133 Philosophical discussion | 6 training plans (e.g. the required number of OSCEs is specified for every internship). One can wonder how this affects the motivation of learners. Moreover, how much leeway can learners experience when they frantically try to fulfil all that is demanded of them? This tension between learners’ leeway and control of training institutes also surfaced in the interviews performed by Watling and colleagues,34 who explored what it means to be an agentic learner in medicine. They defined agency as ‘the intentional actions that constitute learners’ participation in the social experience of learning’. The interviews revealed that respondents considered it to be burdensome to show agency, as they needed to defy expectations that were set out by the highly standardised setting of medical training. The authors linked the high degree of standardisation to competency-based education (CBE). While CBE is theoretically intended to be flexible and learner-centred, the outcome- based nature of CBE can also be considered as a fixed and prescriptive image of how doctors should perform, think, and act.34,35 In such a clearly delineated environment, approaches to foster SRL will almost naturally turn out to resemble the treasure hunt-style. Learners are not provided with the opportunity to find their own way through the forest, but are instead (compellingly) directed to follow the paved roads set out by the curriculum, as medical training institutes fear that without these guidelines countless learners will end up in puddles. When learners only encounter treasure hunt-style approaches to foster SRL, they have limited opportunities to experiment with different ways of learning (e.g. only completing assignments that are considered relevant, making a collage or song about one’s experiences). Consequently, learners cannot fully experience through trial and error which types of learning are (not) successful for them. Should SRL be assessed? We just described that medical curricula are highly controlled, which is also resembled by the comprehensive assessment programmes of most medical training institutes. It is therefore not surprising that in the last years it has become more common to assess (aspects of ) SRL during medical education. But how do you assess if learners are ‘metacognitively, motivationally, and behaviourally active participants in their own learning process’? In order to do so, you need to know (and assign value to) how actively involved learners think, feel, and act. Veen and colleagues explained that concepts like SRL are traditionally assessed by a model of representation, where particular language and actions are used to represent the concept that is assessed.36 So, in concern to reflection it is for example common to use rubrics that distinguish between different levels of reflective writing.37,38 It is debatable whether such rubrics, and other assessments based on the model of representation, can actually determine whether learners adequately engage in SRL. Moreover, where it might be possible to assess which child performs best during a treasure hunt, as all children will have to complete the same route and assignments, it will
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