Perspective: viewing "strugglers" through a different lens: how a self-regulated learning perspective can help medical educators with assessment and remediation.

Medical educators are responsible for training current and future generations of physicians; this includes the early and accurate identification of "struggling" medical trainees, which has implications for future training, practice, and success.The authors propose a theory-based framework, Self-Regulated Learning-Microanalytic Assessment and Training (SRL-MAT), that is specifically designed to foster individual medical trainee self-regulatory beliefs and behaviors, and thus provide a distinct method to assist medical trainees who struggle. The SRL-MAT is grounded in social-cognitive theory and research and makes a variety of important assumptions about learning and the essential techniques needed to evaluate trainee functioning. Two critical assumptions are that (1) self-efficacy beliefs are a key personal process affecting trainee behavior, and (2) trainee beliefs and behaviors are dynamic and fluid in nature and thus will often vary across educational contexts, as well as for specific tasks within those contexts. To address these assumptions, the SRL-MAT uses an emergent assessment approach called self-regulated learning microanalysis, a procedure that involves asking a series of temporally sequenced questions about specific regulatory processes as trainees engage in an authentic task or activity. The framework, which is grounded in a foundation of established educational research, is adaptable to practically any task that has a clear beginning and end. The authors believe this framework could make important contributions to traditional medical training assessment frameworks that have been used to identify and remediate strugglers.