Abstract

‘We now accept the fact that learning is a lifelong process of keeping abreast of change. And the most pressing task is to teach people how to learn.’1 I recently met an undergraduate student who had failed his first examination at medical school. He was surprised by his failure because he had attended the same lectures as everyone else and had read the same handouts. Have you ever wondered why some people struggle to learn? An important reason is likely to be their approach to learning. Self-regulated learning (SRL) theory offers a useful perspective that can help tutors understand learners' difficulties and offer structured support. The importance of this perspective has been long acknowledged in childhood education and is now increasingly recognised in medical education.2 Self-regulated learning theory considers the extent to which learners are active participants in their own learning processes. The basic tenet of SRL theory is that effective learning is accomplished through the continuous and dynamic adjustment of specific motivational and cognitive components that enable the learner to achieve particular learning goals, both academic and clinical.3 Prior to learning, effective learners assess the learning task and consider how they might use strategies to successfully achieve the task. An important aspect of SRL is that successful learners adjust their motivational beliefs, such as by making a given topic relevant to their personal interests or by thinking about previous occasions when they were successful with similar learning tasks, and select appropriate cognitive strategies, such as the study technique of reading each paragraph in turn or listing a clear sequence of initial questions with which to obtain a clinical history. During learning or clinical performance, effective learners self-monitor by increasing their awareness of whether they are on track to achieve their intended goals. Checking allows them to make constant adjustments to their chosen motivational or cognitive strategies to ensure that these strategies are working. After the learning task, highly self-regulated learners reflect on their performance and consider whether they might need to modify their approach to the task if and when they face future attempts at learning. An important aspect of this phase is that highly self-regulated learners generally attribute their successes to factors that are within their control, such as the choice of specific strategies, whereas ineffective learners tend to attribute their lack of success to factors outside their control; for example, an ineffective learner might claim that ‘the contents of the chapter were not clear’ or ‘the patient was not typical’. It is important to note that learners may be highly self-regulated in one context but not in another. Like most academic skills, SRL is context-specific. I was able to provide the failing undergraduate to whom I referred earlier with some insight into how he approached learning by using SRL microanalysis. This type of microanalysis involves a structured interview process in which focused questions are used to help identify key SRL processes while the learner is actively engaged in an authentic learning task.4 I gave the student a few pages of lecture notes and asked him to study them. As implied by SRL theory, the student was not adopting a strategic approach to his learning. I was able to ascertain that the student did not have a specific study technique, that he did not check his understanding during the task and that he attributed his lack of success to the content being ‘too difficult’. These findings allowed me to provide focused feedback to the student so that he could improve his use of the SRL processes he had previously underutilised. Many scholars believe that SRL theory has the potential to develop lifelong learners who can successfully respond to the variety of learning challenges they will face in their careers. It is now time to ensure that this potential can be fully realised.

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