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Self-regulated learning: the effect on medical student learning outcomes in a flipped classroom environment.

ABSTRACT: BACKGROUND:The flipped-classroom model is increasingly being adopted in competency-based medical education. However, it poses a major challenge to students who have not mastered self-regulated learning strategies. This study explores which self-regulated learning skills affect student learning performance in the first 2 years of medical school at a university in the midwestern United States. METHODS:Survey data were used to assess how 146 first- and second-year medical students' use of self-regulated learning strategies affected their performance on standardized tests. RESULTS:Based on the results of regression analysis and content analysis, it was found that the use of peer learning and help-seeking positively affected the performance of first- and second-year students, respectively; whereas the use of rehearsal had a negative effect on student learning outcomes. CONCLUSIONS:The study findings imply that during the transition period from traditional lecture-intensive learning to flipped-classroom learning, promoting peer learning and help-seeking could significantly improve students' academic achievement.

SUBMITTER: Zheng B

PROVIDER: S-EPMC7110809 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Self-regulated learning: the effect on medical student learning outcomes in a flipped classroom environment.

Zheng Binbin B Zhang Yining Y

BMC medical education 20200331 1

<h4>Background</h4>The flipped-classroom model is increasingly being adopted in competency-based medical education. However, it poses a major challenge to students who have not mastered self-regulated learning strategies. This study explores which self-regulated learning skills affect student learning performance in the first 2 years of medical school at a university in the midwestern United States.<h4>Methods</h4>Survey data were used to assess how 146 first- and second-year medical students' u ...[more]

PMID: 32234040

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Project description:Self-regulated learning (SRL), which is learners' ability to proactively select and use different strategies to reach learning goals, is associated with academic and clinical success and life-long learning. SRL does not develop automatically in the clinical environment and its development during the preclinical to clinical learning transition has not been quantitatively studied. Our study aims to fill this gap by measuring SRL in medical students during the transitional period and examining its contributing factors.Medical students were invited to complete a questionnaire at the commencement of their first clinical year (T0), and 10 weeks later (T1). The questionnaire included the Motivated Strategies for Learning Questionnaire (MSLQ) and asked about previous clinical experience. Information about the student's background, demographic characteristics and first clinical rotation were also gathered.Of 118 students invited to participate, complete paired responses were obtained from 72 medical students (response rate 61%). At T1, extrinsic goal orientation increased and was associated with gender (males were more likely to increase extrinsic goal orientation) and type of first attachment (critical care and community based attachments, compared to hospital ward based attachments). Metacognitive self-regulation decreased at T1 and was negatively associated with previous clinical experience.Measurable changes in self-regulated learning occur during the transition from preclinical learning to clinical immersion, particularly in the domains of extrinsic goal orientation and metacognitive self-regulation. Self-determination theory offers possible explanations for this finding which have practical implications and point the way to future research. In addition, interventions to promote metacognition before the clinical immersion may assist in preserving SRL during the transition and thus promote life-long learning skills in preparation for real-world practice.

Project description:The flipped classroom (FC), reversing lecture and homework elements of a course, is popular in medical education. The FC uses technology-enhanced pre-class learning to transmit knowledge, incorporating in-class interaction to enhance higher cognitive learning. However, the FC model is expensive and research on its effectiveness remains inconclusive. The aim of this study was to compare the efficacy of the FC model over traditional lecture-based (LB) learning by meta-analysis.We systematically searched MEDLINE, PubMed, ERIC, CINAHL, EMBASE, reference lists and Association for Medical Education in Europe (AMEE) conference books. Controlled trials comparing academic outcomes between the FC and LB approaches in higher education were considered eligible. The main findings were pooled using a random-effects model when appropriate.Forty-six studies (9026 participants) were included, comprising four randomised controlled trials (RCTs), 19 quasi-experimental studies and 23 cohort studies. Study populations were health science (n = 32) and non health science (n = 14) students. The risk of bias was high (36/37 articles). Meta-analyses revealed that the FC had significantly better outcomes than the LB method in examination scores (post-intervention and pre-post change) and course grades, but not in objective structured clinical examination scores. Subgroup analyses showed the advantage of the FC was not observed in RCTs, non-USA countries, nursing and other health science disciplines and earlier publication years (2013 and 2014). Cumulative analysis and meta-regression suggested a tendency for progressively better outcomes by year. Outcome assessments rarely focused on behaviour change.The FC method is associated with greater academic achievement than the LB approach for higher-level learning outcomes, which has become more obvious in recent years. However, results should be interpreted with caution because of the high methodological diversity, statistical heterogeneity and risk of bias in the studies used. Future studies should have high methodological rigour, a standardised FC format and utilise assessment tools evaluating higher cognitive learning and behaviour change to further examine differences between FC and LB learning.

Project description:BackgroundToday, flipped classroom (FC) has been widely used in medical education. However, the effectiveness of FC remains controversial. The variation may cause by different subjects or different course design. Moreover, those studies did not explain how the association among different domains of learning objective was in FCs. The purpose of this study was to explore the help of learning domains from a FC of suturing skill in year-5 medical students.DesignThis study determined sample size according to statistical power. A minimum number of 77 participants for regression analysis are needed. Therefore, this study enrolled 78 medical students in a 2-hour suturing course, which consisted of pre-class video and in-class instruction. Both simple and mattress suturing were taught. The students received an anonymous survey with questionnaire of Help from Instruction Questionnaire for Clinical Skills (HIQ-CS) after the course. The HIQ-CS was developed by medical education team according to Bloom's taxonomy, and its reliability was favorable (Cronbach's ^l = 0.839). Factor loadings among all items in the HIQ-CS was also favorable (0.790 to 0.849). This study determined consensus of students' perspective by median (Me) and interquartile range (IQR), and tested mediation among different learning domains by regression.ResultsThe results showed medical students agreed FC can help them in learning suturing (Me = 4, IQR = 1). The cognitive help (β = .526, p < .001) was completely mediated by psychomotor help (β = .399, p < .001) and affective help (β = .413, p < .001) to overall helps in FC. The affective help (β = .617, p < .001) was partially mediated by psychomotor help to overall helps in FC.ConclusionsFC may help students in learning suturing skill in different domains. Our model explains the cognitive help from FC provides an important foundation for the helps of other domains. Although the model should be examined by different curricula and measurements in future, the model of help from instruction in our study provided an innovated concept and framework in medical education.

Dataset Information

Self-regulated learning: the effect on medical student learning outcomes in a flipped classroom environment.

Publications

Self-regulated learning: the effect on medical student learning outcomes in a flipped classroom environment.

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