Integrating self-regulated learning to be a strong learning line

The forethought phase includes activities such as orienting oneself to the task, setting goals, and planning. Following this is the implementation phase, where the student monitors their own progress and, if necessary, adjusts their approach. The reflection phase involves considering the outcome, evaluating the process, and drawing conclusions for further learning.

Additionally, each phase involves the ability to self-motivate, direct thoughts and behaviors, and regulate emotions.

How did your interest in student self-regulated learning arise?

As a student, how self-regulated learning did you learn?

Sylvia Heeneman: My interest in self-regulated learning stems from both practical experience and my research interests. I observe how students navigate and learn through a curriculum, and I am particularly fascinated by the relationship with assessment. Self-regulated learning cannot be separated from assessment, and it is precisely this interaction between the two that captivates me.

Judith Sieben: The question brings back memories that take a moment to recall. I believe I practiced self-regulation reasonably well at the time, albeit often in a naive manner, without fully understanding the processes involved. In my professional life, I find that self-regulation skills are essential, yet I sometimes encounter limitations, particularly when things get busier. Maintaining these skills under such circumstances and staying aware of them remains challenging, both then and now.

A new English-language Bachelor of Medicine programme was launched in 2022. In this program, both the curriculum and the teaching approach have been revamped. Students now work in small learning teams of 10 students on practical tasks for an entire year, guided by a coach. The students are responsible for their own planning, approach and working methods.

Judith Sieben: Yes, previously, we as teachers determined the order of cases, which was often not optimal for every student. Despite several revisions, students did not see the coherence in the curriculum. Now, in small teams, students have more autonomy and flexibility to determine their own learning plan and approach. Through different work formats and an extended period for case studies, students create their own logical coherence. This results in better student engagement, more variety, and less drudgery in our approach to Problem-Based Learning (PBL).

Are self-regulation skills necessary for students to navigate such a learning environment?

Why is it so important for students to be able to self-regulate learning within education?

Judith Sieben: Yes, we have designed the curriculum so that students need self-regulation skills to navigate it. At the same time, we have also considered the reverse: the learning environment should provide enough room for self-regulation. If everything is too strict, there is little for students to self-regulate. We have thought about how to create space for self-regulation through learning activities, resources, and assessment, and how to integrate these skills into them.

Sylvia Heeneman: We believe it is essential for students to engage in self-regulated learning, as this prepares them for their future field of work where they must make their own decisions about their learning. In medicine, this helps them transition from bachelor to master, where they work as interns in a hectic environment and receive substantial feedback. Self-regulation skills enable them to effectively navigate and continuously improve based on this feedback.

How have you incorporated self-regulated learning into your training? Which self-regulation skills do you emphasize within the programme?

Which self-regulation skills receive the most attention within the curriculum?

Judith Sieben: We have integrated self-regulated learning into our training by using portfolios, which encompass a cycle of evaluation, self-reflection, and goal setting. We pay explicit attention to reflection and the preparation phase. Other aspects, such as the implementation phase, are addressed in one-on-one interactions between students and coaches, focusing on individual learning paths and pacing. While we recognize self-regulation skills such as emotion regulation and self-motivation as essential, these are implicit aspects that require further attention and specific tools or interventions in the future.

Judith Sieben: First, self-evaluation. We encourage students to regularly gather feedback and information and systematically evaluate their own progress. They receive explicit assignments to look at the bigger picture, recognise patterns, and identify what is going well and what still needs improvement. Second, setting personal learning objectives. In addition to subject-specific learning objectives, we encourage students to formulate their own learning goals, which helps them develop competences beyond just knowledge. Although this is sometimes challenging, we support them with specific training and interventions, such as the Study Smart programme, which focuses on the implementation phase of their learning.

We place more emphasis on study skills at the beginning of the programme, such as the Study Smart programme. Throughout the programme, we offer workshops on giving and receiving feedback, and holding each other accountable for behaviour. We are also developing a toolbox to support both coaches and students in various aspects of the learning cycle.

What will the toolbox you are developing include?

How do you ensure students monitor their progess?

Judith Sieben: We are developing a toolbox as part of a Comenius project. This toolbox contains conversation tools for discussions between students and coaches about study progress, as well as tools for exploring tasks. Useful for individual students and teams, the toolbox facilitates co-regulation where students support each other. The products and report will be made available via the Comenius website and the NRO Kennisbank at the end of this calendar year.

Sylvia Heeneman: We work with competency frameworks, known as the ‘Framework Plan for Physician Education’, which all medical faculties must comply with. This framework contains clear attainment targets for each competency. It includes self-analysis, motivation, and leadership as important skills for a doctor. In the curriculum, we integrate these outcomes and continuously evaluate students, focusing on feedback, learning objectives, and collecting progress information in a portfolio. Students receive mid-term advising and at the end of each year they must write an overarching analysis based on their collected evidence, arguing how they meet the required attainment targets. This is then assessed by a decision committee.

Who gives feedback to students?

What explicit learning line objectives or period goals have you formulated for self-regulation skills?

Sylvia Heeneman: We provide feedback to students through specific teachers who observe them throughout the year, such as skills teachers and patient communication teachers. Students also receive feedback from their coach on the learning team process, and work on assignments where they give feedback to each other. This is embedded in our assessment and feedback programme. These varied perspectives provide reliable and versatile feedback, which is used both for the student’s interim adjustment of their learning process and for decision-making.

Judith Sieben: We have formulated explicit learning objectives for self-regulation skills within our longitudinal learning pathway for professional and personal development. For example, students should be able to set their own learning goals based on feedback, seek timely help when they cannot solve something independently, and recognise the importance of these skills for lifelong learning in their future professional careers.

How do you teach students to set effective learning goals?

How labour-intensive is this method of education?

Judith Sieben: We teach students to formulate effective learning goals by having them spar and mirror with a coach, and by teaching them to set SMART goals. We provide instructions and examples within the portfolio system and toolbox, and practice this during workshops. Coaches provide feedback on goal formulation, and buddy sessions between second- and first-year students reinforce the process. It is important for students to recognise that well-formulated learning objectives are beneficial, and that follow-up meetings take place to discuss progress so it does not remain a mere paper exercise. Self-regulated learning occurs in collaboration with others, through repetition and practice.

Judith Sieben: Yes, this method of teaching is labour-intensive, and we have consciously invested in it. In our previous curriculum, we had tutors and mentors, and we converted the allocated teacher time into the role of coaches. This amounts to a coaching role covering about one day per week, which is easily plannable and creates less fragmentation in teaching roles and teacher commitment. This substantial role and commitment make coaching clear and organised. This is part of a deliberate decision in our curriculum to provide effective coaching and create a teacher community. It is not, however, more expensive than our previous curriculum; it is a matter of making deliberate choices on how teacher time is utilised.

From the testing perspective, we have chosen to spend our time on creating tests that facilitate learning and providing feedback, rather than constructing, implementing, and reviewing a comprehensive system of summative tests. We have the same budget as the previous curriculum, but we now allocate resources differently to place more emphasis on guidance and learning.

How long did it take to complete the revision of this undergraduate programme?

Judith Sieben: We began considering the revision of this undergraduate programme in 2018. Despite some delays due to COVID, we initiated the first cohort in 2022. We regard the first year’s iterations as part of our learning journey towards the final outcomes of this curriculum.

What skills are required of teachers to support and guide students in their learning?

Judith Sieben: We need teachers who are well-educated and trained in mentoring and coaching, and who have experience with PBL and group dynamics. The role of the teacher as a coach is complex and challenging, and requires several skills:

• Curriculum Expert: Teachers need to have a thorough understanding of the curriculum to effectively guide students towards their learning goals.
• Learning Coach: The focus is primarily on guiding learning processes rather than on content knowledge, with coaches coming from diverse backgrounds.
• Team Player: Coaches should work collaboratively as a community, supporting one another and conducting peer reviews.
• Student Alliance: A strong, supportive relationship between coach and student, akin to a therapeutic alliance in medicine.

These skills make the role challenging but also highly fulfilling.

What will the toolbox you are developing include?

How do you ensure students monitor their progess?

Judith Sieben: We are developing a toolbox as part of a Comenius project. This toolbox contains conversation tools for discussions between students and coaches about study progress, as well as tools for exploring tasks. Useful for individual students and teams, the toolbox facilitates co-regulation where students support each other. The products and report will be made available via the Comenius website and the NRO Kennisbank at the end of this calendar year.

Sylvia Heeneman: We work with competency frameworks, known as the ‘Framework Plan for Physician Education’, which all medical faculties must comply with. This framework contains clear attainment targets for each competency. It includes self-analysis, motivation, and leadership as important skills for a doctor. In the curriculum, we integrate these outcomes and continuously evaluate students, focusing on feedback, learning objectives, and collecting progress information in a portfolio. Students receive mid-term advising and at the end of each year they must write an overarching analysis based on their collected evidence, arguing how they meet the required attainment targets. This is then assessed by a decision committee.

How do you prepare teachers for this role and support them in developing these competencies?

How are teachers experiencing this new role and how are they embracing it?

Judith Sieben: We prepare teachers for their role by offering an intensive training programme before the start of the academic year. Throughout the year, we support them with weekly work meetings, intervision sessions, and just-in-time information and instructions. This helps them develop the necessary competencies and provides opportunities for exchanging views, training, and discussing challenging situations. In this way, we build collective expertise.

Judith Sieben: I am impressed by how teachers have embraced this new role, despite its complexity. Many teachers already have experience with PBL, tutoring, and mentoring, which provides a solid foundation. Teachers approach the role differently: some focus more on the relational aspect, others on the group process, curriculum, or portfolio.

Learning from each other and acknowledging different areas of expertise is valued. Although teaching students how to learn is challenging and a continual process, teachers increasingly enjoy it and see this role as a long-term commitment. After three years, all coaches remain enthusiastic and dedicated to this role.

How have students received this approach?

Judith Sieben: We have extensively evaluated how students perceive this new approach through focus groups and programme evaluations. Students strongly appreciate having their own coach with whom they speak every two to three weeks, and they value the learning teams that stay together for an entire year, although this sometimes presents challenges due to friction and group dynamics. Additionally, many students feel uncertain about whether they are learning the right content and enough of it, and whether they are up to the required standard. While this uncertainty has always existed, it is now more explicit because of the removal of ‘the test’ that used to provide (false) certainty or clarity. We guide them through this, and while some quickly learn to manage this uncertainty, it remains high in others. As a result, we better prepare them to deal with uncertainty in their future careers.

Judith, you are a member of the SELFLEX consortium and, among other roles, are involved as a supervisor in Sina Gottschlich’s PhD project. You recently conducted an initial study of undergraduate students in the new Medicine programme, examining the self-regulation skills students exhibit within the new context, learning environment, and supervision. What did you observe?

Judith Sieben: We conducted the first study of undergraduate students and analysed what the portfolios reveal about self-regulation skills. Students are highly engaged in learning objectives, task reflection, and self-analysis, but there is less concrete evidence of task strategies such as content engagement, time management, and planning. Interviews indicate that students are often uncertain about their learning and how to motivate themselves in a system like this. Although the system should offer more autonomy, the vision for the future remains difficult for some to grasp. We aim to develop interventions to help students manage uncertainty and self-motivation, also utilising the power of student collaboration (coregulation).

If another course could make one change in teaching to further emphasise and support the importance of self-regulated learning, which change do you think, Sylvia, should be the first?

And for you, Judith, what would be the best thing for an education to tackle first?

Sylvia Heeneman: In my opinion, the most important change would be to start integrating self-regulated learning into the internal learning objectives. Formulate clear attainment targets and learning objectives that emphasise self-regulation and integrate them into all aspects of teaching, including curriculum design and learning activities. Additionally, ensure that assessment does not push students towards test-based learning, but rather supports the development of their self-regulation skills.

Judith Sieben: To encourage self-regulation, we need to provide students with flexibility and responsibility in a less rigid learning environment. This can sometimes be daunting for both students and teachers, but it is essential for their development. It is important that we work step by step towards fostering a feedback culture and growth mindset, moving away from test-oriented grading, to promote self-regulated learning.