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          Abstract

          Clinical workplaces offer postgraduate trainees a wealth of opportunities to learn from experience. To promote deliberate and meaningful learning self-regulated learning skills are foundational. We explored trainees’ learning activities related to patient encounters to better understand what aspects of self-regulated learning contribute to trainees’ development, and to explore supervisor’s role herein. We conducted a qualitative non-participant observational study in seven general practices. During two days we observed trainee’s patient encounters, daily debriefing sessions and educational meetings between trainee and supervisor and interviewed them separately afterwards. Data collection and analysis were iterative and inspired by a phenomenological approach. To organise data we used networks, time-ordered matrices and codebooks. Self-regulated learning supported trainees to increasingly perform independently. They engaged in self-regulated learning before, during and after encounters. Trainees’ activities depended on the type of medical problem presented and on patient, trainee and supervisor characteristics. Trainees used their sense of confidence to decide if they could manage the encounter alone or if they should consult their supervisor. They deliberately used feedback on their performance and engaged in reflection. Supervisors appeared vital in trainees’ learning by reassuring trainees, discussing experience, knowledge and professional issues, identifying possible unawareness of incompetence, assessing performance and securing patient safety. Self-confidence, reflection and feedback, and support from the supervisor are important aspects of self-regulated learning in practice. The results reflect how self-regulated learning and self-entrustment promote trainees’ increased participation in the workplace. Securing organized moments of interaction with supervisors is beneficial to trainees’ self-regulated learning.

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          Social Foundations of Thought and Action : A Social Cognitive Theory

          Presents a comprehensive theory of human motivation and action from a social-cognitive perspective. This insightful text addresses the prominent roles played by cognitive, vicarious, self-regulatory, and self-reflective processes in psychosocial functioning; emphasizes reciprocal causation through the interplay of cognitive, behavioral, and environmental factors; and systematically applies the basic principles of this theory to personal and social change.
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            Social cognitive theory: an agentic perspective.

            The capacity to exercise control over the nature and quality of one's life is the essence of humanness. Human agency is characterized by a number of core features that operate through phenomenal and functional consciousness. These include the temporal extension of agency through intentionality and forethought, self-regulation by self-reactive influence, and self-reflectiveness about one's capabilities, quality of functioning, and the meaning and purpose of one's life pursuits. Personal agency operates within a broad network of sociostructural influences. In these agentic transactions, people are producers as well as products of social systems. Social cognitive theory distinguishes among three modes of agency: direct personal agency, proxy agency that relies on others to act on one's behest to secure desired outcomes, and collective agency exercised through socially coordinative and interdependent effort. Growing transnational embeddedness and interdependence are placing a premium on collective efficacy to exercise control over personal destinies and national life.
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              Social Foundations of Thought and Action: A Social-Cognitive View

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                Author and article information

                Contributors
                +31 (0)30 2823460 , g.sagasser@huisartsopleiding.nl
                Journal
                Adv Health Sci Educ Theory Pract
                Adv Health Sci Educ Theory Pract
                Advances in Health Sciences Education
                Springer Netherlands (Dordrecht )
                1382-4996
                1573-1677
                26 October 2016
                26 October 2016
                2017
                : 22
                : 4
                : 931-949
                Affiliations
                [1 ]ISNI 0000 0004 0444 9382, GRID grid.10417.33, Department of Primary and Community Care, , Radboud University Medical Centre Nijmegen, ; Nijmegen, The Netherlands
                [2 ]ISNI 0000000089452978, GRID grid.10419.3d, Department of Public Health and Primary Care, , Leiden University Medical Centre, ; Leiden, The Netherlands
                [3 ]ISNI 0000 0004 0444 9382, GRID grid.10417.33, Centre on Research in Learning and Education, , Radboud University Medical Centre Nijmegen, ; Nijmegen, The Netherlands
                [4 ]ISNI 0000 0001 2180 7477, GRID grid.1001.0, Department of Health Servicese Research and Policy, , Australian National University, ; Canberra, Australia
                [5 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, , Maastricht University, ; Maastricht, The Netherlands
                Article
                9723
                10.1007/s10459-016-9723-4
                5579156
                27785628
                dc796d89-3299-4795-b4eb-323064bb333c
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 13 January 2016
                : 13 October 2016
                Categories
                Original Paper
                Custom metadata
                © Springer Science+Business Media B.V. 2017

                Education
                gp training,postgraduate training,qualitative observational research,self-regulated learning,supervisors,trainees,workplace learning

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