Medical students’ metacognition and perceptions of learning behavior in problem based versus science-based curriculum

Main Article Content

Adrian Gillissen, MD, MSc Tonja Kochanek, BSc Jan Ehlers, PhD

Abstract

Background: This study explores metacognitive competencies of medical students and provides insight into student’s perceptions on self-regulated and co-regulated learning preferences depending on curriculum type. Once in Germany universities medical students are taught either a problem-based curriculum (PBC) or the classical science based curriculum (SBC), this study evaluates the impact of these two teaching methods on students’ learning behavior.


Methods: Semi-structured interviews with 28 medical students were performed. Data collection and analysis were conducted iteratively, informed by principles of constructivist grounded theory. These study function as the basis to conceptualize a quantitative questionnaire.


Results: Although learning strategies were similar, major differences between groups were the motivation in undergraduate level. PBC -students preferred early patient presentation in undergraduate courses which eases the acquisition of the underlying scientific knowledge base, further triggering the desire to learn beyond the regular curriculum. SBC -students learn primarily for exams using simple memorization, arguing that the tight curriculum and the amplitude of learning matter impede them to study beyond the necessary evil. Studying motivation in PBC is higher than in SBC students although the latter expressed their excitement to see patients when entering the postgraduate study level.


Conclusions: PBC teaching style and working with patients already in undergraduate level motivates students in learning beyond the required minimum than in SBC. With increasing learning load students focus on exam preparations. The study findings suggest an educational model being learner driven, patient case-centered and preferably based on real time observations in order to better apply medical knowledge to the patient case at hand.

Keywords: medical students, learning strategies, perceptions, curriculum

Article Details

How to Cite
GILLISSEN, Adrian; KOCHANEK, Tonja; EHLERS, Jan. Medical students’ metacognition and perceptions of learning behavior in problem based versus science-based curriculum. Medical Research Archives, [S.l.], v. 10, n. 7, july 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2911>. Date accessed: 09 dec. 2024. doi: https://doi.org/10.18103/mra.v10i7.2911.
Section
Research Articles

References

1. Moffat KJ, McConnachie A, Ross S, Morrison JM. First year medical student stress and coping in a problem-based learning medical curriculum. Med Educ. 2004;38(5):482-491. doi:10.1046/j.1365-2929.2004.01814.x
2. Zupanic M, Ehlers JP, Fricke J, et al. Qualitative Studies on Implicit Criteria during the Individualized Selection Procedure for Medical Studies at Witten/Herdecke University (UW/H). GMS J Med Educ. 2019;36(1):Doc3. doi:10.3205/zma001211
3. Newton PM, Miah M. Evidence-Based Higher Education - Is the Learning Styles “Myth” Important? Front Psychol. 2017;8:444. doi:10.3389/fpsyg.2017.00444
4. Husmann PR, O’Loughlin VD. Another Nail in the Coffin for Learning Styles? Disparities among Undergraduate Anatomy Students’ Study Strategies, Class Performance, and Reported VARK Learning Styles. Anat Sci Educ. 2019;12(1):6-19. doi:10.1002/ase.1777
5. Feeley AM, Biggerstaff DL. Exam Success at Undergraduate and Graduate-Entry Medical Schools: Is Learning Style or Learning Approach More Important? A Critical Review Exploring Links Between Academic Success, Learning Styles, and Learning Approaches Among School-Leaver Entry (“Traditional”) and Graduate-Entry (“Nontraditional”) Medical Students. Teach Learn Med. 2015;27(3):237-244. doi:10.1080/10401334.2015.1046734
6. Newble DI, Entwistle NJ. Learning styles and approaches: implications for medical education. Med Educ. 1986;20(3):162-175. doi:10.1111/j.1365-2923.1986.tb01163.x
7. Cilliers FJ, Schuwirth LW, Adendorff HJ, Herman N, van der Vleuten CP. The mechanism of impact of summative assessment on medical students’ learning. Adv Health Sci Educ Theory Pract. 2010;15(5):695-715. doi:10.1007/s10459-010-9232-9
8. van Houten-Schat MA, Berkhout JJ, van Dijk N, Endedijk MD, Jaarsma ADC, Diemers AD. Self-regulated learning in the clinical context: a systematic review. Med Educ. 2018;52(10):1008-1015. doi:10.1111/medu.13615
9. Zupanic M, Hofmann M, Osenberg D, Gardeik K, Jansen P, Fischer MR. The aimed or feared professional future of medical students at the University of Witten/Herdecke. GMS Z Med Ausbild. 2011;28(2):Doc25. doi:10.3205/zma000737
10. Dicicco-Bloom B, Crabtree BF. The qualitative research interview. Med Educ. 2006;40(4):314-321. doi:10.1111/j.1365-2929.2006.02418.x
11. Mayring P. Qualitative Inhaltsanalyse. In: Mey G, Mruck K, eds. Handbuch Qualitative Forschung in der Psychologie: Band 2: Designs und Verfahren. Springer Fachmedien; 2020:495-511. doi:10.1007/978-3-658-26887-9_52
12. Rahm AK, Töllner M, Hubert MO, et al. Effects of realistic e-learning cases on students’ learning motivation during COVID-19. PloS One. 2021;16(4):e0249425. doi:10.1371/journal.pone.0249425
13. Tenny S, Brannan GD, Brannan JM, Sharts-Hopko NC. Qualitative Study. In: StatPearls. StatPearls Publishing; 2021. Accessed June 27, 2021. http://www.ncbi.nlm.nih.gov/books/NBK470395/
14. Ryan, G.W., Bernard, H.R. Data management and analysis methods. In: Handbook of Qualitative Research. 2nd. Sage Publications Ltd; 2000:769-802.
15. Lombardo L, Ehlers J, Lutz G. Is your mind set? - how are intra- and interpersonal competences dealt with in medical education? A multi-professional qualitative study. BMC Med Educ. 2019;19(1):317. doi:10.1186/s12909-019-1748-y
16. Tavakol M, Torabi S, Akbar Zeinaloo A. Grounded Theory in Medical Education Research. Med Educ Online. 2006;11(1):4607. doi:10.3402/meo.v11i.4607
17. Cooper AL, Elnicki DM. Resource utilisation patterns of third-year medical students. Clin Teach. 2011;8(1):43-47. doi:10.1111/j.1743-498X.2010.00393.x
18. Sandover S, Jonas-Dwyer D, Marr T. Graduate entry and undergraduate medical students’ study approaches, stress levels and ways of coping: a five year longitudinal study. BMC Med Educ. 2015;15:5. doi:10.1186/s12909-015-0284-7
19. Wynter L, Burgess A, Kalman E, Heron JE, Bleasel J. Medical students: what educational resources are they using? BMC Med Educ. 2019;19(1):36. doi:10.1186/s12909-019-1462-9
20. Guarino S, Leopardi E, Sorrenti S, De Antoni E, Catania A, Alagaratnam S. Internet-based versus traditional teaching and learning methods. Clin Teach. 2014;11(6):449-453. doi:10.1111/tct.12191
21. Abbasi S, Ayoob T, Malik A, Memon SI. Perceptions of students regarding E-learning during Covid-19 at a private medical college. Pak J Med Sci. 2020;36(COVID19-S4):S57-S61. doi:10.12669/pjms.36.COVID19-S4.2766
22. Alsoufi A, Alsuyihili A, Msherghi A, et al. Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning. PloS One. 2020;15(11):e0242905. doi:10.1371/journal.pone.0242905
23. Lycke KH, Grøttum P, Strømsø HI. Student learning strategies, mental models and learning outcomes in problem-based and traditional curricula in medicine. Med Teach. 2006;28(8):717-722. doi:10.1080/01421590601105645
24. Peine A, Kabino K, Spreckelsen C. Self-directed learning can outperform direct instruction in the course of a modern German medical curriculum - results of a mixed methods trial. BMC Med Educ. 2016;16:158. doi:10.1186/s12909-016-0679-0
25. Richardson JE, Bouquin DR, Tmanova LL, Wright D. Information and informatics literacies of first-year medical students. J Med Libr Assoc JMLA. 2015;103(4):198-202. doi:10.3163/1536-5050.103.4.008
26. Plaice C, Lloyd J, Shaw P. Supporting the library and information needs of UWE health and social care students on placement. Health Inf Libr J. 2017;34(1):32-44. doi:10.1111/hir.12171
27. Kuhn S, Frankenhauser S, Tolks D. Digitale Lehr- und Lernangebote in der medizinischen Ausbildung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018;61(2):201-209. doi:10.1007/s00103-017-2673-z
28. Wouters A, Croiset G, Schripsema NR, et al. Students’ approaches to medical school choice: relationship with students’ characteristics and motivation. Int J Med Educ. 2017;8:217-226. doi:10.5116/ijme.5921.5090
29. Wu H, Li S, Zheng J, Guo J. Medical students’ motivation and academic performance: the mediating roles of self-efficacy and learning engagement. Med Educ Online. 2020;25(1):1742964. doi:10.1080/10872981.2020.1742964
30. Hayat AA, Shateri K, Amini M, Shokrpour N. Relationships between academic self-efficacy, learning-related emotions, and metacognitive learning strategies with academic performance in medical students: a structural equation model. BMC Med Educ. 2020;20(1):76. doi:10.1186/s12909-020-01995-9
31. Kim KJ, Hwang JY, Kwon BS. Differences in medical students’ academic interest and performance across career choice motivations. Int J Med Educ. 2016;7:52-55. doi:10.5116/ijme.56a7.5124
32. Chang C, Colón-Berlingeri M, Mavis B, Laird-Fick HS, Parker C, Solomon D. Medical Student Progress Examination Performance and Its Relationship With Metacognition, Critical Thinking, and Self-Regulated Learning Strategies. Acad Med J Assoc Am Med Coll. 2021;96(2):278-284. doi:10.1097/ACM.0000000000003766
33. Bransen D, Govaerts MJB, Sluijsmans DMA, Driessen EW. Beyond the self: The role of co-regulation in medical students’ self-regulated learning. Med Educ. 2020;54(3):234-241. doi:10.1111/medu.14018
34. Rich JV. Proposing a Model of Co-Regulated Learning for Graduate Medical Education. Acad Med J Assoc Am Med Coll. 2017;92(8):1100-1104. doi:10.1097/ACM.0000000000001583
35. Hadwin AF, Wozney L, Pontin O. Scaffolding the Appropriation of Self-Regulatory Activity: A Socio-Cultural Analysis of Changes in Teacher-Student Discourse about a Graduate Research Portfolio. Instr Sci Int J Learn Sci. 2005;33(5):413-450.