title: Patterns in clinical students' self-regulated learning behavior: a Q-methodology study.
abstract: Students feel insufficiently supported in clinical environments to engage in active learning and achieve a high level of self-regulation. As a result clinical learning is highly demanding for students. Because of large differences between students, supervisors may not know how to support them in their learning process. We explored patterns in undergraduate students' self-regulated learning behavior in the clinical environment, to improve tailored supervision, using Q-methodology. Q-methodology uses features of both qualitative and quantitative methods for the systematic investigation of subjective issues by having participants sort statements along a continuum to represent their opinion. We enrolled 74 students between December 2014 and April 2015 and had them characterize their learning behavior by sorting 52 statements about self-regulated learning behavior and explaining their response. The statements used for the sorting were extracted from a previous study. The data was analyzed using by-person factor analysis to identify clusters of individuals with similar sorts of the statements. The resulting factors and qualitative data were used to interpret and describe the patterns that emerged. Five resulting patterns were identified in students' self-regulated learning behavior in the clinical environment, which we labelled: Engaged, Critically opportunistic, Uncertain, Restrained and Effortful. The five patterns varied mostly regarding goals, metacognition, communication, effort, and dependence on external regulation for learning. These discrete patterns in students' self-regulated learning behavior in the clinical environment are part of a complex interaction between student and learning context. The results suggest that developing self-regulated learning behavior might best be supported regarding individual students' needs.
authors.affiliation: Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands. j.j.berkhout@amc.uva.nl.
authors.forename: Joris J
authors.initials: JJ
authors.lastname: Berkhout
authors.affiliation: Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.|Department of Obstetrics and Gynecology, VU University Medical Center, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Pim W
authors.initials: PW
authors.lastname: Teunissen
authors.affiliation: Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Helmich
authors.affiliation: Institute of Health Policy and Management (BMG), Erasmus University, Rotterdam, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van Exel
authors.affiliation: Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Cees P M
authors.initials: CP
authors.lastname: van der Vleuten
authors.affiliation: Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Debbie A D C
authors.initials: DA
authors.lastname: Jaarsma
mesh_terms: D000328:Adult; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D000068356:Self-Control / Q000523:psychology; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult
keywords: Clinical learning; Q-methodology; Self-regulated learning; Undergraduate medical education