(Mis)Alignment in resident and advisor co-regulated learning in competency-based training.

Area of Science:

• Medical Education
• Competence-Based Medical Education (CBME)
• Residency Training

Background:

• Canadian residency programs implement Academic Advisors (AAs) to support resident progress in Competence-Based Medical Education (CBME).
• AAs are intended to coach residents longitudinally and foster self-regulated learning (SRL) through co-regulated learning (Co-RL).
• The optional nature of the AA role may lead to variability in its implementation and effectiveness.

Purpose of the Study:

• To investigate how AA-resident dyads interpret assessment data.
• To understand how dyads collaboratively create learning goals and action plans.
• To explore efforts in enhancing residents' SRL skills through the AA role.

Main Methods:

• Conducted brief individual interviews with 10 Academic Advisors (AAs) and 10 residents in Internal Medicine.
• Collected data after each of their six meetings over two years.
• Analyzed interview transcripts using an abductive framework with theory-based and evidence-based sensitizing concepts.

Main Results:

• Dyads exhibited variable engagement in self-regulated learning (SRL) and co-regulated learning (Co-RL) based on their "learning stances."
• Stances between AAs and residents did not always align, impacting Co-RL processes.
• Most dyads remained consistent or reactively oscillated, with limited proactive Co-RL focused on developing clinical competencies via SRL.

Conclusions:

• The ideal form of co-regulated learning (Co-RL) was not consistently achieved in the AA-resident dyad implementation.
• Residency programs should refine Competence-Based Medical Education (CBME) processes to better translate 'coaching over time' into practice.
• Recommendations include refining assessment tools, resident orientation, and faculty development practices to enhance Co-RL.