a culture of no shame for receiving academic support and mandating some activities for students who do not maintain a minimum threshold.

CONCLUSIONS

A holistic approach to academically support students that included preventive and interventional strategies was successful in decreasing delayed graduation and academic dismissal.

I don't think that means what you think it means: Why precision in lifelong learning terminology matters to medical education

ISSUE

Medical educators share the belief that fostering the development of lifelong learning skills is a fundamental task for teachers and learners in all stages of a physician's education: undergraduate medical education, graduate medical education, and continuing medical education. A significant challenge to developing and implementing best practices in lifelong learning is the varied interpretation and application of its related terminology, such as 'self-directed learning' in this context.

EVIDENCE

This paper discusses the scholarly origins of key terms in lifelong learning ('self-directed learning' and 'self-regulated learning') and explores their commonalities and their common conflation.

IMPLICATION

The authors propose a renewed attention to precision in use of lifelong learning terminology in medical education across the spectrum as a way to best design and deploy impactful educational experiences for learners at all levels.

The Learning Loop: Conceptualizing Just-in-Time Faculty Development

BACKGROUND

As technology advances, the gap between learning and doing continues to close-especially for frontline academic faculty and clinician educators. For busy clinician faculty members, it can be difficult to find time to engage in skills and professional development. Competing interests between clinical care and various forms of academic work (e.g., research, administration, education) all create challenges for traditional group-based and/or didactic faculty development.

METHODS

The authors engaged in a synthetic narrative review of literature from several unrelated fields: learning technologies, medical education/health professions education, general/higher education. The aim for this review was to synthesize this pre-existing literature to propose a new conceptual model.

RESULTS

The authors propose a new conceptual model, the Just-In-Time Learning Loop, to guide the development of online faculty development for just-in-time delivery.

CONCLUSIONS

The Just-In-Time Learning Loop is a new conceptual framework that may be of use to those engaging in online, digital learning design. Faculty developers, especially in emergency medicine, can integrate leading concepts from the technology-enhanced learning field (e.g., microlearning, micro-credentialing, badging) to create new types of learning experiences for their end-users.

Computer aided self-regulation learning and cognitive training improve generalization ability of patients with poststroke cognitive impairment

Emerging studies suggest the application of self-regulation learning (SRL) to improve generalization abilities in poststroke patients. SRL has been proposed to have an added effect on computer-aided cognitive training (CACT). This study aimed to examine the efficacy of an intervention combining computer-aided SRL (CA-SRL) training and CACT for generalization abilities and cognitive function in patients with poststroke cognitive impairment (PSCI). A total of 75 patients recruited from a rehabilitation centre were randomly assigned to a CA-SRL group, demonstration learning (DL) group and traditional learning (TL) group. Finally, 72 patients were included in the analysis. Over 3 weeks, the patients in these three groups underwent CA-SRL or DL training combined with cognitive training. After the intervention, all outcomes significantly improved (P < 0.05). The CA-SRL group showed better improvements in all trained tasks among the groups, especially in "wash the dishes" and "change the bed". The results of the analysis for generalization abilities showed that CA-SRL group patients obtained the highest scores among the groups in untrained tasks. The mean changes in the Montreal Cognitive Assessment in both the CA-SRL and TL groups were significantly higher than those in the DL group (P < 0.001, P = 0.002) after adjusting for education level and Lawton Instrumental ADL Scale score. In general, the combination of CA-SRL and CACT is effective for PSCI patients and has a better effect on promoting skill generalization from cognitive gains than traditional training.

Co-constructive Patient Simulation: A Learner-Centered Method to Enhance Communication and Reflection Skills

INTRODUCTION

In simulation sessions using standardized patients (SPs), it is the instructors, rather than the learners, who traditionally identify learning goals. We describe co-constructive patient simulation (CCPS), an experiential method in which learners address self-identified goals.

METHODS

In CCPS, a designated learner creates a case script based on a challenging clinical encounter. The script is then shared with an actor who is experienced working as an SP in medical settings. An instructor with experience in the model is involved in creating, editing, and practicing role play of the case. After co-creation of the case, learners with no prior knowledge of the case (peers or a supervisor) interview the SP. The clinical encounter is followed by a group debriefing session.

RESULTS

We conducted 6 CCPS sessions with senior trainees in child and adolescent psychiatry. Topics that are difficult to openly talk about may be especially appropriate for the CCPS model-without overt guidance or solicitation, the scripts developed by learners for this series involved: medical errors and error disclosure; racial tensions, including overt racism; interprofessional conflict; transphobia; patient-on-provider violence; sexual health; and the sharing of vulnerability and personal imperfections in the clinical setting.

CONCLUSIONS

Co-constructive patient simulation provides an alternative multistage and multimodal approach to traditional SP simulation sessions that can adapt iteratively and in real time to new clinical vicissitudes and challenges This learner-centered model holds promise to enrich simulation-based education by fostering autonomous, meaningful, and relevant experiences that are in alignment with trainees' self-identified learning goals.

A story half told: a qualitative study of medical students' self-directed learning in the clinical setting

BACKGROUND

Medical educators have promoted self-directed learning (SDL) as an important means of enabling students to take responsibility for their own learning throughout their training and practice. While SDL has been well-studied in classroom settings, it remains a story half told: barriers to and facilitators of SDL in the clinical setting are not yet well described. The goals of this study were to explicate student experiences of SDL in their clinical training and to identify the roles that local social and cultural contexts play in shaping their experiences of SDL.

METHODS

To understand students' conceptualization and experiences of SDL in the clinical setting, we carried out a qualitative study with 15 medical students at Harvard Medical School. The semi-structured interviews were recorded and transcribed. Using an interpretivist approach, data were analyzed both deductively and inductively using the Framework method of content analysis.

RESULTS

Participants described patient care activities as primary motivators for engagement in SDL in the clinical setting. Participants' descriptions of SDL aligned with Knowles' steps in SDL, with an additional step of consolidation of learning related to their patients' diagnosis and management. Participants described using a range of cognitive, social-emotional, and peer learning strategies to enhance their SDL. Participants who described a growth mindset appeared to engage in SDL more easily. Learning environments that fostered SDL were those in which faculty and residents demonstrated an educational orientation, promoted psychological safety, and invited student engagement. Teams with perceived excessive work demands were perceived to be less supportive of SDL.

CONCLUSIONS

Our study enhances previous classroom-based models of SDL by providing specific, practical implications for both students and faculty in the clinical training setting. Participants described SDL in the clinical setting as patient-centered, and when effectively implemented, SDL appears to support a mastery rather than performance orientation. Our study paves the way for improving medical students' clinical SDL and helping them become lifelong learners in the field of medicine.

Supporting Self-Directed Learning: A National Needs Analysis

INTRODUCTION

It is broadly agreed that physicians must be self-directed learners, and many studies measuring medical student readiness and capacity for self-directed learning (SDL) have been reported. However, less attention has been paid to faculty tasked with guiding students to develop SDL skills. In an effort to determine whether faculty feel equipped to foster SDL, a needs assessment was developed.

METHODS

The faculty needs assessment for fostering SDL (FNA-fSDL) was constructed and distributed nationally to medical educators. Faculty perceptions of the value of SDL, administration support, and faculty development were queried. Items also measured faculty recognition of cognitive, affective, and metacognitive strategies shown to cultivate SDL. Descriptive statistical analysis and frequency comparison tests to identify potential group differences related to work responsibility, classroom/clinical setting, and level of learner served were performed.

RESULTS

Among the 359 respondents representing diverse areas of medical education, there was overwhelming agreement that physicians in training should be self-directed learners and that faculty require training in educational approaches promoting SDL. Faculty were more likely to recognize strategies supporting development of metacognitive skills and least likely to identify those related to cognitive aspects of learning. Fewer than half of faculty had received training in fostering SDL at their home institutions or at conferences.

DISCUSSION

While there is strong support for the development of SDL among learners, these results suggest most faculty do not feel sufficiently trained to accomplish this goal. The FNA-fSDL can be used by institutions to assess their own faculty.

Relationship Between Undergraduate Nursing Students' Self-directed Learning and Training Demands for Nursing Information Systems: A Cross-sectional Study

Self-directed learning refers to an approach to acquiring knowledge and skills in which learners take responsibility for themselves. Currently, it is a feasible way to familiarize with nursing information systems, which are essential components of hospital information systems and widely used in clinical nursing. This study assessed undergraduate nursing students' self-directed learning of nursing information systems and explored influencing factors, using a cross-sectional design and a convenience sample. Participants voluntarily completed a general information questionnaire, a training demands questionnaire for nursing information systems, and the Self-rating Scale for Self-directed Learning, which measured the level of self-directed learning. A total of 353 valid surveys were analyzed, among which 51.8% agreed with the necessity of mastering nursing information systems. Nursing students present a moderate level of self-directed learning, with an advantage in interpersonal skills and a deficiency in learning activities. Students' training demands, confidence in using nursing information systems in clinical practice, attitude toward nursing as a career, and academic performance were identified as predictors of self-directed learning for nursing information systems. Future cross-national research, studies about other factors, and ways to improve formal education are needed.

An innovative MOOC platform: the implications of self-directed learning abilities to improve motivation in learning and to support self-regulation

Purpose

Massive open online courses (MOOCs) have received wide publicity and many institutions have invested considerable effort in developing, promoting and delivering such courses. However, there are still many unresolved questions relating to MOOCs and their effectiveness in a blended-learning context. One of the major recurring issues raised in both academic literature and in the press about MOOCs is the consistently high dropout rate of MOOC learners.

Design/methodology/approach

In this study, we applied mixed methods as an exploratory case study, which prioritised the quantitative and qualitative approaches for the data collection processes. The data were collected using a MOOC Online Self-regulated Learning Questionnaire (MOSLQ) adapted and created from an existing measuring instrument. The quantitative data was analysed using Statistical Package for the Social Sciences (SPSS Version 22) tool to conduct descriptive analysis. The qualitative results obtained from the transcribed focus group interviews in this study revealed the various behavioural patterns of how undergraduate students self-directed their learning. This focus group interview was conducted to reveal the various ways students organised and strategised their learning patterns in order to derive satisfaction in their distinctive learning behaviours and encourage motivation within their study approaches. Quantitative data collected online included a 30 items survey of which 17 respondents completed the survey items in the blended-learning study. The online course survey included 19 items of which data were gathered from 11 respondents.

Findings

Across the data, it is noticeable and clear that time management and goal setting were among the dimensions that are highly rated close to high level among SRL skills investigated in this study. We found that goal setting and task strategies predicted much better attainment of individuals controlling personal course goals, while help seeking was associated with lower goal attainment among majority of the participants.

Research limitations/implications

The study also identified several challenges. For example, there were some challenges in learners completing the survey questions even when several reminders were sent out forth nightly. At this preliminary stage, learners participated as lurkers without engaging fully with other non-academic and academic interactive activities such as surveys, in course quizzes and forums. Most of the participants in this course said they enrolled to know more about the new trend MOOC, to make friends, to have fun and so on. Although, these are some of their intentions for participating, some of the participants at some points contributed to discussion forums.

Practical implications

Our platform currently allows learners to direct their learning within the course and also allow the choice of content prerequisite in order to recommend resources necessary for their learning. This study indicates the necessity to support SRL skills and directing development of self-determination skills among the participants. This study when applied to a larger sample will demonstrate effective measurement on areas of reliability and validity as results from this small sample has indicated some high SRL skill levels for individual learners within the research.

Social implications

However, the success of any e-learning or MOOC platform should consider the following best practices and objectives: the learners' entire learning experience, the strategies used in developing the course content, the planning of the course delivery and the methods of delivery. Therefore, all e-learning platforms should be designed with a primary focus on the way students learn to improve their own learning skills and help them regulate their own independent learning habits. In another related study, the success of any e-learning course implementation should be carefully considered with regards to the course's underlying pedagogy and how learners engage with the content.

Originality/value

There are many e-learning platforms in existence globally, but little has been mentioned about the development of a MOOC platform in general that could allow independent learning and also adequately demonstrating the components and features used in these MOOC designs. This research's implication is to aid instructional designers to apply best practices in the development of an online course. The best approach in designing a good course is to consider the learners and how they could engage with the course resources independently and develop the ability to self-direct their learning. One of the main goals of e-learning platforms is primarily based on developing learning resources that would be suitable for linear course structure as directed by the course developer or instructor.

Using multiple self-regulated learning measures to understand medical students' biomedical science learning

CONTEXT

Understanding self-regulated learning (SRL) is complicated due to the different measures used to identify the key SRL processes. There is a growing trend in applying event measures of SRL (microanalysis and trace) but aptitude measures (questionnaires) continue to be widely used in medical education. A major concern is whether aptitude measures are a valid approach to capture the dimensions of SRL processes. This study examined correlations between SRL microanalysis, SRL trace and the Motivated Strategies for Learning Questionnaire (MSLQ) and how these measures were associated with biomedical science performance.

METHODS

An SRL microanalysis assessment interview was administered to 76 first-year medical students individually when performing a biomedical science learning task. All written materials by students were collected for further trace analysis. Students completed an MSLQ 2 weeks before completing their biomedical science course. Correlation analyses were used to determine the correlations between the three SRL assessment measures. Bivariate and multiple analyses were conducted to compare students on different course or task performance using the three SRL assessment measures.

RESULTS

Microanalytic metacognitive monitoring (κ = 0.30, P < .001) and causal attributions (κ = 0.17, P = .009) had statistically significant correlations with use of the SRL trace strategy. MSLQ self-efficacy correlated with microanalytic self-efficacy (r = .39, P = .001). Bivariate tests showed that microanalytic metacognitive monitoring, causal attributions and adaptive inferences, and SRL trace strategy use had significant associations with task performance (P < .05). Microanalytic self-efficacy, metacognitive monitoring and causal attributions, SRL trace strategy use and MSLQ self-efficacy had significant associations with course performance (P < .05). Measures of use of the SRL trace strategy and MSLQ subscales did not show significant associations with task and course outcomes in multiple analyses (P > .05).

CONCLUSIONS

Event measures, specifically SRL microanalysis, had greater associations with both task and course outcomes compared with the MSLQ measure. The SRL microanalysis is recommended for the assessment of SRL in biomedical science learning. However, to fully understand medical students' SRL a multidimensional assessment approach that combines event and aptitude measures should be used.

Contributions of Positive Psychology in Self-Regulated Learning: A Study With Brazilian Undergraduate Students

Self-regulated learning (SRL) is an important factor for academic success. The present study aimed to investigate the relationship between constructs typical of positive psychology (PP; self-esteem, self-efficacy, affects, life satisfaction, optimism, and hope) and SRL while indicating the explained variance of these constructs in an SRL model. The study comprised 1,046 undergraduate students from 63 public higher education institutions from all demographic regions of Brazil. Significant correlations (p < 0.01) were found between SRL and all PP variables. Moderate correlations were found with self-efficacy and positive affects. The linear regression analysis indicated that one model explains 41.9% of the variance in SRL. The data are discussed based on the potential of PP and SRL interventions to improve academic performance and student adaptation to higher education environments.

Does changing from a teacher-centered to a learner-centered context promote self-regulated learning: a qualitative study in a Japanese undergraduate setting

BACKGROUND

Previous studies indicate that a teacher-centered context could hinder undergraduates from self-regulated learning (SRL), whereas a learner-centered context could promote SRL. However, SRL development between a teacher-centered and a learner-centered context has not directly compared in undergraduate settings. Also, it is still unclear how a contextual change toward learner-centered learning could influence SRL in students, who are strongly accustomed to teacher-centered learning.

METHODS

We conducted three focus groups that examined 13 Japanese medical students who left a traditional curriculum composed of didactic lectures and frequent summative tests and entered a seven-month elective course (Free Course Student Doctor or FCSD). The FCSD emphasizes student-designed individualized learning with support and formative feedback from mentors chosen by students' preference. We also conducted two focus groups that examined 7 students who remained in the teacher-centered curriculum during the same period. Students were asked to discuss their 1) motivation, 2) learning strategies, and 3) self-reflection on self-study before and during the period. Data were analyzed using thematic analysis and code comparison between the two cohorts.

RESULTS

The non-FCSD participants described their motivational status as being one among a crowd set by the teacher's yardstick. Their reflection focused on minimizing the gap between themselves and the teacher-set yardstick with strategies considered monotonous and homogeneous (e.g. memorization). FCSD participants described losing the teacher-set yardstick and constructing their future self-image as an alternative yardstick. They compared gaps between their present status and future self-image by self-reflection. To fill these gaps, they actively employed learning strategies used by doctors or mentors, leading to diversification of their learning strategies.

CONCLUSIONS

A contextual change toward learner-centered learning could promote SRL even in students strongly accustomed to teacher-centered learning. In the learner-centered context, students began to construct their self-image, conduct self-reflection, and seek diverse learning strategies by referring to future 'self' models.

Onramp to Scholarship: Putting Clinical Faculty Members on the Path to Academic Productivity

Many faculty members in the health professions who come from a clinical background lack the research experience to produce original scholarship. Most faculty development programs focus on supporting individual projects, which helps faculty members who are already pursuing an intellectual question to locate useful resources. Those programs provide limited benefit, however, to faculty members without an identified academic project. An independent, health sciences graduate school designed and implemented a solution to create scholarship groups in which early career faculty members joined ongoing projects led by an experienced investigator. Groups presented internally at a midyear check-in and an end of the academic year poster session. Of the four groups launched in September 2017, three pursued systematic reviews or analyses of existing data. At the end of 9 months, all 4 groups had drafted a manuscript for peer review. Collectively, members of the group had made five poster presentations at national or international conferences and hosted one continuing education workshop. The experience suggests that collaborative projects are a viable form of faculty development to enhance scholarly productivity. Borrowing from the postdoctoral model of scientific mentoring, early career faculty members sacrifice some autonomy of intellectual pursuits in exchange for expert guidance. Senior investigators invest time in coaching novice researchers in exchange for additional intellectual labor and perspectives.

Successful completion of clinical electives - Identification of significant factors of influence on self-organized learning during clinical electives with student focus groups

Background: The Medical Licensure Act prescribes a total of four months of clinical electives in which the medical students are to work in a self-organized manner in outpatient and inpatient care. Since no specific learning objectives or learning content are given and students come into contact with different structures of outpatient and inpatient care, the learning success in a clinical elective is often rather random. In order to make self-organized learning (SOL) in clinical electives as effective as possible, we identified factors in the area of inpatient care that have an influence on SOL and thus the learning success during a clinical elective. Methods: To investigate this question a qualitative and explorative approach was chosen. In 2015, a total of 21 students from semester 1 to 11 participated in six semi-structured focus group discussions at Hamburg Medical Faculty. In these, the students were asked about their experiences and expectations with regard to SOL in clinical electives. The interviews were transcribed literally and analyzed using Grounded Theory in parallel to further data collection. Results: Three main categories were identified, which had an impact on SOL in clinical electives, each with two sub-categories: People (elective students and physicians), learning itself (learning content and learning process) and the framework (local conditions and organizational structure). For example, elective students exhibiting openness and self-initiative as well as a good working atmosphere and few hierarchical structures were conducive to SOL, while shyness and lack of integration into the ward's medical team inhibited SOL. A mentor formally assigned to the student can promote SOL through guidance, supervision and the transfer of responsibility. Continuous feedback from mentors or peers promotes SOL. Framework conditions, such as a smooth administrative organization, also affect SOL, but elective students have limited influence over these. Conclusion: The creation of suitable framework conditions and considering the needs of the people involved in clinical electives and the requirements of learning itself are necessary steps in order to enable successful SOL during clinical electives. Suitable framework conditions could be compiled and widely disseminated on an empirical basis. Training for teachers and elective students on various aspects of clinical electives, from professional behavior to practical skills, could be a suitable preparatory measure to promote SOL in clinical electives and contribute to a better learning success of the elective students.