{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:12:20Z","timestamp":1762297940407,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T00:00:00Z","timestamp":1358294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["asmepublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Education"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p>\n                    <jats:bold>Context\u2002<\/jats:bold>\n                    Simulation\u2010based medical education allows trainees to engage in self\u2010regulated learning (SRL), yet research aimed at elucidating the mechanisms of SRL in this context is relatively absent. We compared \u2018unguided\u2019 SRL with \u2018directed\u2019 SRL (DSRL), wherein learners followed an expert\u2010designed booklet.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods\u2002<\/jats:bold>\n                    Year\u20031 medical students (\n                    <jats:italic>n<\/jats:italic>\n                    \u2003=\u200337) were randomly assigned to practise identifying seven cardiac murmurs using a simulator and video only (SRL group) or a simulator and video plus the booklet (DSRL group). All participants completed a 22\u2010item test 3\u2003weeks later. To compare interventions, we analysed students\u2019 diagnostic accuracy. As a novel source of evidence, we documented how participants autonomously sequenced the seven murmurs during initial and delayed practice sessions. In addition, we surveyed clinical educators (\n                    <jats:italic>n<\/jats:italic>\n                    \u2003=\u200317) to find out how they would sequence their teaching of these murmurs.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results\u2002<\/jats:bold>\n                    The DSRL group used 50% more training time than the SRL group (p\u2003&lt;\u20030.001). The groups\u2019 diagnostic accuracy, however, did not differ significantly on the post\u2010test, retention test or transfer test items (p\u2003&gt;\u20030.12). Despite practising with the expert\u2010defined \u2018timing\u2010based\u2019 approach to murmur diagnosis (i.e. systolic versus diastolic), 84% of DSRL participants implemented a location\u2010based approach (i.e. practising aortic murmurs separately from mitral murmurs) during a second, unguided practice session. Notably, most SRL participants used that same approach spontaneously. By contrast, clinical educators were split in their use of the timing\u2010based (\n                    <jats:italic>n<\/jats:italic>\n                    \u2003=\u200310) and the location\u2010based (\n                    <jats:italic>n<\/jats:italic>\n                    \u2003=\u20036) approaches. Chi\u2010squared analyses suggested educators\u2019 conceptions for organising murmurs differed significantly from students\u2019 conceptions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions\u2002<\/jats:bold>\n                    Contrary to our predictions, directing students\u2019 SRL produced no additional benefit and increased their practice time. Our findings suggest one potential source of these results was a divergence between student and educator conceptions for structuring the practice of cardiac auscultation skills. This phenomenon has not been well articulated in the medical education literature, and may have important implications in many (especially technology\u2010mediated) educational contexts.\n                  <\/jats:p>","DOI":"10.1111\/medu.12088","type":"journal-article","created":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T23:00:00Z","timestamp":1358377200000},"page":"198-209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Divergence in student and educator conceptual structures during auscultation training"],"prefix":"10.1111","volume":"47","author":[{"given":"Ryan","family":"Brydges","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Peets","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S 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