When uncertain, medical trainees often seek to co-regulate their learning with supervisors and peers. Evidence suggests they may enact self-regulated learning (SRL) strategies differently when engaged in self- versus co-regulated learning (Co-RL). We compared the impacts of SRL and Co-RL on trainees' acquisition, retention, and preparation for future learning (PFL) of cardiac auscultation skills during simulation-based training. In our two-arm, prospective, non-inferiority trial, we randomly assigned first- and second-year medical students to the SRL (N = 16) or Co-RL conditions (N = 16). Across two learning sessions separated by two-weeks, participants practiced and were assessed in diagnosing simulated cardiac murmurs. We examined diagnostic accuracy and learning trace data across sessions, and conducted semi-structured interviews to explore participants' understandings of their underlying choices and learning strategies. SRL participants' outcomes were non-inferior to Co-RL participants on the immediate post-test and retention test, but not on the PFL assessment (i.e., inconclusive). Analyzing interview transcripts (N = 31) generated three themes: perceived utility of initial learning supports for future learning; SRL strategies and sequencing of murmurs; and perceived control over learning across sessions. Co-RL participants regularly described relinquishing control of learning to supervisors and regaining it when on their own. For some trainees, Co-RL seemed to interfere with their situated and future SRL. We posit that transient clinical training sessions, typical in simulation-based and workplace-based settings, may not allow the ideal processes of Co-RL to unfold between supervisor and trainee. Future research must examine how supervisors and trainees can share accountability to develop the shared mental models that underlie effective Co-RL.

中文翻译：

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放弃控制？在基于模拟的培训期间，监督员共同监管可能会扰乱学生的自我调节学习。

当不确定时，医学实习生通常会寻求与主管和同行共同规范他们的学习。有证据表明，当他们进行自我调节学习 (Co-RL) 与协同调节学习 (Co-RL) 时，他们可能会采用不同的自我调节学习 (SRL) 策略。我们比较了 SRL 和 Co-RL 对受训者在基于模拟的培训期间获得、保留和准备未来心脏听诊技能 (PFL) 的影响。在我们的双臂、前瞻性、非劣效性试验中，我们将一年级和二年级医学生随机分配到 SRL（N = 16）或 Co-RL 条件（N = 16）。在相隔两周的两个学习课程中，参与者练习并接受了诊断模拟心脏杂音的评估。我们检查了跨会话的诊断准确性和学习跟踪数据，并进行了半结构化访谈，以探索参与者对其基本选择和学习策略的理解。SRL 参与者的结果在即时后测和保留测试中不劣于 Co-RL 参与者，但在 PFL 评估上（即不确定）。分析访谈记录 (N = 31) 产生了三个主题：初步学习支持未来学习的感知效用；SRL 策略和杂音排序；以及对跨会话学习的感知控制。Co-RL 参与者经常描述将对学习的控制权交给监督者并在他们自己时重新获得。对于一些受训者来说，Co-RL 似乎会干扰他们的情境和未来的 SRL。我们假设短暂的临床培训课程，典型的基于模拟和基于工作场所的设置，可能不允许 Co-RL 的理想过程在主管和受训者之间展开。未来的研究必须研究主管和学员如何分担责任，以开发构成有效 Co-RL 基础的共享心智模型。