{"title":"Evaluating the Instructional Strategies Influencing Self-Regulated Learning in Clinical Clerkship Years: A Mixed Studies Review.","authors":"Sahar Fatima, Wei-Han Hong, Mohamad Nabil Mohd Noor, Chan Choong Foong, Vinod Pallath","doi":"10.1080/10401334.2025.2468953","DOIUrl":null,"url":null,"abstract":"<p><p>Self-regulated learning (SRL) can significantly improve academic achievement and clinical performance. The clinical clerkship is a crucial setting for reinforcing and extending SRL skills and behaviors into clinical practice. However, learning in clinical settings is often opportunistic and contextual, requiring diverse instructional strategies and tailored learning opportunities. Studies from the past two decades have indicated challenges in implementing SRL strategies particularly in Asian countries. While many of the pedagogical approaches used in medical education include aspects of SRL theory, a comprehensive overview of effective SRL instructional strategies in clinical clerkships is lacking. We reviewed all studies (published between January 2012 and May 2024, identified <i>via</i> systematic search of EBSCOhost, PubMed, ScienceDirect, Scopus, and Web of Science) that discuss instructional strategies influencing SRL among clinical clerkship students, in general, and with special reference to the Asian context. Twenty seven articles were included in the final analysis. We conducted convergent integrated synthesis on the data extracted from all included studies to generate categories and themes. SRL instructional strategies reported included implementing learning plans and goal setting, operationalizing formal mentoring and feedback processes, utilizing technology-enhanced learning, facilitating collaborative group learning, providing simulation-based learning experiences, and applying experiential learning strategies. When implemented effectively, such strategies were shown to promote self-regulated learning, motivational beliefs, self-monitoring, and self-reflection. Faculty support, mentoring and timely feedback were crucial in successfully implementing SRL strategies. Incorporating SRL into existing curricula was ideal for ensuring feasibility and long-term sustainability. Limited research from the Asian region indicates that SRL has not been used to its full potential in Asian medical education. Asian medical students' SRL potential could be maximized with shared roles of students and teachers in a student-driven approach. Medical educators should take responsibility for providing opportunities and a conducive environment to foster SRL among clinical clerkship students. Future research should prioritize longitudinal, experimental studies with comparison groups and objective SRL outcome measures to rigorously evaluate the impact of instructional strategies in the clinical clerkship context.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-19"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Teaching and Learning in Medicine","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.1080/10401334.2025.2468953","RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0
Abstract
Self-regulated learning (SRL) can significantly improve academic achievement and clinical performance. The clinical clerkship is a crucial setting for reinforcing and extending SRL skills and behaviors into clinical practice. However, learning in clinical settings is often opportunistic and contextual, requiring diverse instructional strategies and tailored learning opportunities. Studies from the past two decades have indicated challenges in implementing SRL strategies particularly in Asian countries. While many of the pedagogical approaches used in medical education include aspects of SRL theory, a comprehensive overview of effective SRL instructional strategies in clinical clerkships is lacking. We reviewed all studies (published between January 2012 and May 2024, identified via systematic search of EBSCOhost, PubMed, ScienceDirect, Scopus, and Web of Science) that discuss instructional strategies influencing SRL among clinical clerkship students, in general, and with special reference to the Asian context. Twenty seven articles were included in the final analysis. We conducted convergent integrated synthesis on the data extracted from all included studies to generate categories and themes. SRL instructional strategies reported included implementing learning plans and goal setting, operationalizing formal mentoring and feedback processes, utilizing technology-enhanced learning, facilitating collaborative group learning, providing simulation-based learning experiences, and applying experiential learning strategies. When implemented effectively, such strategies were shown to promote self-regulated learning, motivational beliefs, self-monitoring, and self-reflection. Faculty support, mentoring and timely feedback were crucial in successfully implementing SRL strategies. Incorporating SRL into existing curricula was ideal for ensuring feasibility and long-term sustainability. Limited research from the Asian region indicates that SRL has not been used to its full potential in Asian medical education. Asian medical students' SRL potential could be maximized with shared roles of students and teachers in a student-driven approach. Medical educators should take responsibility for providing opportunities and a conducive environment to foster SRL among clinical clerkship students. Future research should prioritize longitudinal, experimental studies with comparison groups and objective SRL outcome measures to rigorously evaluate the impact of instructional strategies in the clinical clerkship context.
自我调节学习能显著提高学业成绩和临床表现。临床实习是在临床实践中强化和扩展SRL技能和行为的重要环境。然而,临床环境中的学习往往是机会性的和情境性的,需要多样化的教学策略和量身定制的学习机会。过去二十年的研究表明,在执行SRL战略方面存在挑战,特别是在亚洲国家。虽然医学教育中使用的许多教学方法包括SRL理论的各个方面,但缺乏对临床见习人员中有效的SRL教学策略的全面概述。我们回顾了所有研究(发表于2012年1月至2024年5月之间,通过EBSCOhost、PubMed、ScienceDirect、Scopus和Web of Science的系统搜索确定),这些研究讨论了教学策略对临床实习学生SRL的影响,并特别参考了亚洲背景。在最后的分析中纳入了27篇文章。我们对从所有纳入的研究中提取的数据进行了收敛综合,以生成类别和主题。报告的SRL教学策略包括实施学习计划和目标设定,实施正式的指导和反馈过程,利用技术增强学习,促进协作小组学习,提供基于模拟的学习体验,以及应用体验学习策略。当有效实施时,这些策略被证明可以促进自我调节学习、动机信念、自我监控和自我反思。教师的支持、指导和及时的反馈对于成功实施SRL策略至关重要。将SRL纳入现有课程是确保可行性和长期可持续性的理想选择。来自亚洲地区的有限研究表明,在亚洲医学教育中,SRL尚未充分发挥其潜力。在以学生为导向的方法中,学生和教师的共同角色可以最大限度地发挥亚洲医学生的SRL潜力。医学教育工作者有责任为临床见习学生提供机会和有利的环境来培养他们的自主学习能力。未来的研究应优先考虑纵向、实验组的实验研究和客观的SRL结果测量,以严格评估教学策略在临床见习背景下的影响。
期刊介绍:
Teaching and Learning in Medicine ( TLM) is an international, forum for scholarship on teaching and learning in the health professions. Its international scope reflects the common challenge faced by all medical educators: fostering the development of capable, well-rounded, and continuous learners prepared to practice in a complex, high-stakes, and ever-changing clinical environment. TLM''s contributors and readership comprise behavioral scientists and health care practitioners, signaling the value of integrating diverse perspectives into a comprehensive understanding of learning and performance. The journal seeks to provide the theoretical foundations and practical analysis needed for effective educational decision making in such areas as admissions, instructional design and delivery, performance assessment, remediation, technology-assisted instruction, diversity management, and faculty development, among others. TLM''s scope includes all levels of medical education, from premedical to postgraduate and continuing medical education, with articles published in the following categories: