Using self-regulated learning theory to understand the beliefs, emotions, and behaviors of struggling medical students.

This study explored whether motivational, emotional, and behavioral aspects of self-regulated learning (SRL) are associated with academic performance in medical school. Across two academic years (2008-2009 and 2009-2010), 248 (73%) of 342 second-year students in an introductory clinical reasoning course completed surveys assessing 10 SRL constructs. Performance was operationalized as students' average grade on three course exams, and a tercile split was used to compare those in the lowest and highest third of achievement using a one-way multivariate analysis of variance. Findings revealed differences in the beliefs and emotions of the two extreme groups, F(10,136) = 2.08, P = .03. Compared with high-performing students, low performers reported lower task value (Cohen d = -0.33) and self-efficacy beliefs (d = -0.33) as well as greater anxiety (d = 0.63), frustration (d = 0.54), and boredom (d = 0.44). Low-performing medical students in a clinical reasoning course demonstrated deficiencies in key SRL measures, providing insight for future, tailored remediation strategies.