Effects of problem-based learning as reported in curricular comparison studies have been shown to be inconsistent over different medical schools. Therefore, we decided to summarize effects of a single well-established problem-based curriculum rather than to add up sometimes-conflicting findings from different problem-based curricula. Effect sizes were computed for 270 comparisons. The results suggest that students and graduates from the particular curriculum perform much better in the area of interpersonal skills, and with regard to practical medical skills. In addition, they consistently rate the quality of the curriculum as higher. Moreover, fewer students drop out, and those surviving need less time to graduate. Differences with respect to medical knowledge and diagnostic reasoning were on average positive but small. These outcomes are at variance with expectations voiced in recent contributions to the literature. They demonstrate that constructivist curricula can have positive effects on learning even...

Constructivist, Problem-Based Learning Does Work: A Meta-Analysis of Curricular Comparisons Involving a Single Medical School

Medical Education 2012: 46:678688 Context Medical schools wish to better understand why some students excel academically and others have difficulty in passing medical courses. Components of self-regulated learning (SRL), such as motivational beliefs and learning strategies, as well as participation in scheduled learning activities, have been found to relate to student performance. Although participation may be a form of SRL, little is known about the relationships among motivational beliefs, learning strategies, participation and medical school performance. Objectives This study aimed to test and cross-validate a hypothesised model of relationships among motivational beliefs (value and self-efficacy), learning strategies (deep learning and resource management), participation (lecture attendance, skills training attendance and completion of optional study assignments) and Year 1 performance at medical school. Methods Year 1 medical students in the cohorts of 2008 (n = 303) and 2009 (n = 369) completed a questionnaire on motivational beliefs and learning strategies (sourced from the Motivated Strategies for Learning Questionnaire) and participation. Year 1 performance was operationalised as students average Year 1 course examination grades. Structural equation modelling was used to analyse the data. Results Participation and self-efficacy beliefs were positively associated with Year 1 performance (beta = 0.78 and beta = 0.19, respectively). Deep learning strategies were negatively associated with Year 1 performance (beta = - 0.31), but positively related to resource management strategies (beta = 0.77), which, in turn, were positively related to participation (beta = 0.79). Value beliefs were positively related to deep learning strategies only (beta = 0.71). The overall structural model for the 2008 cohort accounted for 47% of the variance in Year 1 grade point average and was cross-validated in the 2009 cohort. Conclusions This study suggests that participation mediates the relationships between motivation and learning strategies, and medical school performance. However, participation and self-efficacy beliefs also made unique contributions towards performance. Encouraging participation and strengthening self-efficacy may help to enhance medical student performance.

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Motivation, learning strategies, participation and medical school performance.

On the Use and Misuse of Lectures in Higher Education

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

The Themes, Institutions, and People of Medical Education Research 1988-2010: Content Analysis of Abstracts from Six Journals.

Research has reported equivocal results regarding the relationship between study time investment and academic performance in higher education. In the setting of the active, assignment-based teaching approach at Hasselt University (Belgium), the present study aimed (a) to further clarify the role of study time in academic performance, while taking into account student characteristics (e.g. gender, prior domain knowledge), and (b) to examine the relation between a number of student and course characteristics and study time. Data included course-specific study time recordings across the entire term, grades for 14 courses, expert ratings of six course characteristics, and other data from the records of 168 freshmen in business economics. For most courses, study time predicted grades, even beyond student characteristics. However, there were differential results depending on the course considered, stressing the importance of examining relations at course level instead of globally across courses. As to study tim...

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Do diligent students perform better? Complex relations between student and course characteristics, study time, and academic performance in higher education

In this article, an alternative for Tinto's integration theory of student persistence is proposed and tested. In the proposed theory, time available for individual study is considered a major determinant of both study duration and graduation rate of students in a particular curriculum. In this view, other activities in the curriculum, in particular lectures, constrain self-study time and therefore must have a negative impact on persistence. To test this theory, we collected study duration and graduation rate information of all-almost 14,000 students-enrolling in eight Dutch medical schools between 1989 and 1998. In addition, information was gathered regarding the timetables of each of these curricula in the particular period: lectures hours, hours spent in small-group tutorials, practicals, and time available for self-study. Structural equation modeling was used to study relations among these variables. In line with our predictions, time available for self-study was the only determinant of graduation rate and study duration. Lectures were negatively related to self-study time, negatively related to graduation rate, and positively related to study duration. The results suggest that extensive lecturing may be detrimental in higher education. However, in the curricula employing limited lecturing considerable energy was spent in supporting self-study activities of students and preventing postponement of learning. Given our findings, both activities will likely have large pay offs, in particular in curricula with low graduation rates.

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J. Bulte

Papers

Learning more by being taught less: a “time-for-self-study” theory explaining curricular effects on graduation rate and study duration