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Using Self-Regulated Learning Microanalysis to Examine Regulatory Processes in Clerkship Students Engaged in Practice

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Medical students use self-regulated learning (SRL) for multiple-choice questions (MCQs), but their metacognitive reflection on diagnostic reasoning is limited. Improving critical evaluation of reasoning processes may enhance SRL and performance in medical education.

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Area of Science:

  • Medical Education
  • Cognitive Psychology
  • Assessment in Learning

Background:

  • Self-regulated learning (SRL) is a key metacognitive process in education.
  • SRL assessment has been used in medical education, but not specifically for multiple-choice questions (MCQs).
  • Understanding SRL during MCQs can reveal learning barriers and inform educational strategies.

Purpose of the Study:

  • To investigate self-regulated learning processes during MCQ answering in medical education.
  • To analyze students' strategic planning, metacognitive monitoring, causal attributions, and adaptive inferences.
  • To identify discrepancies between forethought strategies and actual performance during MCQs.

Main Methods:

  • A microanalytic protocol was used to assess SRL in internal medicine clerkship students.
  • Participants completed seven MCQs, with their responses transcribed and coded for SRL components.
  • The protocol targeted strategic planning, metacognitive monitoring, causal attributions, and adaptive inferences.

Main Results:

  • Students often prioritized basic diagnostic strategies in forethought but engaged in higher-order reasoning (integration, comparison) during performance.
  • Self-reflection predominantly focused on management errors and negative self-appraisals, with limited adaptation of diagnostic reasoning.
  • Few students explicitly identified or critically evaluated their diagnostic reasoning processes after incorrect answers.

Conclusions:

  • Medical students utilize complex diagnostic reasoning during MCQs but are often unaware of or unable to articulate these processes.
  • Self-reflection on MCQs is often critical of abilities and management, potentially impacting self-efficacy.
  • Interventions encouraging explicit evaluation of diagnostic reasoning and attributions to controllable factors may improve SRL and MCQ performance.