Developments and preferences in learning and teaching

Over a decade ago, Williams (1992) showed that the majority (72%) of a sample of 99 first-year undergraduates at a Welsh institution preferred student-centred learning, characterised by a shift from lecturers as expert sources of knowledge to a facilitative role. Sander et al. (2000) reinforced this result in their exploration of undergraduate students’ expectations of and preferences in teaching, learning and assessment. A convenience sample of 395 first-year university undergraduates, from three British universities, enrolled on a medical, business studies or psychology degree, showed similarities in expectations and preferences. Specifically, the students expected to be taught by formal and interactive lectures but preferred to be taught by interactive lectures and group-based activities. Their least favoured learning methods were formal lecture, role-play and student presentations. Students asked to rate various qualities of a good teacher selected ‘teaching skill’, followed by ‘approachability’ as the most important.

7.4.1.1 Experiential activities and practical work

Beylefeld et al. (2005) investigated the usefulness of providing students with community-located experiences in the first year as a basis for reflection. They observed the degree to which community-located experiences influenced the quality of a reflective writing exercise of 128 students (66 Afrikaans-speaking, and 62 English-speaking) in a South African university. Student’s emotional states tended to

move from negative to positive as the visit continued. This was important for the students’ personal growth, signifying their awareness of how perspectives can be distorted. Nearly all (94%) regarded the visit as being important prior to immersing themselves in the theory of primary healthcare. The authors concluded that reflective writing can be promoted through using a real-world experience as stimulus, and a framework for guiding students’ thoughts. Aronson et al. (2005) also suggested that one-off experiential interventions might provide an important complement to didactics around issues of intercultural awareness and sensitivity with medical students. Medical students, in a US institution, participated in group activities in which they shared personal experiences, solved a hypothetical problem, and engaged in team- building exercises. Importantly, experiential interventions must provide students with sufficient time to reflect upon and discuss feelings, thoughts and attitudes that emerge during this kind of intercultural awareness training.

Tan’s (1990) Malaysian study explored first-year medical student’s approaches to undertaking experiments. Comparing a control group, who performed an experiment for themselves in the usual way, and an experimental group, who were given a programmed text to study before the experiment, revealed that the latter group showed significant gains in performance, although the results might be compromised because both groups were inadequately prepared for the practical exercise and many students failed to study the programmed text conscientiously. This study suggested that, in general, pre-preparation for practical activities augments learning. Tan et al. (1989) had already suggested the need to review the role of practical work to maximise its benefits.

Williamson (1999) provided a case study of a flexible resource-based learning approach to media studies. In an Australian institution, designed to encourage students to apply and reflect on writing formats drawn from professional fields such as journalism and screen production. The aim was to encourage an interest in the broader social conditions affecting media practices and the diverse settings in which these forms can operate. Problems encountered and suggested strategies were noted. Thirty-five years ago, Sherman et al. (1969) compared a new architectural drawing method with the existing traditional method and showed the new method produced better results. Adamson (1979) described a method used at an Australian university for implementing a home experiment approach in first-year biology.

7.4.1.2 Reconfiguring curricula and content

In some cases, innovation is no more than reconfiguring content. Maude (1991) reported an approach to geography that integrated human and physical geography, in a first-year undergraduate course in Australia. The reasons for teaching the course, its content and structure and problems that had to be resolved in its design were discussed. Strayhorn (1989) explored the impact of a major curriculum revision on students’ perceptions of the quality of the medical school learning environment, social supports, and their own mental and social well-being. First-year students’ perceptions one year before the curriculum revision were compared with first-year students’ perceptions two years after the introduction of the new curriculum. The findings suggested that well-considered and well-executed efforts to improve the quality of a medical school’s learning environment can be successful and can raise students’ perceptions of their overall well-being.

One of the rare studies of first-year postgraduate experience reported the

at a UK university, in line with the General Medical Council’s requirements (Challis et al., 1998).

In other cases, there are calls for a reconstruction of the curriculum to enhance the first-year experience. Lines (2004) reviewed good practice in several institutions around the world and argued that, greater emphasis might be placed on a coherent and thought-through curriculum. Additional resources including investment in staff development might be required but evidence suggests that the impact upon the student experience can be both significant and positive.

7.4.1.3 Problem-based learning

De Volder and De Grave (1989) discussed training programmes in problem-based learning for first-year students in a Dutch university and highlighted the value of the approach. Similarly, Feletti et al. (1988) explored students’ satisfaction with, and changes in approach to, learning during their first year in problem-based curricula for agriculture, architecture, medicine and para-medicine. Students at each school showed little change in approach. However, students’ approach to learning correlated with their degree of satisfaction with their course, which, they claimed, further

endorsed the merits of problem-based curricula.

Roberts et al. (2005) evaluated the introduction of large class problem-based learning into an undergraduate medical curriculum. They compared the outcomes of a problem-based learning module conducted in a large class format within a lecture theatre with a module having the same defined learning outcomes delivered in small group format, both supported by e-learning resources. There seemed to be no significant differences in learning outcomes, based on various measures, between the large and small groups, although it is recognised that students would prefer the small group teaching format. Within institutions where resources to support small group problem-based learning are limited, the large group format supported with e- learning techniques may be a useful alternative approach.

Koufogiannakis et al. (2005) undertook a controlled study to explore the impact of librarians in first-year medical and dental student problem-based learning groups in a Canadian university. Informal feedback had suggested that librarian involvement in groups was beneficial. To test this, six librarians were assigned randomly to a third of the 18 existing problem-based learning groups. Students were given pre- and post- tests at the outset and upon completion of the six-week course and there was a small positive librarian impact, although final examination scores showed no impact. There was also no difference in attitudes or comfort levels between students who had a librarian in their group and those who did not.

In Australia, Rolfe et al. (1998) compared the performance of Australian doctors in their first (intern) and subsequent first year of postgraduate hospital training on traditional and problem-based programmes. Data on 349 doctors (79 percent

response rate) indicated that there were no significant differences between graduates from different educational backgrounds during internship or residency. The study also suggests that gender and age are factors influencing junior doctors’ performance.