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Logo of bmcmeduBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Education
 
BMC Med Educ. 2012; 12: 67.
Published online Aug 6, 2012. doi:  10.1186/1472-6920-12-67
PMCID: PMC3479408
How do postgraduate GP trainees regulate their learning and what helps and hinders them? A qualitative study
Margaretha H Sagasser,corresponding author1 Anneke WM Kramer,1 and Cees PM van der Vleuten1,2,3,4
1Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Radboud, The Netherlands
2Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
3King Saud University, Riyadh, Saudi Arabia
4University of Copenhagen, Copenhagen, Denmark
corresponding authorCorresponding author.
Margaretha H Sagasser: g.sagasser/at/elg.umcn.nl; Anneke WM Kramer: a.kramer/at/elg.umcn.nl; Cees PM van der Vleuten: c.vandervleuten/at/maastrichtuniversity.nl
Received March 19, 2012; Accepted June 26, 2012.
Abstract
Background
Self-regulation is essential for professional development. It involves monitoring of performance, identifying domains for improvement, undertaking learning activities, applying newly learned knowledge and skills and self-assessing performance. Since self-assessment alone is ineffective in identifying weaknesses, learners should seek external feedback too. Externally regulated educational interventions, like reflection, learning portfolios, assessments and progress meetings, are increasingly used to scaffold self-regulation.
The aim of this study is to explore how postgraduate trainees regulate their learning in the workplace, how external regulation promotes self-regulation and which elements facilitate or impede self-regulation and learning.
Methods
In a qualitative study with a phenomenologic approach we interviewed first- and third-year GP trainees from two universities in the Netherlands. Twenty-one verbatim transcripts were coded. Through iterative discussion the researchers agreed on the interpretation of the data and saturation was reached.
Results
Trainees used a short and a long self-regulation loop. The short loop took one week at most and was focused on problems that were easy to resolve and needed minor learning activities. The long loop was focused on complex or recurring problems needing multiple and planned longitudinal learning activities. External assessments and formal training affected the long but not the short loop. The supervisor had a facilitating role in both loops. Self-confidence was used to gauge competence.Elements influencing self-regulation were classified into three dimensions: personal (strong motivation to become a good doctor), interpersonal (stimulation from others) and contextual (organizational and educational features).
Conclusions
Trainees did purposefully self-regulate their learning. Learning in the short loop may not be visible to others. Trainees should be encouraged to actively seek and use external feedback in both loops. An important question for further research is which educational interventions might be used to scaffold learning in the short loop. Investing in supervisor quality remains important, since they are close to trainee learning in both loops.
Keywords: Self-regulation, Workplace-based learning, Postgraduate training, Professional development, Qualitative research methods
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