131 Philosophical discussion | 6 Four philosophical questions about SRL In the above it has become clear that SRL is a comprehensive, theoretical concept, that is not always successfully fostered by medical training programs. We therefore argue that those who aim to foster SRL should be willing to ask themselves (philosophical) questions about the concept, as such a contemplation can support deliberate decision-making, implementation, and evaluation. Accordingly, we formulated four interrelated questions about SRL which will be discussed below. The ‘treasure hunt/dropping-continuum’ will be used to further elaborate on these questions. The first question considers the relevance of definitional issues related to SRL. Further, the relationship between SRL and autonomy will be questioned. Subsequently, the third question explores the effect of current medical curricula on the opportunities to foster SRL. Lastly, we will contemplate on the complexities related to the assessment of SRL. What are the consequences of the difficulties to explicate what is (not) SRL? We explained that SRL is a comprehensive concept that is difficult to define. This might explain the abundance of lingo present that seems derived from the SRL rationale that actively engaged learners learn more effectively than inactive learners, such as ‘student- centred learning’ and ‘active learning’.19,20 Related to this are the efforts of medical training institutes to foster ‘reflective learning’.21,22 While terms like this are commonplace, they are also catch-all terms that can mean different things in different contexts and for different people. Conway and colleagues already discussed the importance of precision in lifelong learning terminology, which includes SRL and self-directed learning, as ‘differences in the interpretation and application of a word or phrase between groups of users, particularly when unrecognized, can have impactful real-world implications’.23 (p. 702) Imagine the reactions of children who expected directions on where to go, as they were told to go on a treasure hunt, but who are instead dropped in the woods directionless. Likewise, instructions provided to learners to foster SRL should be consistent with the approach that is performed. In order to do so, it is important that all involved stakeholders are aware of the definition and theoretical underpinnings of SRL, so chances of misperception are minimised. How does SRL relate to autonomy? We think that it is important to consider the relationship between SRL and autonomy during this contemplation of approaches to foster SRL, as the ‘self’ in SRL implies a focus on and appreciation of autonomy; one learns most effectively when learning comes from within oneself. Matthew Crawford explains that our western emphasis on autonomy is in essence political.24 For this, he uses the work of the 17th century thinker John Locke who
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