Search

Introduction: Recent conceptualizations of self-regulated learning acknowledge the importance of co-regulation, i.e., students’ interactions with others in their networks to support self-regulation. Using a social network approach, the aim of this study is to explore relationships between characteristics of medical students’ co-regulatory networks, perceived learning opportunities, and self-regulated learning. Methods: The authors surveyed 403 undergraduate medical students during their clinical clerkships (response rate 65.5%). Using multiple regression analysis, structural equation modelling techniques, and analysis of variance, the authors explored relationships between co-regulatory network characteristics (network size, network diversity, and interaction frequency), students’ perceptions of learning opportunities in the workplace setting, and self-reported self-regulated learning. Results: Across all clerkships, data showed positive relationships between tie strength and self-regulated learning (β = 0.095, p< 0.05) and between network size and tie strength (β = 0.530,p< 0.001), and a negative relationship between network diversity and tie strength (β = −0.474,p< 0.001). Students’ perceptions of learning opportunities showed positive relationships with both self-regulated learning (β = 0.295, p< 0.001) and co-regulatory network size (β = 0.134, p< 0.01). Characteristics of clerkship contexts influenced both co-regulatory network characteristics (size and tie strength) and relationships between network characteristics, self-regulated learning, and students’ perceptions of learning opportunities. Discussion: The present study reinforces the importance of co-regulatory networks for medical students’ self-regulated learning during clinical clerkships. Findings imply that supporting development of strong networks aimed at frequent co-regulatory interactions may enhance medical students’ self-regulated learning in challenging clinical learning environments. Social network approaches offer promising ways of further understanding and conceptualising self- and co-regulated learning in clinical workplaces.

Introduction: Portfolio-based assessments require that learners’ competence development is adequately reflected in portfolio documentation. This study explored how students select and document performance data in their portfolios and how they perceive these data to be representative for their competence development. Methods: Students uploaded performance data in a competency-based portfolio. During one clerkship period, twelve students also recorded an audio diary in which they reflected on experiences and feedback that they perceived to be indicants of their competence development. Afterwards, these students were interviewed to explore the extent to which the performance documentation in the portfolio corresponded with what they considered illustrative evidence of their development. The interviews were analyzed using thematic analysis. Results: Portfolios provide an accurate but fragmented picture of student development. Portfolio documentation was influenced by tensions between learning and assessment, student beliefs about the goal of portfolios, student performance evaluation strategies, the learning environment and portfolio structure. Discussion: This study confirms the importance of taking student perceptions into account when implementing a competency-based portfolio. Students would benefit from coaching on how to select meaningful experiences and performance data for documentation in their portfolios. Flexibility in portfolio structure and requirements is essential to ensure optimal fit between students’ experienced competence development and portfolio content.

Assessment in competency‐based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA‐ADEE Shaping the Future of Dental Education II.1The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace‐based assessment (WBA) within competency‐based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2Acknowledging that no oneassessment method can result in a valid assessment of competence, Miller proposed a four‐level framework for assessment. The lowest level involves measuring what students know (“knows”), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems (“knows how”). Next is an assessment of task performance in standardized settings (“shows how”), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace (“does”). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace—the highest level of Miller's assessment pyramid (“does”). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the “does” level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.

Supplemental Digital Content is available in the text.

Over the last decade assessment practices of professional competence evaluation have rapidly changed, partly as a result of growing dissatisfaction with previous forms of student assessment. New strategies for the assessment of competence show an increasing emphasis on performance-based assessment (also known as ‘authentic’ assessment). Changes have been prompted by the awareness of the enormous influence of assessment on student learning. This paper will describe the development and the use of a performance-based test at Kerkrade Midwifery School in the Netherlands. The objective structured clinical examinations (OSCE) based midwifery competence test (MCT) was designed to assess competence in risk assessment and management in midwifery care during the final stages of the educational programme. First experiences with the MCT suggest that the test is a powerful tool in the guidance of student learning. Our experiences also suggest that, although several aspects of the test need further attention, the MCT is a useful and acceptable tool for evaluating competence of student-midwives.