Why should I prepare? a mixed method study exploring the motives of medical undergraduate students to prepare for clinical skills training sessions

BACKGROUND: Although preparation for educational activities is considered beneficial for student learning, many students do not perform preparatory assignments. This phenomenon has received little attention in the literature although it might provide medical educators with the opportunity to enhance student learning. Therefore, we explored why students prepare or not prepare. METHODS: An explorative mixed methods study was performed. In a qualitative study, 24 short group interviews with medical undergraduate students (n=209) were conducted on why they prepared for skills training sessions. In a subsequent quantitative study the resulting themes were used to construct a questionnaire. The questionnaire was presented to all undergraduate medical students at Maastricht University and 847 students completed it. Scales were constructed by a combination of exploratory factor analysis, reliability analysis, and content analysis. Between-class differences in the scale scores were investigated using ANOVA. RESULTS: The qualitative study showed that students’ opinions on preparation are influenced by both personal factors, categorized as ‘personal learning style’, ‘attitudes and beliefs’, and ‘planning and organization’, as well as external factors, including ‘preparatory advice’, ‘pressure, consequence, and checking of preparation’, ‘teacher-related motivations’, and ‘contents and schedule of the training sessions’. The quantitative study showed that ‘the objective structured clinical examination’ and ‘facilitation of both understanding and memorizing the learning material’, were the two most motivating items. The two most demotivating aspects were ‘other students saying that preparation was not useful’ and ‘indistinct preparatory advices’. Factor analyses yielded three scales: ‘urge to learn’, ‘expected difficulties’, and ‘lack of motivation‘. Between group differences were found between the three classes on the first two scales. CONCLUSIONS: Students make an active and complex choice whether to prepare or not, based on multiple factors. Practical implications for educational practice are discussed

Self-explanation in the domain of statistics: an expertise reversal effect

This study investigated the effects of four instructional methods on cognitive load, propositional knowledge, and conceptual understanding of statistics, for low prior knowledge students and for high prior knowledge students. The instructional methods were (1) a reading-only control condition, (2) answering open-ended questions, (3) answering open-ended questions and formulating arguments, and (4) studying worked-out examples of the type of arguments students in the third group had to formulate themselves. The results indicate that high prior knowledge students develop more propositional knowledge of statistics than low prior knowledge students. With regard to conceptual understanding, the results indicate an expertise reversal effect: low prior knowledge students learn most from studying worked-out examples, whereas high prior knowledge students profit most from formulating arguments. Thus, novice students should be guided into the subject matter by means of worked-out examples. As soon as students have developed more knowledge of the subject matter, they should be provided with learning tasks that stimulate students to solve problems by formulating arguments