학업과제 중 의과대학생의 자기조절학습SRL (Med Educ, 2016)

Self-regulated learning processes of medical students during an academic learning task

Roghayeh Gandomkar,1 Azim Mirzazadeh,1,2 Mohammad Jalili,1,3 Kamran Yazdani,4 Ladan Fata5 &

John Sandars6




도입 

 

INTRODUCTION

적절한 remediation을 하기 위한 'struggling' 의과대학생에 대한 이해에 관심이 높아지고 있다. 의과대학 1학년에서 특히 중요한데, 적절히 교정되지 않으면 지속될 가능성이 높기 때문이다. 최근 SRL이 remediation 설계에 널리 사용되고 있고, 특히 의과대학 초기에 악순환을 끊고자 사용한다. 더 나아가서, SRL microanalytic 을 가지고 비-의학학습적 맥락에서 struggler를 찾고 remediate하려고 시도하기도 한다.

There is increasing interest in gaining greater understanding of the ‘struggling’ medical student so that appropriate remediation can take place.1 This is of great importance during the first years of medical school because early weak performance is likely to continue if it is not adequately addressed.2 Recently, self-regulated learning (SRL) theory has been applied increasingly in the design of remedia- tion interventions,3 including at an early stage of medical school in order to stop this cycle.4 More- over, there is a growing trend in the use of an SRL microanalytic approach to identify5 and remediate strugglers in non-medical academic contexts by pro- viding more effective feedback on the essential SRL processes.6

Pizzimenti and Axelson은 1학년에서 해부학 학습의 성공은 SRL 사용에 달렸다고 주장하였다. 그러나 이 때 SRL은 MSLQ로 측정되었다. SRL보고 스케일의 사용에는 근본적 문제가 있다. 따라서 우리는 SRL microanalytic 을 사용하였다.

Pizzimenti and Axelson7 noted that the success of Year 1 medical students on a gross anatomy course was related to their use of SRL processes. However, the SRL processes in this study were identified through the use of the Motivated Strategies for Learning Questionnaire (MSLQ).7 There are inher- ent limitations in the use of SRL self-report scales; therefore, we employed SRL microanalytic method- ology during a biomedical science learning task to capture the task-specific and fine-grained nature of SRL processes.8

개념틀 

Conceptual framework


이론적으로 본 연구는 SRL의 사회-인지모델에 기반하고 있으며, 이 모델에서는 학업적 SRL을 역동적이고 순환적 프로세스로 본다. 세 단계로 이뤄지는데, forethought, performance, self-reflection이다.

Theoretically, the current study is based on a social- cognitive model of SRL that considers academic SRL as a dynamic and cyclical process characterised by three sequential interrelated phases: forethought; performance, and self-reflection.9

  • Forethought 에서는 자기효능감, 목표설적, 전략적 행동 등이 학생의 학습노력이나 동기부여에 선행하며 적절한 학습테크닉 선택에 영향을 준다.
    Forethought pro- cesses, such as self-efficacy beliefs, goal setting and strategic planning, precede any learning efforts and mobilise students’ motivation and their choice of the appropriate learning techniques for the learning task they face.
  • Performance는 학습과제 중간에 발생하며, 자기조절학습자가 메타인지적으로 스스로의 학습을 모니터링하여 Forethought 단계에서 선택한 동기부여 혹은 학습테크닉이 가장 적절한지를 확인한다.
    Performance processes occur during the learning activity, when self-regulated learners metacognitively monitor their learning to ensure that the motivation and techniques chosen in the forethought phase are the most appropriate to suc- cessfully complete the task.
  • self-reflection 에서는 학습과제를 수행한 이후에 causal attribution과 adaptive inference를 하는 것이다.
    In the self-reflection phase after the performance of the learning task, the processes of causal attributions and adaptive inferences occur.10

Causal attributions 이란 학습자가 가지고 있는 특정 과제에서 이룬 성과의 원인에 대한 인식이다. 이것이 중요한 이유는 이후의 동기부여나 테크닉 선택에 영향을 주기 때문이다. 고성과자는 자신의 실패를 개인적으로 통제가능한 요인의 탓으로 돌리며(학습 테크닉 등), 저성과자는 통제불가능한 요인(능력, 난이도)에 돌린다.

Causal attributions refer to learners’ perceptions of the causes of the outcomes they attain in a particular task.11 The importance of causal attributions is that it directs the subsequent motivation of learners and their choice of tech- niques.10 High-performing learners tend to attribute their failure in the learning task to personally con- trollable factors, such as their use of specific learn- ing techniques, whereas low-performing learners tend to attribute unfavourable results to uncontrol- lable sources, such as ability or the difficulty of the learning task.


효과적인 SRL은 proactive engagement이며, 과제-특이적 프로세스를 사용해야 한다. 비-의학교육에서 SRL의 차이에 따른 성취도의 차이가 밝혀진 바 있다. 

Research suggests that a key feature of an effective self-regulated learner is proactive engagement in the process of learning and the use of task-specific processes prior to, during and follow-ing a learning task.12 In the non-medical education domain differences in SRL processes between high and low performers on various academic learning tasks have been identified.13–15



SRL microanalysis 

Self-regulated learning microanalysis

사회인지이론의 측면에서 SRL은 (Global, fixed가 아니라) 맥락- 특이적, 과제-특이적 사건이다. 이 가정이 중요한 이유는  SRL microanalytic 접근법이 특정 SRL 프로세스에 따라 커스토마이즈 되기 때문이다. SRL microanalysis는 구조화된 인터뷰 프로토콜을 포함하는데, 이는 think-aloud 인터뷰와 비슷해서 잘 정의된 학습과제를 수행하기 전/중간/후에 개방형 또는 폐쇄형의 과제-특이적 질문을 한다.

Through the lens of social-cognitive theory, SRL is considered to be a context- and task-specific event, rather than a global, fixed trait. Based on this important assumption, the SRL microanalytic approach is customised to specific SRL processes related to a learning task and measures processes within all three phases of the SRL cyclical loop. Self- regulated learning microanalysis involves a struc- tured interview protocol, similar to that used in think-aloud interviews, that involves administering open-ended or closed task-specific questions before, during and after the completion of a well-defined learning task.16


 

 

방법 

METHODS

참여자와 세팅 

Participants and setting

This study was conducted at Tehran University of Medical Sciences (TUMS) School of Medicine. The TUMS School of Medicine introduced a new out- come-based undergraduate medical curriculum from September 2011.

절차

Procedure

Students who were eligible to participate were invited by telephone to enrol in the study. Those who agreed to do so were given a scheduled appointment. Participants were briefed about the format of the session and specifically that students would not be allowed to make use of extra aids, such as books, or have access to the Internet during the completion of the learning task. Pens, high- lighters and blank papers were available on the desk. There was no time limit for completing the learning task.


자료

Materials


학생들에게 충분히 도전이 될 만한 수준의 신경과학 주제를 줌. 

A biomedical science learning task was developed on the topic of basal ganglia. This topic was selected based on expert opinion in the medical school that neuroscience topics were sufficiently challenging for students, and because participants had not previ- ously completed any learning tasks related to the basal ganglia or similar subject during their first semester.

제공 자료, MCQ, 문항 개발 

All students were provided with a one- page text in which a case of chorea was presented and the normal structure and function of the basal ganglia described. Students were instructed to answer a multiple-choice question (MCQ) that required the integration and application of the basic biomedical science knowledge provided with the case presentation.23 The learning task was devel- oped with the cooperation of two faculty members from the anatomy department. The validity and fea- sibility of the biomedical science task were exam- ined in a pilot study with 14 Year 2 students drawn from another cohort.

척도 

Measures 


SRL microanalysis 

Self-regulated learning microanalytic measures

참여학생의 SRL프로세스를 평가하기 위해서 SRL microanalytic assessment 를 개발하였다. Cleary의 가이드라인을 따름. 자기효능감을 측정하는 폐쇄항 질문과 6개의 SRL프로세스 관련 개방형 질문으로 이루어져 있다.

To assess the SRL processes of participants, an SRL microanalytic assessment protocol was devel- oped based on guidelines provided by Cleary et al.8 The protocol consisted of a closed question for the measuring self-efficacy measure24 and six open-ended questions for five SRL sub-processes including (two questions referred to the metacognitive monitoring measure).12
  1. goal setting,
  2. strategic planning,
  3. metacog- nitive monitoring, (2개 질문)
  4. causal attributions and
  5. adaptive inferences measures 

 

Forethought를 측정하는 질문은 참여자가 학습과제를 수행하기 직전에 물어보았다. 두 개의 메타인지 모니터링 질문은 학습과제 진행 중에 물었다. 기존 경험에 따라 performance 단계의 질문은 학습자가 과제를 시작한지 5분이 지난 이후에 물었다. Self reflection 단계의 질문은 과제를 마친 후 물었다.

Questions measuring forethought phase processes were administered immediately before participants started the learning task. Two metacognitive moni- toring questions measuring performance phase processes were asked during the biomedical science learning task. Based on our prior experi- ence in the pilot study and in order to standard- ise the protocol, we asked these performance phase questions at 5 minutes after students com- menced the learning task. Self-reflection phase questions were posed after participants had com- pleted the learning task.



개방형 응답의 분석 

To analyse participants’ responses to open-ended questions, we developed a coding scheme according to previous research on SRL microanalysis across different tasks,17–20 as well as related literature on biomedical science learning strategies.5,25 To con- textualise this, we discussed and modified the cod- ing scheme in consultation with a panel of experts, and further refined it based on the pilot study results. Participants’ responses were coded indepen- dently by two authors (RG and LF) into one of the predetermined categories for each SRL measure. When a participant’s response to an SRL item could be coded into more than one category, it was coded at the highest-level category possible. For example, if the respondent reported both task-specific and task-general processes, we coded the process as task- specific. Appendix S1 shows details of SRL sub-pro- cesses questions, coding categories and examples.

의과학 성취 척도 

Biomedical science performance outcome measures

두 가지를 사용하였음. (1)기존의 의과학 성취, (2)주어진 학습과제에서의 성취

We used two measures of biomedical science perfor- mance: (i) previous biomedical science perfor- mance, and (ii) the learning task performance test.

첫 번째 척도에 대해서, 대부분의 학생이 유사한 SRL프로세스를 쓸 거라는 가정에서, 기존 시험 performance의 양극단 점수를 포함시켜서 SRL 측정과 의과학 수행능력 간 관계를 보고자 했다.

For the first measure, participants’ prior perfor- mance in biomedical science was measured as the weighted average score on three examinations administered at the end of each interdisciplinary biomedical science block in the first semester. In view of the likelihood that most medical students would have the same SRL processes, we included two extremes of previous examination performance in order to capture significant associations between more SRL measures and biomedical science performance.26

두 번째, 학습과제에 대해서 MCQ 응답 결과를 사용
For the learning task performance test measure, to assess performance in the biomedical science learning task, participants were required to answer an MCQ regarding the underlying mechanism of presentations of chorea disease at the end of the basal ganglia passage.

통계분석 

Statistical analysis



결과

 

RESULTS


Table 1 presents a summary of descriptive results for the SRL microanalytic measures during the learning task for all participants and by study group.

 

 



 

 


Regression analyses

Table 2 displays a summary of the logistic regression results for the associations of SRL measures with previous biomedical science performance

 

 

 

Table 3 provides a summary of logistic regression results for the associations of SRL measures with being a high task performer during the learning task.


 

고찰 

DISCUSSION

비록 SRL이 전체 의학교육과정에 필수적이긴 하지만 우리가 아는 한 이것이 SRL microanalytic 접근법으로 의과학 학습에서의 SRL프로세스를 탐구한 첫 번째이다.  

To our best knowledge, this is the first study to use an SRL microanalytic approach to explore SRL pro- cesses during biomedical science learning, although SRL represents an essential skill for scientific think- ing throughout the entire medical education and practice experience.27

자기효능감 신념이  높고 메타인지 모니터링과 인과관계 귀인에서 과제-특이적 프로세스가 높을수록 기존 의과학 performance가 높았다. 학습과제 진행중에는 univariate analysis에서는 인과관계 귀인과 적응적 추론이 관계가 있었으나 multiple analysis에서는 인과관계 귀인만 관련되었다.

We identified that higher self-efficacy beliefs and a task-specific process (versus a task-general process) for metacognitive monitoring and causal attribu- tions measures were associated with previous biomedical science performance in both univariate and multiple analyses. We also identified that causal attributions and adaptive inferences were associated with learning task performance in univariate analysis and also that only causal attributions was associated with learning task performance in multiple analysis.


DiBenedetto and Zimmerman는 과거 과학과목 성취수준의 차이가 있는 학생에서 SRL microanalytic 프로토콜이 세 개의 자기조절학습 단계에 걸쳐서 차이를 보여줄 수 있다고 주장하였다. 그러나 이들은 일부 forethought measure (목표설정, 자기효능감, 기대성과)에서 차이를 찾지 못했다.

DiBenedetto and Zimmerman5 reported that an SRL microanalytic protocol can detect differences in self-regulatory processes throughout the three phases of the cycli- cal model of SRL among participants at different levels of prior science achievement. However, they did not find differences in some forethought mea- sures, including goal setting, self-efficacy and out- come expectation.5


저자들은 메타인지 모니터링과 자기성찰 프로세스가 가장 강력한 과거 과학과목 성취라고 지적했으며, 여기에는 strategic planning and strategy use가 포함된다. 그러나 이런 기존 연구와 달리 우리는 strategic planning과의 관곌르 찾지 못했다.

authors also noted that metacognitive monitoring and self-reflection processes were the strongest pre- dictors of students’ prior science performance in comparison with the other SRL measures, including strategic planning and strategy use.22 By contrast with these earlier findings, we did not discover any associations between strategic planning and previous performance.

주어진 학습과제  수행능력에 있어서, 우리는 self-reflection의 subprocess (인과관계 귀인, 적응적 추론)이 유일하게 예측력이 있음을 보여주었다. 이런 결과는 학생이 자신의 수행능력에 대한 귀인을 어떻게 하는지가 중요함을 보여주며, 의과대학 초반의 remediation에서 attribution-based training을 필수적 요소로 포함시켜야 함을 보여준다. Attribution-based training은 학습자들이 자신의 학습에 대해서 통제불가능하다고 믿었던 것을 다시 생각해보고, 적절한 학습전략을 사용함으로써 향상될 수 있다는 방식의 통제가능하다는 생각으로 바꾸게 하는 것이다.

In terms of biomedical science learning task per- formance, we unexpectedly found that the self- reflection sub-processes (causal attributions and adaptive inferences) were the only predictive mea- sures. These results underscore the importance of medical students’ attributions for their biomedical science performance and the need to include attri- bution-based training as an integral component of remediation interventions in the early years of medical school. Attribution-based training chal- lenges learners to reconsider the uncontrollable beliefs they hold about their learning performance and exchange these for controllable beliefs that their performance can be improved by using appropriate learning strategies.28

과학 학습과 관련된 기존 문헌은 SRL측정을 밝히는데 개념/지식 시험은 차이가 없음을 보여주었다. 참여자들의 친숙도 혹은 lack of challenge가 이것을 설명해줄수도 있다. 

Previous research in science learning has also revealed no differences between conceptual and knowledge tests in terms of uncovering SRL measures associations.21 The participants’ familiarity with and lack of challenge in the learning task may also represent possible explanations.


함의

Implications for practice and future research


과제-특이적 SRL microanalytic measures 는 높은 평가자간 신뢰도를 보여주었다.

The task-customised SRL microanalytic measures showed high levels of inter-rater reliability and pro- vided fine-grained results for the SRL processes as learners engaged in a biomedical science learning task.

SRL 프로세스를 밝히는 것의 장점은 교육자들이 SRL프로세스에 대해 피드백을 줄 수 있게 하는데, 이는 효과적인 피드백과 수행능력 향상에 필수적이다. K-12 대상의 기존 연구에서는 과학과목에서 낙제한 경험이 있는 학생에서 시험 퍼포먼스와 SRL프로세스 모두에 상당한 향상이 있었고, 특히 self-reflection sub-process에 향상이 있었다. 의과대학에서도 적용할 수 있을 것.

The main advantage of identifying SRL processes is to offer educators a framework31 for pro- viding feedback on SRL processes, which is essential for effective feedback and for improving perfor- mance.32,33 Previous research using a model of indi- vidualised feedback and training based on SRL microanalysis in the K–12 (kindergarten to 12th grade) context observed marked improvement in both test performance and SRL processes,6 particu- larly in self-reflection sub-processes,34 in students with previous science learning failure. The use of sim- ilar personalised remediation approaches that focus on SRL processes also has potential application in the academic context of medical school, including in peer mentoring programmes.35

개별화된 접근법에 더하여, 이번 연구는 의과대학 초반의 remediation을  attribution-based training 과 metacognitive interventions 중심으로 개편해야 함을 보여준다. 이 훈련 프로그램에서는 학습자가 자신의 성공과 실패에 대하여 생각하는 방식을 재구조화하여 학습자의 동기부여, 학습전략과 성취를 강화한다. 또한 학습자들에게 메타인지 스킬을 적용하게끔 독려한다. 교육자들은 학생의, 동료의, 혹은 자기 자신의 바람직한 귀인성향의 예시를 들어줌으로써 '통제가능한 귀인'에 대해서 말해줄 수 있다. 또한 biomedical science에서 과제-특이적 학습 프로세스를 모델링하여 학생의 메타인지 모니터링과 자기효능감을 강화시켜줄 수도 있다.

In addition to personalised approaches, the present findings have implications for directing the content of formal remediation interventions in the early years of medical school towards attribution-based training and metacognitive interventions. These training programmes are designed to enhance lear- ner motivation, learning strategies and achievement by restructuring how learners think about their suc- cesses and failures,28 as well as by encouraging them to apply metacognitive skills.36 Biomedical science educators may also use the results of this investiga- tion to infuse their routine teaching activities. They may communicate controllable attributions during a teaching event by exemplifying students’, peers’ or their own desirable attributions.37 They may also enhance students’ metacognitive monitoring and self-efficacy by modelling the use of task-specific pro- cesses for the learning of biomedical science con- cepts during teaching episodes.38

Strengths and limitations



CONCLUSIONS


1 Hauer KE, Ciccone A, Henzel TR, Katsufrakis P, Miller SH, Norcross WA, Papadakis MA, Irby DM. Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature. Acad Med 2009;84 (12):1822–32.

23 Kulasegaram KM, Martimianakis MA, Mylopoulos M, Whitehead CR, Woods NN. Cognition before curriculum: rethinking the integration of basic science and clinical learning. Acad (10):1578–85.




Appendix S1. Self-Regulated Learning (SRL) Micro- analytic Protocol (Bioscience learning task).
 


 2016 Oct;50(10):1065-74. doi: 10.1111/medu.12975.

Self-regulated learning processes of medical students during an academic learning task.

Author information

  • 1Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • 2Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. mirzazad@tums.ac.ir.
  • 3Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. mirzazad@tums.ac.ir.
  • 4Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • 5Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • 6Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • 7Academic Unit of Medical Education, School of Medicine, University of Sheffield, Sheffield, UK.

Abstract

OBJECTIVES:

This study was designed to identify the self-regulated learning (SRL) processes of medical students during a biomedical science learning task and to examine the associations of the SRL processes with previous performance in biomedical science examinations and subsequent performance on a learning task.

METHODS:

A sample of 76 Year 1 medical students were recruited based on their performance in biomedical science examinations and stratified into previous high and low performers. Participants were asked to complete a biomedical science learning task. Participants' SRL processes were assessed before (self-efficacy, goal setting and strategic planning), during (metacognitive monitoring) and after (causal attributions and adaptive inferences) their completion of the task using an SRL microanalytic interview. Descriptive statistics were used to analyse the means and frequencies of SRL processes. Univariate and multiple logistic regression analyses were conducted to examine the associations of SRL processes with previous examination performance and the learning taskperformance.

RESULTS:

Most participants (from 88.2% to 43.4%) reported task-specific processes for SRL measures. Students who exhibited higher self-efficacy (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.09-1.90) and reported task-specific processes for metacognitive monitoring (OR 6.61, 95% CI 1.68-25.93) and causal attributions (OR 6.75, 95% CI 2.05-22.25) measures were more likely to be high previous performers. Multiple analysis revealed that similar SRL measures were associated with previous performance. The use of task-specific processes for causal attributions (OR 23.00, 95% CI 4.57-115.76) and adaptive inferences (OR 27.00, 95% CI 3.39-214.95) measures were associated with being a high learning task performer. In multiple analysis, only the causal attributions measure was associated with high learning task performance.

CONCLUSIONS:

Self-efficacy, metacognitive monitoring and causal attributions measures were associated positively with previous performance. Causal attributions and adaptive inferences measures were associated positively with learning task performance. These findings may inform remediation interventions in the early years of medical school training.

PMID:
 
27628723
 
DOI:
 
10.1111/medu.12975
[PubMed - in process]


+ Recent posts