The purpose, adaptability, confidence, and engrossment model: A novel approach for supporting professional trainees’ motivation, engagement, and academic achievement

Trainees often decide to pursue a career in the professions because they see it as a means to attain their life goals: to become the kind of person they want to be, to live the kind of life they want to lead, and to make the kind of impact they want to have on the world. The life goals trainees pursue through a professional career are derived from their conception of their ideal self and are thus the most important and self-defining goals that they possess. In this article, we propose a novel approach for designing training activities to harness the motivational potential of professional trainees’ life goals, toward supporting their deep engagement in training activities. We propose that activities can be designed to help trainees make links between (1) the concepts and skills covered in an activity, (2) the professional practice behaviors that an activity prepares them to enact, and (3) the life goals that are served by enacting these professional practice behaviors. Informed by Control Theory and Self-Determination Theory, we predict that this design may promote trainees’ adoption of activity-specific goals that emphasize deep understanding, long-term retention, and transfer, and enhance their autonomous motivation to attain their goals. However, there are some situations when this design may be less effective for, or even harmful to, trainees’ motivation. Specifically, we predict that helping trainees establish a purpose for learning by linking an activity to their life goals may be most effective when they can adapt an activity to best align with their purpose, when they are confident in their ability to attain their activity-specific goal, and when they become engrossed in an activity because it affords interest- and curiosity-stimulating actions. We package our theoretical analysis into the PACE model of motivational design. When our predictions are supported by more empirical evidence, the model can help educators set the PACE for trainees, thereby motivating them to engage deeply in training activities

L’intégration des évaluations de l’apprentissage autorégulé dans les activités d’évaluation dans les professions de la santé : un appel à l’action

How well have healthcare professionals and trainees been prepared for the inevitable demands for new learning that will arise in their future? Given the rapidity with which ‘core healthcare knowledge’ changes, medical educators have a responsibility to audit whether trainees have developed the capacity to effectively self-regulate their learning. Trainees who engage in effective self-regulated learning (SRL) skilfully monitor and control their cognition, motivation, behaviour, and environment to adaptively meet demands for new learning. However, medical curricula rarely assess trainees’ capacity to engage in this strategic process. In this position paper, we argue for a paradigm shift toward assessing SRL more deliberately in undergraduate and postgraduate programs, as well as in associated licensing activities. Specifically, we explore evidence supporting an innovative blend of principles from the science on SRL, and on preparation for future learning (PFL) assessments. We propose recommendations for how program designers, curriculum developers, and assessment leads in undergraduate and postgraduate training programs, and in licensing bodies can work together to develop integrated assessments that measure how and how well trainees engage in SRL. Claims about lifelong learning in health professions education have gone unmatched by responsive curricular changes for far too long. Further neglecting these important competencies represents a disservice to medical trainees and a potential risk to the future patients they will care for.Dans quelle mesure les professionnels de la santé et les étudiants ont-ils été préparés aux exigences inévitables de nouveaux apprentissages qui se présenteront à eux à l’avenir? Étant donné la rapidité avec laquelle les « connaissances de base en matière de soins de santé » évoluent, les enseignants en médecine ont la responsabilité de vérifier si les étudiants ont développé la capacité d’autoréguler adéquatement leurs apprentissages. Ceux qui pratiquent efficacement l’apprentissage autorégulé (AAR) surveillent et contrôlent habilement leur cognition, leur motivation, leur comportement et leur environnement pour s’adapter à la nécessité de nouveaux apprentissages. Cependant, les programmes d’études médicales évaluent rarement la capacité des étudiants à s’engager dans ce processus stratégique. Dans cet exposé de position, nous plaidons en faveur d’un changement de paradigme vers une évaluation plus ciblée de l’AAR dans les formations doctorale et postdoctorale, ainsi que pour les activités d’évaluation. Plus précisément, nous explorons les résultats convaincants de l’emploi d’un mélange innovant de principes issus de la recherche en matière d’AAR et d’évaluations de la préparation à l’apprentissage futur. Nous proposons des recommandations pour une collaboration entre les responsables de la conception de programmes d’études, ceux de l’élaboration du cursus, ceux chargés de l’évaluation dans les programmes d’études prédoctorales et postdoctorales et les organismes responsables de l’octroi d’un titre de compétence en vue de créer des évaluations intégrées qui mesurent la méthode et la qualité de l’AAR chez les étudiants. Les programmes d’études tardent encore à traduire dans la pratique la reconnaissance de l’importance de l’apprentissage tout au long de la vie dans l’éducation médicale. Continuer à négliger ces compétences importantes ne ferait que nuire aux étudiants en médecine et potentiellement à leurs futurs patients

Medical student changes in self-regulated learning during the transition to the clinical environment

BACKGROUND: Self-regulated learning (SRL), which is learners’ ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors. METHODS: Medical students were invited to complete a questionnaire at the commencement of their first clinical year (T0), and 10 weeks later (T1). The questionnaire included the Motivated Strategies for Learning Questionnaire (MSLQ) and asked about previous clinical experience. Information about the student’s background, demographic characteristics and first clinical rotation were also gathered. RESULTS: Of 118 students invited to participate, complete paired responses were obtained from 72 medical students (response rate 61%). At T1, extrinsic goal orientation increased and was associated with gender (males were more likely to increase extrinsic goal orientation) and type of first attachment (critical care and community based attachments, compared to hospital ward based attachments). Metacognitive self-regulation decreased at T1 and was negatively associated with previous clinical experience. CONCLUSIONS: Measurable changes in self-regulated learning occur during the transition from preclinical learning to clinical immersion, particularly in the domains of extrinsic goal orientation and metacognitive self–regulation. Self–determination theory offers possible explanations for this finding which have practical implications and point the way to future research. In addition, interventions to promote metacognition before the clinical immersion may assist in preserving SRL during the transition and thus promote life-long learning skills in preparation for real-world practice. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-017-0902-7) contains supplementary material, which is available to authorized users

A Critical Reappraisal of Self-learning in Health Professions Education: Directed Self-guided Learning Using Simulation Modalities

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.Ph

Self-regulated learning in healthcare profession education: Theoretical perspectives and research methods

© 2015 John Wiley & Sons, Ltd. All rights reserved. This chapter introduces self-regulated learning (SRL) theory to medical education researchers, particularly those who might be interested in applying SRL frameworks to study and improve healthcare profession education. It first provides a broad definition of SRL, followed by a review of the common assumptions that underlie SRL theories. The chapter then discusses three influential frameworks and describes several research methods to explore SRL in various healthcare profession education contexts. Most models of SRL have in common several core features. First, most theories of SRL describe a self-oriented feedback loop composed of multiple processes and sub-processes. Second, SRL theories relates to motivation. Third, students have some type of goal, criterion or standard against which their academic progress can be compared. Three influential theoretical perspectives that represent the continuum from largely cognitive to largely social descriptions of SRL include: information processing/control theory, social-cognitive theory and social-constructivist theory