Fatima Sahar, Hong Wei-Han, Mohd Noor Mohamad Nabil, Foong Chan Choong, Pallath Vinod
Medical Education & Research Development Unit (MERDU), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
Teach Learn Med. 2025 Feb 24:1-19. doi: 10.1080/10401334.2025.2468953.
Self-regulated learning (SRL) can significantly improve academic achievement and clinical performance. The clinical clerkship is a crucial setting for reinforcing and extending SRL skills and behaviors into clinical practice. However, learning in clinical settings is often opportunistic and contextual, requiring diverse instructional strategies and tailored learning opportunities. Studies from the past two decades have indicated challenges in implementing SRL strategies particularly in Asian countries. While many of the pedagogical approaches used in medical education include aspects of SRL theory, a comprehensive overview of effective SRL instructional strategies in clinical clerkships is lacking. We reviewed all studies (published between January 2012 and May 2024, identified systematic search of EBSCOhost, PubMed, ScienceDirect, Scopus, and Web of Science) that discuss instructional strategies influencing SRL among clinical clerkship students, in general, and with special reference to the Asian context. Twenty seven articles were included in the final analysis. We conducted convergent integrated synthesis on the data extracted from all included studies to generate categories and themes. SRL instructional strategies reported included implementing learning plans and goal setting, operationalizing formal mentoring and feedback processes, utilizing technology-enhanced learning, facilitating collaborative group learning, providing simulation-based learning experiences, and applying experiential learning strategies. When implemented effectively, such strategies were shown to promote self-regulated learning, motivational beliefs, self-monitoring, and self-reflection. Faculty support, mentoring and timely feedback were crucial in successfully implementing SRL strategies. Incorporating SRL into existing curricula was ideal for ensuring feasibility and long-term sustainability. Limited research from the Asian region indicates that SRL has not been used to its full potential in Asian medical education. Asian medical students' SRL potential could be maximized with shared roles of students and teachers in a student-driven approach. Medical educators should take responsibility for providing opportunities and a conducive environment to foster SRL among clinical clerkship students. Future research should prioritize longitudinal, experimental studies with comparison groups and objective SRL outcome measures to rigorously evaluate the impact of instructional strategies in the clinical clerkship context.
自我调节学习（SRL）能够显著提高学业成绩和临床实践表现。临床实习是将SRL技能和行为强化并扩展到临床实践中的关键场所。然而，在临床环境中的学习往往具有机会性和情境性，需要多样化的教学策略和量身定制的学习机会。过去二十年的研究表明，在实施SRL策略方面存在挑战，尤其是在亚洲国家。虽然医学教育中使用的许多教学方法都包含SRL理论的各个方面，但缺乏对临床实习中有效SRL教学策略的全面概述。我们回顾了所有（2012年1月至2024年5月期间发表，通过对EBSCOhost、PubMed、ScienceDirect、Scopus和Web of Science进行系统检索确定）讨论影响临床实习学生SRL的教学策略的研究，总体而言，并特别参考亚洲背景。最终分析纳入了27篇文章。我们对从所有纳入研究中提取的数据进行了收敛性综合分析，以生成类别和主题。报告的SRL教学策略包括制定学习计划和设定目标、实施正式的指导和反馈流程、利用技术增强学习、促进小组协作学习、提供基于模拟的学习体验以及应用体验式学习策略。当有效实施时，这些策略被证明能够促进自我调节学习、动机信念、自我监控和自我反思。教师支持、指导和及时反馈对于成功实施SRL策略至关重要。将SRL纳入现有课程对于确保可行性和长期可持续性是理想的。来自亚洲地区的有限研究表明，SRL在亚洲医学教育中尚未得到充分利用。在以学生为导向的方法中，通过学生和教师的共同作用，可以最大限度地发挥亚洲医学生的SRL潜力。医学教育工作者应负责提供机会和有利环境，以培养临床实习学生的SRL。未来的研究应优先进行纵向、有对照组的实验研究以及客观的SRL结果测量，以严格评估教学策略在临床实习背景下所产生的影响。
