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      Integrated problem-based learning versus lectures: a path analysis modelling of the relationships between educational context and learning approaches

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          ABSTRACT

          Students’ approaches to learning are central to the process of learning. Previous research has revealed that influencing students’ approaches towards deep learning is a complex process and seems much more difficult than expected, even in student-activating learning environments. There is evidence that learning approaches are impacted not only by the learning environment, but also by how students perceive it. However the nature of the links between the environment itself, the way in which it is perceived by students and students’ learning approaches is poorly understood. This study aimed at investigating the relationships between students’ perception of their educational context and learning approaches in three learning environments differing by their teaching formats (lecture or problem-based-learning PBL) and integration level of the curriculum (traditional or integrated). We tested the hypothesis that a PBL format and an integrated curriculum are associated to deeper approaches to learning and that this is mediated by student perception. The study sample was constituted of 1394 medical students trained respectively in a traditional lecture-based ( n = 295), in an integrated lecture-based ( n = 612) and in an integrated PBL-based ( n = 487) curricula. They completed a survey including the Dundee-Ready-Educational-Environment-Measure (students’ perceptions of the educational environment) and the Revised-Study-Process-Questionnaire (learning approaches). Data were analysed by path analysis. The model showed that the learning environment was related to students’ learning approaches by two paths, one direct and one mediated via students’ perception of their educational context. In the lecture-based curricula students’ used deeper approaches when it was integrated and both paths were cumulative. In the PBL-based curriculum students’ did not use deeper approaches than with lectures, due to opposite effects of both paths. This study suggested that an integrated lecture-based curriculum was as effective as a PBL curriculum in promoting students’ deep learning approaches, reinforcing the importance of integrating the curriculum before choosing the teaching format.

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          AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education-a unifying perspective.

          J Genn (2001)
          This paper looks at five focal terms in education - curriculum, environment, climate, quality and change - and the interrelationships and dynamics between and among them. It emphasizes the power and utility of the concept of climate as an operationalization or manifestation of the curriculum and the other three concepts. Ideas pertaining to the theory of climate and its measurement can provide a greater understanding of the medical curriculum. The learning environment is an important determinant of behaviour. Environment is perceived by students and it is perceptions of environment that are related to behaviour. The environment, as perceived, may be designated as climate. It is argued that the climate is the soul and spirit of the medical school environment and curriculum. Students' experiences of the climate of their medical education environment are related to their achievements, satisfaction and success. Measures of educational climate are reviewed and climate measures for medical education are discussed. These should take account of current trends in medical education and curricula. Measures of the climate may subdivide it into different components giving, for example, a separate assessment of so-called Faculty Press, Student Press, Administration Press and Physical or Material Environmental Press. Climate measures can be used in different modes with the same stakeholders. For example, students may be asked to report, first, their perceptions of the actual environment they have experienced and, second, to report on their ideal or preferred environment. The same climate index can be used with different stakeholders giving, for example, staff and student comparisons. In addition to the educational climate of the environment that students inhabit, it is important to consider the organizational climate of the work environment that staff inhabit. This organizational climate is very significant, not only for staff, but for their students, too. The medical school is a learning organization evolving and changing in the illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Considerations of climate in the medical school, along the lines of continuous quality improvement and innovation, are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations, their quality of health and their longevity may be threatened.
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            The integrated curriculum in medical education: AMEE Guide No. 96.

            The popularity of the term "integrated curriculum" has grown immensely in medical education over the last two decades, but what does this term mean and how do we go about its design, implementation, and evaluation? Definitions and application of the term vary greatly in the literature, spanning from the integration of content within a single lecture to the integration of a medical school's comprehensive curriculum. Taking into account the integrated curriculum's historic and evolving base of knowledge and theory, its support from many national medical education organizations, and the ever-increasing body of published examples, we deem it necessary to present a guide to review and promote further development of the integrated curriculum movement in medical education with an international perspective. We introduce the history and theory behind integration and provide theoretical models alongside published examples of common variations of an integrated curriculum. In addition, we identify three areas of particular need when developing an ideal integrated curriculum, leading us to propose the use of a new, clarified definition of "integrated curriculum", and offer a review of strategies to evaluate the impact of an integrated curriculum on the learner. This Guide is presented to assist educators in the design, implementation, and evaluation of a thoroughly integrated medical school curriculum.
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              Improving the quality of student learning: the influence of learning context and student approaches to learning on learning outcomes

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                Author and article information

                Journal
                Med Educ Online
                Med Educ Online
                ZMEO
                zmeo20
                Medical Education Online
                Taylor & Francis
                1087-2981
                2018
                03 July 2018
                : 23
                : 1
                : 1489690
                Affiliations
                [a ]Department of public health, Biostatistics, Institute of pharmaceutic and biological sciences , Lyon, France
                [b ]Emerging pathogens laboratory - Fondation Mérieux, International Center for Infectiology Research(CIRI) , Lyon, France
                [c ]Unit of Development and Research in Medical Education, University of Geneva Faculty of Medicine , Geneva, Switzerland
                [d ]Medical Education Unit, Faculty of science and medicine, University of Lausanne , Lausanne, Switzerland
                Author notes
                CONTACT Anne Baroffio anne.baroffiobarbier@ 123456unige.ch UDREM/Medical Center , 1 rue Michel Servet, 1211 Geneva 4, Switzerland
                Author information
                http://orcid.org/0000-0002-1299-6576
                http://orcid.org/0000-0002-7434-9585
                http://orcid.org/0000-0001-9322-2494
                http://orcid.org/0000-0001-5185-7811
                http://orcid.org/0000-0003-4453-8083
                Article
                1489690
                10.1080/10872981.2018.1489690
                6041782
                29966510
                302abb38-2f10-4c45-b7ee-b6a197269770
                © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 February 2018
                : 12 June 2018
                Page count
                Figures: 2, Tables: 6, References: 61, Pages: 13
                Funding
                Funded by: Swiss Federal Office of Public Health
                Award ID: REF-13.005595
                Award ID: 14.001567
                Award ID: 15.029074
                This work was supported by the University of Geneva (CH) Faculty of Medicine; Swiss Federal Office of Public Health [Grant number REF-13.005595, 14.001567, 15.029074];
                Categories
                Research Article

                Education
                educational context,integrated curriculum,learning approaches,medical education,path analysis models,problem-based learning,student perception of the educational context,undergraduate medical students

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