Ross Shelley, Pirraglia Cassandra, Aquilina Alexandra M, Zulla Rosslynn
Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.
Med Teach. 2022 May;44(5):527-534. doi: 10.1080/0142159X.2021.2004307. Epub 2021 Nov 22.
Competency-based medical education (CBME) emphasizes the need for learners to be central to their own learning and to take an active role in learning. This approach has a dual aim: to encourage learners to actively engage in their own learning, and to push learners to develop learning strategies that will prepare them for lifelong learning. This review paper proposes a theoretical bridge between CBME and lifelong learning and puts forth the argument that in order for CBME programs to produce the physicians truly needed in our society now and in the future, learning environments must be intentionally designed to foster mastery goal orientations and to support the development of adaptive self-regulated learning skills and behaviours.
This narrative literature review incorporated results of searches conducted by a subject librarian in PsycInfo and MedLine. Articles were also identified through reference lists of identified papers to capture older key citations. Analysis of the literature used a constructivist epistemological approach to develop an integrative description of the interaction of achievement goal orientation, self-regulated learning, learning environment, and lifelong learning.
Findings from achievement goal theory research support the assumption that adoption of a mastery goal orientation facilitates the use of adaptive learning behaviours, such as those described in self-regulated learning theory. Adaptive self-regulated learning strategies, in turn, facilitate effective lifelong learning. The authors offer evidence for how learning environments influence goal orientations and self-regulated learning, and propose that CBME programs intentionally plan for such learning environments. Finally, the authors offer specific suggestions and examples for how learning environments can be designed or adjusted to support adoption of a mastery goal orientation and use of self-regulated learning behaviours and strategies to help support development of adaptive lifelong learners.
基于能力的医学教育（CBME）强调学习者应成为自身学习的核心，并在学习中发挥积极作用。这种方法有双重目标：鼓励学习者积极参与自身学习，并促使学习者制定学习策略，为终身学习做好准备。这篇综述论文提出了CBME与终身学习之间的理论桥梁，并提出论点，即要使CBME项目培养出我们社会现在和未来真正需要的医生，就必须有意设计学习环境，以培养掌握目标导向，并支持适应性自我调节学习技能和行为的发展。
本叙述性文献综述纳入了一名学科馆员在PsycInfo和MedLine中进行检索的结果。还通过已识别论文的参考文献列表来识别文章，以获取早期的关键引用文献。文献分析采用建构主义认识论方法，对成就目标导向、自我调节学习、学习环境和终身学习之间的相互作用进行综合描述。
成就目标理论研究的结果支持这样一种假设，即采用掌握目标导向有助于使用适应性学习行为，如自我调节学习理论中所描述的那些行为。反过来，适应性自我调节学习策略又有助于有效的终身学习。作者提供了学习环境如何影响目标导向和自我调节学习的证据，并建议CBME项目有意规划这样的学习环境。最后，作者针对如何设计或调整学习环境以支持采用掌握目标导向以及使用自我调节学习行为和策略来帮助培养适应性终身学习者提供了具体建议和示例。
