This thesis explores whether a carefully designed educational program can impact unfavourably on a proportion of students, what the magnitude of this proportion may be, whether previously identified ???deep enhancing??? features could stimulate surface approaches in some students, and the possible reasons for such paradoxical impact. These questions are set within a context of continuing efforts to find the ???ideal??? medical curriculum, and where evaluation studies of these curricular methods have failed to demonstrate the expected degree of positive impact. This leads to the final question of the thesis, which is whether the phenomenon of different responses by different students, could help explain the less-than-expected positive impact of curricular innovations reported in the literature. The questions were explored through a series of three studies. The First study consisted of individual student interviews and surveys (using the R-SPQ-2F, Biggs et al 2001) during a traditional program in medicine and upon conclusion of an educational program designed along currently accepted principles associated with higher quality learning outcomes. The two follow up studies included surveying students in two other settings in medical education. These studies were useful to overcome some of the limitations of the First study, and to explore the possible wider prevalence of the findings of the First study. The findings of the First study indicated that one-third of the student group did respond unfavourable to a carefully designed educational program. The interview findings highlighted this phenomenon, and illustrated how these students responded to ???deep enhancing curricular features??? by changing to more surface approaches. The survey findings supported these findings, and helped cluster and categorise students into subgroups who responded to the Pilot program in distinct ways. The two follow up studies indicated similar patterns of response in the other settings of medical education, and suggested that this phenomenon may be more widely prevalent. The findings suggest an area of research that requires further exploration. If confirmed and extended by further work, the findings could have significant theoretical and practical implications for medical education. From a theoretical perspective, the findings enrich the current theory of student approaches to learning by beginning to unravel the complex interaction between student and context factors that lead to approaches. The thesis further contributes to the literature by its finding that some previously identified ???deep enhancing??? context factors could stimulate change to more surface approaches in some students, and by the finding that different students??? approaches could change in different directions, when measured before and after the same ???deep enhancing??? educational context. From a practical perspective, the findings could be relevant to designers and evaluators of medical curricula, and to facilitators of small group learning. An understanding of the different patterns of response that may be expected, and an understanding of different strategies that may better support these different subgroups, may help optimise the benefits of curricular design.
| Identifer | oai:union.ndltd.org:ADTP/243132 |
| Date | January 2005 |
| Creators | Balasooriya, Chinthaka Damith, Public Health & Community Medicine, Faculty of Medicine, UNSW |
| Publisher | Awarded by:University of New South Wales. School of Public Health and Community Medicine |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright Chinthaka Damith Balasooriya, http://unsworks.unsw.edu.au/copyright |
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