Relinquishing control? Supervisor co-regulation may disrupt students' self-regulated learning during simulation-based...

Area of Science:

• Medical Education
• Learning Sciences
• Simulation-Based Training

Background:

• Medical trainees often use co-regulated learning (Co-RL) with supervisors when uncertain.
• Self-regulated learning (SRL) strategies may differ between self- and co-regulated learning environments.

Purpose of the Study:

• To compare the impact of SRL and Co-RL on the acquisition, retention, and preparation for future learning (PFL) of cardiac auscultation skills.
• To investigate how learning strategies and perceived control influence outcomes in simulation-based training.

Main Methods:

• A two-arm, prospective, non-inferiority trial randomly assigned 32 medical students to SRL or Co-RL conditions.
• Participants practiced diagnosing simulated cardiac murmurs across two sessions, with assessments of diagnostic accuracy and learning trace data.
• Semi-structured interviews were conducted to explore trainees' learning strategies and perceptions.

Main Results:

• SRL outcomes were non-inferior to Co-RL for immediate post-test and retention of cardiac auscultation skills.
• Preparation for future learning (PFL) assessment results were inconclusive.
• Interviews revealed themes of perceived utility of learning supports, SRL strategies, and control over learning, with Co-RL sometimes interfering with future SRL.

Conclusions:

• Self-regulated learning (SRL) and co-regulated learning (Co-RL) demonstrate comparable effectiveness for skill acquisition and retention in simulation-based training.
• Co-RL may not always facilitate preparation for future learning, potentially due to trainees relinquishing control.
• Effective Co-RL may require shared accountability and development of shared mental models between supervisors and trainees, especially in transient training settings.