Students' learning approaches at medical schools applying different curricula in Turkey

Objective: To investigate the learning approaches of undergraduate students at different medical schools applying different curricula in Turkey Design: Comparative study Setting: Three medical schools applying different curricula, namely, Hybrid (Akdeniz University), Integrated (Ege University) and Problem Based Learning (Pamukkale University) Subjects: All Year I and Year II students (n = 1038) at these three schools were invited to participate. Interventions: The Revised Two-Factor Study Process Questionnaire was chosen to reveal learning approaches. Another questionnaire was established in order to see any association between learning approaches and demographic characteristics. Statistical analyses were done by using SPSS for PC 13.0. Chi-square test was used for the analysis of the data. Main Outcome Measures: Learning approaches, gender, living area, parents' graduation and high school characteristics of all students Results: Nine hundred and sixty six out of 1038 (93%) students filled out the questionnaires. More participants in Year I had approached their learning activities more deeply than those in Year II (χ2 = 16.417, p = 0.00). Only at the medical school applying Problem Based Learning, more participants in Year II had a deep approach than those in Year I (χ2 = 9.983, p = 0.00 for Year I and χ2 = 16.263, p = 0.00 for Year II). No association between demographic characteristics except gender and learning approaches was found. Conclusions: Application of Problem Based Learning curriculum may be more helpful in developing a deep learning approach than a Hybrid or Integrated curricula. Measurement of learning approaches at later years will provide stronger evidence

Why is my design not working? the role of student factors

This paper brings together the findings of a series of studies that explored the impact of curricular changes on students' approaches to learning. The findings, which were initially surprising, are confirmed by the identification of similar patterns across four different medical educational programmes within Australia and Sri Lanka. The four studies reported in this paper utilised similar methods to examine how students' approaches to learning change in response to 'deepapproach-enhancing' educational programmes. The studies used the R-SPQ-2F questionnaire to measure students' approaches to learning scores before and after students had experienced 'deep-approach-enhancing' educational programmes. Students were asked to use a unique identifier, which allowed comparison of each individual student's approach scores before and after the relevant educational programme. Cluster analysis was performed on the data, and this revealed four patterns of change of deep approach scores. The patterns were similar (although not identical) across the four studies. A significant finding was that while a proportion of students responded by changing to deeper approaches (as expected), a similar proportion of students responded by changing to more surface approaches. The finding that a significant proportion of students adopted surface approaches in response to a 'deep-enhancing' context is of some concern. This paper focuses on this subgroup of students, and explores possible factors that might relate to this unexpected response. From a theoretical perspective, the findings provide a new insight into the current theory of students' approaches to learning by demonstrating a complex pattern of student response. The findings that a subgroup of students respond in ways contrary to that suggested by current educational theory, and the identification of features that characterise this subgroup are significant contributions to the literature. From a practical perspective, the findings have significant implications for designers of educational programmes who are aiming to foster deep approaches in their students.© 2011 Taylor & Francis

Assessment of the validity and reliability of the Turkish adaptation of the study process questionnaire (R-SPQ-2F)

Objective: Determination of the learning approaches is an important issue in the field of medical education. The cultural and linguistic adaptation of a well-known scale is a more effective and reliable way than preparing a new scale. The aim of the present study was to evaluate the validity and reliability of the Turkish version of Biggs' Revised Two Factor Learning Approaches Scale. Material and Methods: First and second term students from three different medical faculties in Turkey were enrolled in the study (n= 1027). The scale was assessed for test reliability and reproducibility, and students who answered all the questions (n= 993) were included in the analyses. Confirmatory factor analyses were performed to assess structure validity. Cronbach Alpha values were determined for each subdimension and test-retest reliability cofactors were calculated for the analysis of the reliability. Results: In the validity assessments of the new form of the scale, fit indexes selected for confirmatory factor analyses in the original study were selected and evaluated in the Turkish version as well. In all subdimensions, the Comperative Fit Index (CFI) was > 0.9, the Standardized Root-Mean-Square Residual (SRMR) and the Root Mean Square Error of Approximation (RMSEA) were < 0.08. Cronbach Alpha value was calculated as 0.772 and 0.800, for Deep and Surface Learning Approaches, respectively. Both values were in the acceptable range. Results of the test-retest analyses revealed correlation coefficients of 0.687 and 0.604 (p< 0.01), for Deep and Surface Learning Approaches, respectively. Conclusion: These results suggest that the investigated scale is a valid and reliable measuring method that can be used for investigations. © 2010 by Türkiye Klinikleri

Relationship between ongoing learning approaches and development of clinical reasoning ability

Objective: There are close similarities between the advice for improving clinical reasoning and characteristics of students with a deep learning approach. No study in the literature has explored the relationship between ongoing learning approaches and clinical reasoning ability. This study was designed to explore this relationship. Design: Cross sectional study Setting: A single medical school at the University of New South Wales Subjects: Two hundred and sixty year-4 students were invited to participate voluntarily in this study after institutional ethics approval was obtained Interventions: The Revised Two-Factor Study Process Questionnaire and Diagnostic Thinking Inventory (DTI) were used. A potential relationship between these two variables was explored using the Pearson correlation. Main Outcome Measures: Learning approaches and clinical reasoning abilities of participants Results: One hundred and eighty two out of 216 (84.3%) students responded. There was a significant positive correlation between deep approach and DTI scores while there was a significant negative correlation between surface approach and DTI scores. Conclusions: Ongoing deep approach of early clinical students can improve the development of their clinical reasoning ability while ongoing surface approach may impair this ability. Evaluating ongoing learning approach may be important in sustaining clinical reasoning development

Relationship between students&#146; approaches to learning and the development of clinical reasoning ability

This study investigates the relationship between learning approaches and the development of clinical reasoning ability. The main questions for the study were: Is there a statistically significant relationship between students&#146; learning approaches and development of clinical reasoning ability? If there is a relationship between approaches to learning and development of clinical reasoning ability, which students develop this ability faster? And How does learning approach change relate to the development of reasoning ability?The Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) was used in order to evaluate participants&#146; learning approaches and Diagnostic Thinking Inventory (DTI) to measure participants&#146; diagnostic thinking ability. In order to determine changes of learning approaches, the same students were invited to fill out the same questionnaires one year later.This quantitative study was followed by a qualitative inquiry including in-depth interviews aimed at exploring the association of a change in learning approach score with the development of clinical reasoning ability. These interviews also explored the factors influencing learning approaches of these students. Those students with the greatest change in R-SPQ-2F scores between the two surveys were selected for interview.Analysis of the findings of both the quantitative and qualitative phases of this research leads the researcher to conclude that;-there is a correlation between ongoing learning approaches and the development of clinical reasoning ability; this correlation is positive if the approach is deep and it is negative if the approach is surface,-progress towards either end of the learning approach continuum is associated with observation of experts, reasoning practice and/or feedback from experts, and-progress towards either end of the learning approach continuum seems an earlier and better indicator of developing reasoning ability than categorization of learning approach because both learning approach change and the factor causing this change were associated with the development of clinical reasoning ability.This study contributes to understanding of the importance of ongoing learning approaches and the development of clinical reasoning ability by encouraging deep learning approach characteristics. Factors affecting learning approaches are also associated with the development of clinical reasoning ability. Their effect is more than expected