title: Using self-regulated learning theory to understand the beliefs, emotions, and behaviors of struggling medical students.
abstract: BACKGROUND
  This study explored whether motivational, emotional, and behavioral aspects of self-regulated learning (SRL) are associated with academic performance in medical school.
  
  
  METHODS
  Across two academic years (2008-2009 and 2009-2010), 248 (73%) of 342 second-year students in an introductory clinical reasoning course completed surveys assessing 10 SRL constructs. Performance was operationalized as students' average grade on three course exams, and a tercile split was used to compare those in the lowest and highest third of achievement using a one-way multivariate analysis of variance.
  
  
  RESULTS
  Findings revealed differences in the beliefs and emotions of the two extreme groups, F(10,136) = 2.08, P = .03. Compared with high-performing students, low performers reported lower task value (Cohen d = -0.33) and self-efficacy beliefs (d = -0.33) as well as greater anxiety (d = 0.63), frustration (d = 0.54), and boredom (d = 0.44).
  
  
  CONCLUSIONS
  Low-performing medical students in a clinical reasoning course demonstrated deficiencies in key SRL measures, providing insight for future, tailored remediation strategies.
authors.affiliation: Department of Preventive Medicine and Biometrics, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA. anthony.artino@usuhs.mil
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Artino
authors.forename: Paul A
authors.initials: PA
authors.lastname: Hemmer
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Durning
mesh_terms: D000704:Analysis of Variance; D001007:Anxiety; D001519:Behavior; D003469:Culture; D003625:Data Collection; D004522:Educational Status; D004644:Emotions; D007858:Learning; D020377:Self Efficacy; D013337:Students, Medical / Q000523:psychology*