The study enrolled 26 students, 19 were female (73.7%) and 7 were male students (26.9%). They represented 38.8% of the second-year physiotherapy class.
There were 15 successful students (57%) and 11 (43%) unsuccessful students on the goniometric task. There were proportionally fewer female students in the unsuccessful group (n=7) 63.6% compared to the successful group (n=12) 80%.
(a) Forethought phase
In the forethought phase, most successful students [14:15 (93%)] had planned the task ahead and only one student stated no planning for performance. The plans described by the successful students fell into three categories: positioning the patient (patient focus) and correct technical performance using the goniometer (technique focus) combined (n=6, 40%), technique focus (n=3, 20%), or patient focus alone (n=5, 33.3%).
We present three illustrative statements on focusing on the technique made by successful students:
017: "I think I have a plan ... I put the goniometer first. I would ask him to raise his arm and measure it. "
020: "First I place the stretcher at a comfortable height, I ask the patient to get into the most comfortable position and explain what he has to do. He should be comfortable".
015: "Yes, I have a plan. First, I place the patient in a supine position, to be comfortable and I adjust the stretcher. Then, I put the axis of the goniometer on the lateral side of the humerus, the fixed arm parallel to the midline of the humerus... The fixed one remains there, and another moves parallel to the midline of the humerus. And I ask him for the flexion movement. And I measure it"
In the forethought phase, six (54.5%) unsuccessful students were unable to explain their action plan or stated they had no strategy for performing the task. These students were categorised as “Without a plan”. The plans of unsuccessful students could also be categorized into technique (n=2, 18.9%), patient (n=1, 9.1%) or technique and patient (n=2, 18.9%).
(b) Performance phase
The narratives of successful students were very detailed, revealing attention to the details of their performances. Successful students mentioned they were under the impression they had committed a mistake (n=9, 60%), related to the procedure (e.g., incorrect/imperfect positioning of the goniometer (n=6, 40%) or to their own posture or the position of the bed (non-procedural) (n=3, 20%). There was a single successful student who did not acknowledge to have self-monitored their performance. In contrast, none of the unsuccessful students could recognize their mistakes. Answers were divided in two categories: those who explicitly mentioned they had made no mistakes (n=5, 46%) or those who were unable to answer the question (n=6, 54.5%). This finding suggests that the student had internalised the task to a level of expertise and the key SRL processes had become routinized. For more SRL microanalysis procedure details see table 2 and 3. (Table 2 and 3 near here)
We present two illustrative statements of self-monitoring and awareness of procedural mistakes by successful students;
06: "I made mistakes; I think ... I have to put the goniometer in this way… I am not considering the alignment of the goniometer..."
26: "I think I am making mistakes in my posture ... maybe my leg on the stretcher."
(c) Self- evaluation phase
There was little difference in answers by successful or unsuccessful students to the question on self-evaluation. Successful students (n=7, 47%) were mostly focused on the importance of paying attention in lectures. An illustrative statement from a successful student :
026: "what I remember from lectures…I should put it in the right way and if it should go in the arm or move or not..."
The median scores of successful and unsuccessful students’ self-evaluation judgments of performance (calibration) were, respectively, 6 and 8. After the task, the judgment scores were higher for successful students (median = 8) than unsuccessful students (mean = 7). The differences between the judgment of performance scores pre and post task were statistically significant (t=2.613, p=.015) with a medium effect size (r=0.45) .
There were three unsuccessful students with high judgment of performance scores before starting the task who were unable to complete the task. After the task, two of these students reduced their judgment. The other student maintained the same judgment after an unsuccessful performance. Although the student who maintained a high judgment of performance had a planned the performance, the student lacked awareness of mistakes when self-monitoring his performance. These findings suggest that the student was overconfident and poorly calibrated in his initial and final judgments in relation to his performance on the task.
The satisfaction scores were higher in successful students (mean=8.07), than in unsuccessful students (mean=6.27). This difference between successful and unsuccessful students was significant (t=2.663, p=0.014).
The inter-rater kappa coefficients for strategic planning (0.792), self-monitoring (0.946) and self-evaluation (0.846) were high. For internal consistency, an alpha-Cronbach coefficient of 0.846 was obtained for self-judgment prior and post task, and satisfaction post-task.