No abstract

An understanding of how students approach their learning has important implications for medical education. Of particular interest is the fact that the approach students use in their study has a significant impact on both the quality of the learning and their academic success. It would clearly be of value to identify students whose approach to learning was predictive of unsatisfactory performance. This paper describes the initial development of two versions of an inventory (questionnaire) which was designed to aid in the diagnosis of student learning problems. Preliminary information is given on the reliability and validity of these instruments. Factor analyses support the underlying design. Correlation of subscales with academic performance has provided encouraging evidence of the potential of these inventories in identifying students with specific learning or study problems.

A trial of problem-based learning (PBL) was conducted with first-year undergraduate medical students who had no background knowledge of behavioural science and who included a substantial proportion with a first language other than English. Responses to standardized and open-ended evaluation questions showed greater variability and there was no clear preference for PBL over traditional methods. Students found the PBL exercise time-consuming and felt they needed more guidance. Feedback from clinicians and working in groups were seen as positive aspects of the exercise. Students with a first language other than English reported that language, but not cultural background, was an impediment to effective participation. It is recommended that this group of students be offered extra support for PBL in a subject-based setting, and that all students would benefit from a formal induction session.

Recent studies have provided information about the approaches to studying and learning used by medical students. However, no published work is available on the approaches of practising doctors. The Adelaide Diagnostic Learning Inventory for Medical Students (ADLIMS) was modified and administered to a random sample of 308 physicians (internists). Generally speaking, physicians seem to have lower scores on surface approach and higher scores on deep approach than students. Level of clinical experience did not appear to influence this finding. However, marked differences were apparent between the approaches adopted by physicians with additional postgraduate academic training and those without. The former had a much stronger tendency to use the more desirable deep approach. The latter seemed to rely more on the less desirable surface approach. Further longitudinal studies will be required to determine whether this difference is attributable to self-selection of those who have already developed a deep approach or is causally related to a training in research. Although these findings must be interpreted with caution, some implications are clear. Physicians should become more aware of the way they learn and about the way they teach. Inappropriate patterns of learning may be entrenched during the undergraduate and immediate postgraduate years. If validated, these findings may provide support for the inclusion of research projects in medical school and during specialist training.

A questionnaire survey was conducted of a random sample of 308 physicians to determine their actual and preferred approach to continuing education. Demographic data raised questions about the possible influence of the undergraduate institution attended, the future impact of the growing proportion of women physicians and the effect of increasing subspecialisation. The average physician spends eight-nine hours a week on educational activities and 2.5-4.0 hours a week teaching. Unstructured ad hoc reading and postgraduate activities predominate over methods based on specific, individual needs or on current patient problems. The educational desirability of this is questioned. Physicians are avid attenders at conferences with 10-15% being at a national or international meeting in any one survey week. It appears physicians would prefer to use a wider range of educational activities including more refresher courses and innovative methods. By comparison, Canadian physicians showed similar, but more strongly evident, preferences. These findings have important implications for the College. It appears physicians need to be better informed about potentially more effective learning methods and account ought to be taken of their preference for methods which are not currently widely available.