Abstract
ObjectivesWe investigated students' conception of learning for an examination in internal medicine, infectious diseases and dermatology-venereology, in three separate examinations versus a single integrated one. MethodsThe study was carried out during a curricular change, with one cohort belonging to a new integrated examination and the other to the former non-integrated examination. Forty-eight interviews were carried out among medical undergraduates regarding the role of the examination in the learning process. The interviews were analyzed according to the phenomenographic approach to identify the students' conception of learning. ResultsThe learning approaches could be categorized in 47 of the 48 students into 4 major groups: application directed, holistic, comprehensive and tactical memorizing learning. The result indicated that comprehensive learning was the most common approach among students following either examination-form; tactical memorizing learning was more prevalent among students following the non-integrated examination and holistic learning was applied more frequently among students following the integrated examination. Nine of the 47 students changed their approaches over time, the majority switching to a compre-hensive approach. No significant gender difference was observed. ConclusionsComprehensive learning was the most common strategy employed and students who changed during the course most often switched to this. However, only a minor change in approach was observed after a switching to an integrated examination, i.e. it takes more than just an integrated examination to change the stu-dent's conception of learning.
Highlights
There is a changing focus in healthcare which calls for a curriculum change, with a shift from the cure of disease, episodic care, and anecdotal care to the preservation of health, continuous and comprehensive care and evidencebased medicine.[1]
The result indicated that comprehensive learning was the most common approach among students following either examination-form; tactical memorizing learning was more prevalent among students following the non-integrated examination and holistic learning was applied more frequently among students following the integrated examination
Learning conceptions The analysis yielded four categories representing different approaches in the students’ own conception of learning for the final written examination(s). These categories are presented below with quotes to elucidate their meaning. Application directed learning This category is based on learning for life and is characterized by the student’s own responsibility for learning, which goes beyond the examination
Summary
There is a changing focus in healthcare which calls for a curriculum change, with a shift from the cure of disease, episodic care, and anecdotal care to the preservation of health, continuous and comprehensive care and evidencebased medicine.[1]. The medical programme at Karolinska Institutet conducted a curriculum change in 2008. Some major reasons for this were to add primary care across the whole programme, to launch clinical electives as well as a 20-week individual scientific project. Another purpose was to stimulate integration between subjects, both vertically and horizontally. The examination was the main change towards employing integration for the students. This curriculum change gave us the unique opportunity to analyze potential changes in the students’ conception of learning in preparation for a written integrated examination in undergraduate medical training
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