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

The self-regulated learning of medical students in the clinical environment – a scoping review

Abstract Background Self-regulated learning is the individual’s ability to effectively use various strategies to reach their learning goals. We conducted this scoping review to explore what has been found regarding self-regulated learning in the clinical environment and how this was measured. Methods Using Arksey and O’Malley’s five-stage framework, we searched three medical and educational databases as well as Google Scholar for literature on the self-regulated learning of medical students in the clinical environment published between 1966 and February 2017. After results were screened and relevant studies were identified, the data was summarised and discursively reported. Results The search resulted in 911 articles, with 14 articles included in the scoping review after the inclusion criteria was applied. Self-regulated learning was explored in these studies in various ways including qualitative, quantitative and mixed methods. Three major findings were found: 1) levels of self-regulated learning change in the clinical environment, 2) self-regulated learning is associated with academic achievement, success in clinical skills and mental health and 3) various factors can support self-regulated learning levels in medical students. Conclusions Most of articles exploring the self-regulated learning of medical students during the clinical years have been published in the last 5 years, suggesting a growing interest in the area. Future research could explore the self-regulated learning levels of medical students during the clinical years using a longitudinal approach or through the use of novel qualitative approaches

TOI-954 b and K2-329 b: short-period Saturn-mass planets that test whether irradiation leads to inflation

We report the discovery of two short-period Saturn-mass planets, one transiting the G subgiant TOI-954 (TIC 44792534, V = 10.343, T = 9.78) observed in TESS sectors 4 and 5 and one transiting the G dwarf K2-329 (EPIC 246193072, V = 12.70, K = 10.67) observed in K2 campaigns 12 and 19. We confirm and characterize these two planets with a variety of ground-based archival and follow-up observations, including photometry, reconnaissance spectroscopy, precise radial velocity, and high-resolution imaging. Combining all available data, we find that TOI-954 b has a radius of 0.852(-0.062)(+0.053) R-J and a mass of 0.174(-0.017)(+0.018) M-J and is in a 3.68 day orbit, while K2-329 b has a radius of 0.774(-0.024)(+0.026) R-J and a mass if 0.260(-0.022)(+0.020) M-J and is in a 12.46 day orbit. As TOI-954 b is 30 times more irradiated than K2-329 b but more or less the same size, these two planets provide an opportunity to test whether irradiation leads to inflation of Saturn-mass planets and contribute to future comparative studies that explore Saturn-mass planets at contrasting points in their lifetimes

Potential Roles for Infectious Agents in the Pathophysiology of Primary Biliary Cirrhosis: What's New?

Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease serologically characterized by the presence of high-titer antimitochondrial antibodies and, histologically by chronic nonsuppurative cholangitis and granulomata. The aetiology of the disease remains elusive, although genetic, epigenetic, environmental, and infectious factors have been considered important for the induction of the disease in genetically prone individuals. The disease shows a striking female predominance and becomes clinically overt at the fourth to sixth decade. These characteristics have prompted investigators to consider infections that predominate in women at these ages as the likely candidates for triggering the disease. Recurrent urinary tract infections due to Escherichia coli were the first infections to be considered pathogenetically relevant. Over the years, several other microorganisms have been linked to the pathogenesis of PBC owing to epidemiological, immunological, microbiological, or experimental findings in animal models. Recent studies have provided data supporting the pathogenic role of Novosphingobium aromaticivorans and betaretroviruses. Several reports have linked other organisms to the induction of the disease and/or the maintenance of the auto-aggressive responses that are perpetuated over the course of the disease. This review highlights the findings of the most recent studies investigating the link between infections and PBC. We also discuss the close interplay of the infectious agents with other environmental and genetic factors, which may explain the multifaceted nature of this puzzling disease