13 Introduction | 1 The context of this thesis The studies of this thesis were performed in the context of the Dutch General Practitioner (GP) specialty training. This training programme is provided by eight training institutes across the Netherlands. Three of the training institutes participated in the studies (Radboudumc, Maastricht University, Leiden University Medical Centre). The GP specialty training has a formal competency framework and guidelines for training and assessment (e.g. educational plan and the assessment protocol), but the implementation of these outlines differs between the institutes. The duration of the specialty training programme is generally three years. GP trainees learn while working in general practice and adjacent fields (emergency-, mental health- and chronic care). This WPL is guided by experienced doctors (mostly GPs), who work on site with the trainee and function as supervisors. In addition, trainees receive education in peer trainee groups during a weekly academic day, which is provided by faculty of the training institutes (GPs and behavioural scientists). Trainees are obligated to document information concerning learning and assessment in a digital portfolio. The portfolio is intended to support SRL and is an essential component during programmatic assessment. Accordingly, portfolio content is used to inform annual progress decisions. Content and structure of the portfolio are based on the research- informed NijMaas guidelines.40 The portfolio offers eleven unique pre-structured forms that trainees can fill out themselves and/or send to others in order to obtain feedback (e.g. a mini-CEX and a form to formulate learning objectives and plans). Trainees have the opportunity to select the various forms at their own discretion. Alongside the pre-structured forms, trainees can add their own (learning) documents to a separate folder of the portfolio (e.g. individual trainings plans and test results). Reflexivity statement My experience with (qualitative) research was limited before I started this PhD trajectory. I studied psychology, which prepared me to be quantitative researcher. While I followed a course on qualitative research after my study and was a research assistant for an interview study, I learned most about qualitative research throughout this PhD project. I started with a deductive approach to quantify the presence of SRL within portfolio content (Chapter 3) and grew towards exploring the factors and processes related to portfolio use for the support of SRL through an inductive, qualitative approach (Chapter 4). This development was accompanied by an expansion of worldviews, from post-positivism towards contextualism. While I did learn about ontology, epistemology and other aspects of research philosophy during my study, it was during this project that I first started to realise why this even matters.
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