The challenge of understanding, evaluating and providing feedback on regulation during group learning

Keywords: Group learning, Feedback, Regulation during learning, Social regulation


Learning in groups is commonly used in academic and clinical health professions education (HPE). There is growing recognition that regulation during learning is essential for both the individual learner and group learning. The authors in this article propose a practical approach for understanding, evaluating and providing feedback on regulation during group learning. The approach is informed by previous studies conducted in other areas of education. Three varieties of regulation during group learning are discussed: individual, co-regulation and shared regulation. Each variety of regulation has a focus on three essential activities during group learning: task, social and motivation. Illustrative scenarios are presented to describe how the approach can be practically used in HPE. The specific and additional focus on regulation can enhance current approaches for providing feedback on group learning and the authors discuss recommendations for practical implementation and future research.


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Author Biographies

John Sandars, Edge Hill University (EHU), Ormskirk, Lancashire, LS, United Kingdom.

MD from University of Manchester, Manchester, UK; Professor of Medical Education, Edge Hill University Medical School, Ormskirk, UK.

Dario Cecilio-Fernandes, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.

PhD from the University of Groningen, Groningen, Netherlands; researcher in the Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Brazil.

Roghayeh Gandomkar, Tehran University of Medical Sciences, Tehran, THR, Iran.

PhD from Tehran University of Medical Sciences, Tehran, Iran; Assistant Professor, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran.


Rakesh Patel, University of Nottingham (UON), Nottingham, NG, United Kingdom.

MD from University of Leicester, Leicester, UK; Clinical Associate Professor of Medical Education, University of Nottingham, UK and honorary consultant nephrologist, Nottingham University Hospitals NHS Trust, UK.


Qin Y, Wang Y, Floden RE. The effect of problem-based learning on improvement of the medical educational environment: a systematic review and meta-analysis. Med Prin Pract. 2016;25(6):525-532.

Reimschisel T, Herring AL, Huang J, Minor TJ. A systematic review of the published literature on team-based learning in health professions education. Med Teach. 2017;39(12):1227-1237.

Patel EA, Aydın A, Desai A, Dasgupta P, Ahmed K. Current status of simulation-based training in pediatric surgery: a systematic review. J Pediatr Surg. 2019;54(9):1884-1893.

Baik D, Abu-Rish Blakeney E, Willgerodt M, Woodard N, Vogel M, Zierler B. Examining interprofessional team interventions designed to improve nursing and team outcomes in practice: a descriptive and methodological review. J Interprof Care. 2018;32(6):719-727.

Johnson DW, Johnson RT. Cooperation and competition: Theory and research. Edina, MN: Interaction Book Company; 1989.

Laal M, Ghodsi SM. Benefits of collaborative learning. Procedia Soc Behav Sci. 2012; 31:486-490.

Roseth CJ, Johnson DW, Johnson RT, Promoting early adolescents’ achievement and peer relationships: The effects of cooperative, competitive, and individualistic goal structures. Psychol Bull. 2008;134(2):223–246.

Rosen MA, DiazGranados D, Dietz AS, et al; Teamwork in healthcare: Key discoveries enabling safer, high-quality care. Am Psychol. 2018;73(4):433-450.

Schmutz JB, Meier LL, Manser T. How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis. BMJ Open. 2019;9(9): e028280.

Lutfiyya MN, Chang LF, McGrath C, Dana C, Lipsky MS. The state of the science of interprofessional collaborative practice: A scoping review of the patient health-related outcomes based literature published between 2010 and 2018. Plos One. 2019;14(6):e0218578.

Siddaiah-Subramanya M, Nyandowe M, Zubair O. Self-regulated learning: why is it important compared to traditional learning in medical education? Adv Med Educ Pract. 2017;17(8):243-246.

Panadero E. A review of self-regulated learning: Six models and four directions for research. Front Psychol. 2017; 8:422.

Demirören M, Turan S, Öztuna D. Medical students’ self-efficacy in problem-based learning and its relationship with self-regulated learning. Med Educ Online. 2016;21(1):30049.

Duffy MC, Azevedo R, Sun NZ, Griscom SE, Stead V, Crelinsten L, Wiseman J, Maniatis T, Lachapelle K. Team regulation in a simulated medical emergency: An in-depth analysis of cognitive, metacognitive, and affective processes. Instr Sci. 2015;43(3):401-426.

Butler DL, Winne PH. Feedback and self-regulated learning: A theoretical synthesis. Rev Educ Res.1995;65(3):245-281.

Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77(1):81-112.

Patel R, Green W, Shahzad MW, Church H, Sandars J. Using a self-regulated learning-enhanced video feedback educational intervention to improve junior doctor prescribing. Med Teach. 2020;42(8):886-895.

Parikh A, McReelis K, Hodges B. Student feedback in problem based learning: a survey of 103 final year students across five Ontario medical schools. Med Educ. 2001;35(7):632-636.

Zimmerman BJ. A social cognitive view of self-regulated academic learning. J Educ Psychol. 1989;81(3):329 -339.

Zeidner M, Stoeger H. Self-Regulated Learning (SRL): A guide for the perplexed. High Abil Stud. 2019;30(1-2):9-51.

Järvelä S, Hadwin AF. New frontiers: Regulating learning in CSCL. Educ Psychol. 2013;48(1):25-39.

Grau V, Whitebread D. Self and social regulation of learning during collaborative activities in the classroom: the interplay of individual and group cognition. Learn Instr. 2012; 22:1–12.

Hayes S, Uzuner-Smith S, Shea P. Expanding learning presence to account for the direction of regulative intent: self-, co-and shared regulation in online learning. J Interact Online Learn. 2015; 19:1–19.

Hadwin A, Oshige M. Self-regulation, coregulation, and socially shared regulation: exploring perspectives of social in self-regulated learning theory. Teach Coll Rec. 2011; 113:240–264.

Saab N. Team regulation, regulation of social activities or co-regulation: Different labels for effective regulation of learning in CSCL. Metacogn Learn. 2012;7(1):1-6.

Panadero E, Järvelä S. Socially shared regulation of learning: A review. Europ Psychol. 2015;20(3):190-203.

Zimmerman BJ. Investigating self-regulation and motivation: Historical background, methodological developments, and future prospects. Am Educ Res J. 2008;45(1):166-183.

Van de Mortel TF. Faking it: social desirability response bias in self-report research. Aust J Adv Nurs. 2008;25(4):40-48.

Bull P. Communication under the microscope: The theory and practice of microanalysis. New York, NY: Routledge; 2013.

Bracco F, De Tonetti G, Masini M, Passarelli M, Geretto F, Celleno D. Crisis resource management in the delivery room: development of behavioral markers for team performance in emergency simulation. Int J Environ Res Public Health. 2018;15(3):439.

Kelly E, Richards JB. Medical education: giving feedback to doctors in training. BMJ. 2019;366:l4523.

Meijer H, Hoekstra R, Brouwer J, Strijbos J. Unfolding collaborative learning assessment literacy: a reflection on current assessment methods in higher education. [published online ahead of print March 6, 2020]. Assess Eval High Educ. doi:10.1080/02602938.2020.1729696.

Endacott R, Gale T, O’Connor A, Dix S. Frameworks and quality measures used for debriefing in team-based simulation: a systematic review. BMJ Simul Technol Enhanc Learn. 2019;5:61-72.

Kim J, Neilipovitz D, Cardinal P, Chiu M, Clinch J. A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study. Crit Care Med. 2006;34(8):2167-2174.

Leggett H, Sandars J, Roberts T. Twelve tips on how to provide self-regulated learning (SRL) enhanced feedback on clinical performance. Med Teach. 2019;41(2):147-151.

Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education. Acad Med. 2015;90(5):609-614.

Malmberg J, Järvelä S, Järvenoja H. Capturing temporal and sequential patterns of self-, co-, and socially shared regulation in the context of collaborative learning. Contemp Educ Psychol. 2017; 49:160-74.

How to Cite
Sandars, J., Cecilio-Fernandes, D. ., Gandomkar, R. ., & Patel, R. . (2021). The challenge of understanding, evaluating and providing feedback on regulation during group learning. Scientia Medica, 31(1), e39294.
Education in Health Sciences