자기조절학습과 의과대학 학업성적의 관계(Med Teach, 2015)

자기조절학습과 의과대학 학업성적의 관계(Med Teach, 2015)

Self-regulated learning and academic performance in medical education

SUSANNA M. LUCIEER1, LAURA JONKER2,3, CHRIS VISSCHER2, REMY M. J. P. RIKERS4,5 & AXEL P. N. THEMMEN1,6

의료전문직은 변화하는 사회에 맞춰서 높은 수준을 유지해야 한다. CME에서 배우기 위해서는 아래와 같은 것을 해야 하며, 요약하면 의사들은 자기조절적 학습자가 되어야 한다는 것이다. 이것은 학습과정에 있어 행동, 메타인지, 학습동기 등이 주도적이어야 함을 뜻한다.

The medical profession has to ensure that high standards in providing patient care are repeatedly being met in the context of a rapidly and constantly changing medical world (Brydges &Butler 2012; Bjork et al. 2013). This means that medical doctors have to stay updated with the developments in their field of expertise and have to maintain their competencies (Greveson& Spencer 2005; Artino et al. 2012; Brydges & Butler 2012;Premkumar et al. 2013). To be able to benefit and choose from the many opportunities of continuous medical education,medical doctors have to define their own learning needs, set personal goals and engage in the most appropriate learning activities (Lycke et al. 2006; Brydges et al. 2012; Premkumaret al. 2013). In short, medical doctors have to be self-regulated learners, which means that they have to be behaviorally, meta-cognitively and motivationally proactive in their learning process (Zimmerman 1986; Wolters 1998; Jonker et al. 2010).

Ertmer와 Newby에 따르면, 자기조절적 학습자는 다음의 것을 할 수 있다. 다른 연구자는 자기조절학습의 동기와 관련된 요인을 언급했는데 아래와 같다. 그러나 이러한 요인들은 학습자가 스스로 사용할 동기가 없으면 별로 가치가 없고, 그래서 두 가지를 추가했다. (노력과 자기효능감)

According to Ertmer and Newby (1996), self-regulated learners are individuals who are able to 

• plan their study behavior, 
• monitor their progress, 
• reflect upon, and 
• evaluate the entire learning process. 

Other researchers also highlighted the importance of motivational components in self-regulated learning (Hong & O’Neil 2001; Sitzmann & Ely 2011). They argued that one may be 

• able to plan, 
• monitor, 
• reflect upon, and 
• evaluate his or her learning behavior, 

but that these competencies are of little value when one is not motivated to employ them. Therefore, they added two subcomponents of motivation to the concept of self-regulated learning, i.e., effort and self-efficacy. 

• Effort is crucial to reach the goals self- regulated learners have set, and 
• self-efficacy is important since one needs to have trust in his or her own potential in order to complete a task (Hong & O’Neil 2001; Sitzmann & Ely 2011).

불행하게도, 자기조절적 학습 기술은 의과대학기간에 늘 강조되는 것은 아니다. 어떤 연구에서는 의과대학동안 학생들의 자기조절학습능력이 향상된다고 나오나, 일부 졸업생들은 그렇게 잘 준비되지 않았다고 느낀다. 

Unfortunately, self-regulated learning skills are not always emphasized during medical school (Artino et al. 2012). While studies showed that students do develop self-regulated learning skills during medical school (Loyens et al. 2008), some graduates feel uncertain and unprepared to do so (Artino et al. 2012). Therefore, it is important to investigate to what extent medical students’ self-regulated learning skills change during their education.

자기조절학습은 학업능력을 가장 잘 예측해주는 요인으로 나타나기도 한다. 자기조절학습은 능동적인 학습과정으로서 목표를 설정하고 효과적인 학습전략을 개발하는 것이다. 이 단계는 학습능력의 정신능력을 변화시키는데, 예컨대 목표설정, 학습전략 개발, 향상과 효과성의 모니터링 등이다. 어떻게 학습발달과정을 모니터링하고, 학습 행동을 조절하고 적응시킬 것인지가 진정으로 효과적인 학습자의 요건으로 여겨진다. 비록 지난 연구들이 자기조절 학습이 반드시 높은 성취를 위해 필요한 기술은 아니라고 하기도 하나, 자기조절적 학습자가 더 효과적인 학습자라는 것이 보여진 바도 있다.

It has also been shown that self-regulated learning is one of the best predictors of academic performance (Pintrich & Degroot 1990). Self-regulated learning is viewed as a proactive learning process that is used to set learning goals and develop effective strategies for learning (Zimmerman 2008). This process helps people to transform mental abilities in academic skills, such as setting goals, developing learning strategies, and monitoring the progress and effectiveness of their learning (Zimmerman 2002, 2008). Knowing how to monitor the progress of your learning and how to control and adapt your learning behavior, is seen as a requirement for being a truly effective learner (Ertmer & Newby 1996; Bjork et al. 2013). Although research suggests that it is not necessary to use self- regulated learning skills for high achievement (Ablard & Lipschultz 1998), it has been shown that self-regulated learners are more effective learners (Nota et al. 2004; Toering et al. 2009) who get more out of their potential (Zimmerman 1986) and attain higher grades during high school (Nota et al. 2004) and in college (Ablard & Lipschultz 1998).

In this study, the Self-Regulation of Learning Self-Report Scale (SRL-SRS) is used. This questionnaire contains six subscales: 

• planning, 
• monitoring, 
• evaluation, 
• reflection, 
• effort, and 
• self-efficacy, 

following the theories of Ertmer and Newby (1996) and Hong and O’Neill (2001).

Setting

Participants

Instruments

The Self-Regulation of Learning Self-Report Scale (SRL-SRS) was used to investigate the students’ level of self-regulated learning. The SRL-SRS contains 50 items on a 4- or 5-point Likert scale, depending on the subsection of the questionnaire. Following the theory described by Ertmer and Newby (1996) and Hong and O’Neill (2001), the questionnaire comprises six subscales of original English-language questionnaires: planning, monitoring, evaluation, reflection, effort, and self-efficacy. An example of a question in the subscale monitoring is: ‘‘While making an assignment, I check my progress,’’ and an example from the subscale effort is: ‘‘I keep trying to finish my assignment, even when I find the assignment extremely difficult’’. The questionnaire has been compiled and validated in a Dutch study (Toering et al. 2012). The questionnaire was originally created for high school students. Therefore, in this study, minor changes were made in a few questions, e.g., the term homework was replaced by study assignments.

Measurements of academic performance

Data analysis 

Data were analyzed with the use of IBM SPSS AMOS version 18.0 (SPSS, Inc., Chicago, IL) and IBM SPSS Statistics version 21.0 (SPSS, Inc., Chicago, IL). Confirmatory factor analysis and Cronbach’s alpha were used to investigate whether the constructs to of the questionnaire fitted the model and measure the internal consistency of the factors. A one-way ANOVA was performed to compare the level of self-regulated learning skills of the first and third-year medical students, a p value of 50.05 was considered significant. For the subscale reflection, Welch F was calculated since equal variances could not be assumed. Effect sizes, eta squared, were converted where 0.01, 0.06 and 0.14 indicate a small, medium, and large effect, respectively (Cohen 1988; Lakens 2013). The correlation between the self-regulated learning skills and the measures of academic performance were calculated with Pearson correlations and multinomial logistic regression analysis. Here, given the multiple comparisons, a more conservative p value of 50.01 was considered significant.

결과

Validation of the questionnaire

Change of self-regulated learning skills

Correlation with academic performance

자기조절학습은 GPA에서 작은 부분만 설명한다.

Multinomial logistic regression analyses showed that self- regulated learning skills explained a small proportion of the variance in GPA among first-year medical students: R2 ¼0.086, Model 2 (18) ¼1592.612, p50.001 as well as some of the R2 ¼0.105, Model 2 variance of the third-year students: (18) ¼38.735, p ¼0.003

1학년과 3학년을 비교하면 의과대학기간동안 자기조절 학습 기술은 별로 달라지지 않았다.

Concerning the first question, we hypothesized thatstudents’ self-regulated learning skills would change duringmedical school. However, we found that the levels of mostself-regulated learning skills did not differ between the firstand third year at medical school, except reflection, which washigher in the third year.

이는 어쩌면 최고의 학생들만 의과대학에 입학하기 때문이 ceiling effect 때문일 수도 있다.

It is however possible that, since only the best students are accepted for medical school (Razack et al. 2012) these students already score relatively high at entrance, and therefore show little development of self-regulated learning during medical school itself (i.e. ceiling effect)

사람들은 흔히 스스로의 학습행동을 어떻게 관리해야하며, 어떻게 학습하는 것인가에 대해서 배우지 않아도 된다는 가정을 한다.

In addition, most people have a strong assumption thatchildren and adults do not need to be taught how to learn andhow to manage their learning behavior (Bjork et al. 2013). 

연구에 따르면 자기조절학습 기술은 학습될 수 있으나, 중요한 것은 그것이 특별히 강조되어야 한다는 점이다.

Research showed that self-regulated learning skillscan be taught, but they have to be specifically emphasized(Zimmerman, 1989; Hong & O’Neil 2001

더 나아가, 사람들은 종종 학습과 기억에 대한 잘못된 정신모형을 가지고 있고, 특히 '좋은 수행능력'에 대한 기준이나 준거에 대한 지식이 없을 경우에는 자신의 자기조절학습 기술에 대해서 과대평가하는 경향이 있다. 마찬가지로 1학년에서 아마도 자신을 과대평가 했을 수 있다.

Further, people often have a flawed mental model of how they learn and remember (Bjork et al. 2013) and tend to overestimate their self-regulated learning skills (Zimmerman2008), especially when they do not have knowledge of the criteria and standards of good performance (Kostons et al.2012). It is possible that first-year students overestimated their use of self-regulated learning skills more than third-year students, and thus, reported a higher use of self-regulated learning skills. 

본 연구는 수행능력의 일부가 자기조절학습능력으로 설명 가능하나, 여전히 많은 부분은 설명되지 않음을 보여준다.

This study confirmed that some variation in performance could be explained by the students’ self-regulated learning skills, both in the first-year and in the third-year, but a large part of the variation remained unexplained. 

'노력'이 관련되어 있었음. 

Effort was also related to first-year academic performance.According to Hong and O’Neill (2001), effort is necessary to actually use the other self-regulated learning skills one possesses. Effort is crucial to reach the goals a learner has set (Hong & O’Neil 2001) and is required to persist on difficult tasks (Pintrich & Degroot 1990; Hong & O’Neil 2001)

모니터링과 관련해서, 가장 낮은 분위의 GPA를 가진 학생보다 그 윗 분위의 학생들이 더 낮은 monitoring level을 보였다 이는 Kruger-Dunning effect라고 설명될 수 있다(수행능력이 매우 떨어지는 학습자는 스스로의 학습에 대한 모니터링을 거의 안하며, 그래서 그들이 그것을 하지 않는다는 것 조차 알지 못한다.)

Regards to monitoring,not the students with the lowest GPA reported the lowest level,but those with the second lowest GPA. This could be the result of the so called Kruger–Dunning effect; poorly performing learners rarely monitor their learning and consequently are unlikely to notice that they are not doing so (Ertmer &Newby 1996; Kruger & Dunning 1999; Langendyk 2006;Kostons et al. 2012). 

3학년에는 effort만 관련되어 있었음.

In the third year of medical school, only effort was to some extent related to performance differences.

cross-sectional design이라는 한계가 있으나, 그룹간 age, gender가 비슷하고 sample size가 크고, response rate가 비슷하고, 모든 학생이 같은 학교에 다니므로 수용가능하다. 모든 학생이 비슷한 패턴으로 변할 것이라는 가정이 가능하다.

One notable limitation of this study is the use of a cross-sectional design,while a longitudinal design would have been more appropriate. Still, a cross-sectional design is deemed acceptable since the groups are comparable in age and gender, the sample size is large, the response rate is comparable, and all students attended the same medical school and in the same curriculum. It is therefore appropriate to assume that all students will change in a similar way (William & Darity2008). 

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Med Teach. 2015 Aug 27:1-9. [Epub ahead of print]

Self-regulated learning and academic performance in medical education.

Lucieer SM1, Jonker L, Visscher C, Rikers RM, Themmen AP.

Author information

• 1a Institute of Medical Education Research Rotterdam , Erasmus MC, The Netherlands .

Abstract

CONTENT:

Medical schools aim to graduate medical doctors who are able to self-regulate their learning. It is therefore important to investigate whether medical students' self-regulated learning skills change during medical school. In addition, since these skills are expected to be helpful to learn more effectively, it is of interest to investigate whether these skills are related to academic performance.

METHODS:

In a cross-sectional design, the Self-Regulation of Learning Self-Report Scale (SRL-SRS) was used to investigate the change in students' self-regulated learning skills. First and third-year students (N = 949, 81.7%) SRL-SRS scores were compared with ANOVA. The relation with academic performance was investigated with multinomial regression analysis.

RESULTS:

Only one of the six skills, reflection, significantly, but positively, changed during medical school. In addition, a small, but positive relation of monitoring, reflection, and effort with first-year GPA was found, while only effort was related to third-year GPA.

CONCLUSIONS:

The change in self-regulated learning skills is minor as only the level of reflection differs between the first and third year. In addition, the relation between self-regulated learning skills and academic performance is limited. Medical schools are therefore encouraged to re-examine the curriculum and methods they use to enhance their students' self-regulated learning skills. Future research is required to understand the limited impact on performance.

PMID:

 

26313552

 

[PubMed - as supplied by publisher]