Directed self‐regulated learning versus instructor‐regulated learning in simulation training
- 12 June 2012
- journal article
- research article
- Published by Wiley in Medical Education
- Vol. 46 (7), 648-656
- https://doi.org/10.1111/j.1365-2923.2012.04268.x
Abstract
Simulation training offers opportunities for unsupervised, self-regulated learning, yet little evidence is available to indicate the efficacy of this approach in the learning of procedural skills. We evaluated the effectiveness of directed self-regulated learning (DSRL) and instructor-regulated learning (IRL), respectively, for teaching lumbar puncture (LP) using simulation. We randomly assigned internal medicine residents in postgraduate year 1 to either DSRL ('directed' to progress from easy to difficult LP simulators during self-regulated learning) or IRL (in groups of four led by an instructor). All participants practised for up to 50 minutes and completed a pre-test, post-test and delayed (by 3 months) retention test on the simulator. Pairs of blinded trained experts independently rated all videotaped performances using a validated global rating scale and a modified version of a validated checklist. Participants provided measures of LP experience and self-reported confidence. We analysed the pre-post (n = 42) and pre-post-retention performance scores (n = 23) using two separate repeated-measures analyses of variance (anovas) and computed Pearson correlation coefficients between participants' confidence and performance scores. Inter-rater agreement was strong for both performance measures (intra-class correlation coefficient > 0.81). The groups achieved similar pre-test and post-test scores (p > 0.05) and scores in both groups improved significantly from the pre- to the post-test (p < 0.05). On retention, a significant interaction (F(2,42) = 3.92, p = 0.03) suggests the DSRL group maintained its post-test performance, whereas that in the IRL group dropped significantly (p < 0.05). Correlations between self-reported confidence and post-test performance were positive and significant for the DSRL group, and negative and non-significant for the IRL group. Both IRL and DSRL led to improved LP performance immediately after practice. Whereas the IRL group's skills declined after 3 months, the DSRL group's performance was maintained, suggesting a potential long-term benefit of this training. Participants in the DSRL group also developed a more accurate relationship between confidence and competence following practice. Further research is needed to clarify the mechanisms of self-regulated learning and its role in simulation contexts.Keywords
This publication has 33 references indexed in Scilit:
- Exploring the divergence between self-assessment and self-monitoringAdvances in Health Sciences Education, 2010
- Use of simulator-based medical procedural curriculum: the learner's perspectivesBMC Medical Education, 2010
- Comparing self‐guided learning and educator‐guided learning formats for simulation‐based clinical trainingJournal of Advanced Nursing, 2010
- Supervising the Supervisors—Procedural Training and Supervision in Internal Medicine ResidencyJournal of General Internal Medicine, 2010
- How to Select, Calculate, and Interpret Effect SizesJournal of Pediatric Psychology, 2009
- Self-Directed Learning in Problem-Based Learning and its Relationships with Self-Regulated LearningEducational Psychology Review, 2008
- Beyond the Comfort Zone: Residents Assess Their Comfort Performing Inpatient Medical ProceduresAmerican Journal Of Medicine, 2006
- Competence of New Emergency Medicine Residents in the Performance of Lumbar PuncturesAcademic Emergency Medicine, 2005
- Does Simulator Training for Medical Students Change Patient Opinions and Attitudes toward Medical Student Procedures in the Emergency Department?Academic Emergency Medicine, 2005
- Patient Opinions and Attitudes toward Medical Student Procedures in the Emergency DepartmentAcademic Emergency Medicine, 2003