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Socially shared regulated learning (SSRL) is essential in enhancing collaborative learning processes. This study explores the association between medical students’ team decision-making, SSRL, and heart rate changes while a diagnosing patient case in a technology rich learning environment. A multimodal analysis approach was used to study the interactions between dyads by leveraging logfiles and verbal data with physiological data. Specifically, we investigate the sequential patterns between team diagnostic actions and four types of SSRL interactions (i.e., metacognitive, cognitive, emotional, and motivational) related to heart rate change points. The investigation of heart rate change points and their association with SSRL interactions reveals a significant association with motivational interaction, highlighting the diverse roles of metacognitive, cognitive, emotional, and motivational dimensions in SSRL.