Contextual attributes promote or hinder self-regulated learning: A qualitative study contrasting rural physicians with undergraduate learners in Japan

Abstract

Background and objectives: Previous studies support the notion that East Asian medical students do not possess sufficient self-regulation for postgraduate clinical training. However, some East Asian physicians who are employed in geographically isolated and educationally underserved rural settings can self-regulate their study during the early phase of their postgraduate career. To explore the contextual attributes that contribute to self-regulated learning (SRL), we examined the differences in self-regulation between learning as an undergraduate and in a rural context in East Asia.

Methods: We conducted interviews and diary data collection among rural physicians (n = 10) and undergraduates (n = 11) in Japan who undertook self-study of unfamiliar diseases. We analyzed three domains of Zimmerman’s definition of SRL: learning behaviors, motivation, and metacognition using constructivist grounded theory.

Results: Rural physicians recognized their identity as unique, and as professionals with a central role of handling diseases in the local community by conducting self-study. They simultaneously found themselves being at risk of providing inappropriate aid if their self-study was insufficient. They developed strategic learning strategies to cope with this high-stakes task. Undergraduates had a fear of being left behind and preferred to remain as one of the crowd with students in the same school year. Accordingly, they copied the methods of other students for self-study and used monotonous and homogeneous strategies.

Conclusions: Different learning contexts do not keep East Asian learners from being self-regulated. Awareness of their unique identity leads them to view learning tasks as high-stakes, and to initiate learning strategies in a self-regulated manner. Teacher-centered education systems cause students to identify themselves as one of the crowd, and tasks as low-stakes, and to accordingly employ non-self-regulated strategies.

Acknowledgements

The authors are sincerely grateful to Dr. Anique de Bruin and Prof. Shizukiyo Ishikawa for their excellent suggestions, and are grateful to Ms. Yasuko Koguchi and Ms. Kaori Tasaki for their assistance.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Self-regulated learning (SRL): Learners’ active participation in their own learning process from metacognitive, motivational, and behavioral perspectives

Zimmerman BJ. 1989. A social cognitive view of self-regulated academic learning. J Educ Psychol. 81:329–339.

Notes on contributors

Yasushi Matsuyama, MD, MHPE, PhD, is an Assistant Professor in the Medical Education Centre, Jichi Medical University, Japan.

Motoyuki Nakaya, PhD, is a Professor in the Department of Psychology and Human Developmental Sciences, Nagoya University, Japan.

Hitoaki Okazaki, MD, PhD, is a Professor in the Medical Education Centre, Jichi Medical University, Japan.

Jimmie Leppink, PhD, is an Assistant Professor in the Faculty of Health, Medicine and Life Sciences, Department of Educational Development and Research, Maastricht University, The Netherlands.

Cees van der Vleuten, PhD, is a Professor in the Faculty of Health, Medicine and Life Sciences, Department of Educational Development and Research, Maastricht University, The Netherlands.

Additional information

Funding

This work was supported by JSPS KAKENHIJSPS KAKENHI [grant number JP17K08924], and Japan Medical Education Foundation.