Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia.
Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Australia.
BMJ Open. 2019 May 24;9(5):e026796. doi: 10.1136/bmjopen-2018-026796.
OBJECTIVES: The formative aspect of the mini-clinical evaluation exercise (mini-CEX) in postgraduate medical workplace-based assessment is intended to afford opportunities for active learning. Yet, there is little understanding of the perceived relationship between the mini-CEX and how trainees self-regulate their learning. Our objective was to explore trainees' perceptions of their mini-CEX experiences from a learning perspective, using Zimmerman's self-regulated learning theoretical framework as an interpretive lens. DESIGN: Qualitative, using semi-structured interviews conducted in 2017. The interviews were analysed thematically. SETTING: Geriatric medicine training. PARTICIPANTS: Purposive sampling was employed to recruit geriatric medicine trainees in Melbourne, Australia. Twelve advanced trainees participated in the interviews. RESULTS: Four themes were found with a cyclical inter-relationship between three of these themes: namely, goal setting, task translation and perceived outcome. These themes reflect the phases of the self-regulated learning framework. Each phase was influenced by the fourth theme, supervisor co-regulation. Goal setting had motivational properties that had significant impact on the later phases of the cycle. A 'tick box' goal aligned with an opportunistic approach and poorer perceived educational outcomes. Participants reported that external feedback following assessment was critical for their self-evaluation, affective responses and perceived outcomes. CONCLUSIONS: Trainees perceived the performance of a mini-CEX as a complex, inter-related cyclical process, influenced at all stages by the supervisor. Based on our trainee perspectives of the mini-CEX, we conclude that supervisor engagement is essential to support trainees to individually regulate their learning in the clinical environment.
目的:迷你临床演练评估(mini-CEX)在研究生医学基于工作场所的评估中的形成性方面旨在提供主动学习的机会。然而,对于 mini-CEX 与学员如何自我调节学习之间的感知关系,我们知之甚少。我们的目的是从学习的角度探讨学员对他们的 mini-CEX 体验的看法,使用 Zimmerman 的自我调节学习理论框架作为解释性视角。
设计:定性,使用 2017 年进行的半结构化访谈。对访谈进行了主题分析。
设置:老年医学培训。
参与者:采用目的抽样法在澳大利亚墨尔本招募老年医学学员。12 名高级学员参加了访谈。
结果:发现了四个主题,其中三个主题之间存在循环的相互关系:即目标设定、任务转化和感知结果。这些主题反映了自我调节学习框架的各个阶段。每个阶段都受到第四个主题,即主管共同调节的影响。目标设定具有动机性,对周期的后期阶段有重大影响。与机会主义方法和较差的感知教育结果相关的“勾选框”目标。参与者报告说,评估后提供的外部反馈对他们的自我评价、情感反应和感知结果至关重要。
结论:学员认为 mini-CEX 的表现是一个复杂的、相互关联的循环过程,在各个阶段都受到主管的影响。基于我们对学员对 mini-CEX 的看法,我们得出结论,主管的参与对于支持学员在临床环境中自我调节学习至关重要。
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