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A crash course in metacognition: evaluation of a 5-week study skills programme for students in the first year of undergraduate medical education

Authors

  • Fiza Ahmed
  • Dr Clare Penlington
  • Dr Lesley Robson

Theme

8BB Teaching and learning: Principles

INSTITUTION

Queen Mary University of London - Medical Education - London - United Kingdom

Background

Bridging the transition between secondary and undergraduate medical education can be challenging for many first-year medical students. Although 'active learning' has emerged as a tenet of education theory in recent decades, ironically, the 'active learner' has been  largely ignored in this mix - there is little evidence of interventions designed to support students' metacognitive development, i.e. their ability to plan and undertake their studies using a wide range of techniques.

The failure to adapt to the medical school workload has been attributed to many factors, including a lack of requisite study skills, 'competencies associated with... organizing, synthesizing, remembering and using information'1. There is scarce literature regarding evaluations of study skills support offered by medical schools2 3

Summary of Work

STUDY AIMS


This study aimed to add to the existing knowledge base in the following domains:

 

1. To measure the value of a study skills course aimed at first-year undergraduate medical students at a UK medical school, in terms of impact on academic performance and participant perceptions
 

2. To measure the value of integrating study skills with the content of the medical curriculum

 

 


THE STUDY SKILLS COURSE


The course was 5 weeks in duration, with weekly sessions; it was targeted at first-year students who had performed poorly in the first assessment of the year.


The sessions involved group discussions and collaborative activities, and were facilitated both by university teachers with educational experience, and senior medical students. Sessions included problem-based learning and concept maps.

 


An example of a concept map produced collaboratively by students during Session 4


 

MIXED-METHODS EVALUATION OF THE PROGRAMME


QUANTITATIVE EVALUATION
 

  1. Attendance rates were monitored throughout the course
     
  2. In-course assessment results: mean changes in students' post-intervention assessment scores were compared from baseline (pre-intervention assessment scores), according to the number of course sessions attended.


QUALITATIVE EVALUATION
 

  1. Focus groups were undertaken with students and teachers of the course (including senior medical students), to illuminate perceptions of the course in terms of purpose, design, delivery and perceived outcomes.
     
  2. E-mail survey - an e-mail was sent to students who had not attended sessions, to understand their reasons for poor attendance.
Summary of Results

POST-INTERVENTION ASSESSMENT SCORE PROGRESS


    STUDENT/TEACHER PERCEPTIONS OF THE COURSE

 

 

Conclusion

Student engagement with this short study skills programme yielded positive short-term results in supporting the early stages of medical students' development as self-directed learners:

 

  • Students gained an insight into different learning techniques and were encouraged to experiment with these approaches, to manage the demanding workload of the course
     
  • This effect may have contributed to the improvement of aspects of students' assessment scores post-intervention.
Take-home Messages

When planning an intervention to support medical students' development as lifelong learners from the earliest stages of their training:
 

  • HARNESS the power of senior student role models, using their experiences to guide and reassure struggling junior students
     
  • UNDERSTAND the negative impact of the preclinical hidden curriculum6 on students' willingness to seek help in their studies
     
  • SHARE RESULTS so that struggling students benefit from robust, evidence-based interventions
References
  1. Hoover, J.J. and Patton, P.R. (1995) Teaching students with learning problems to use study skills: A teacher’s guide. Austin, TX: Pro-Ed.
  2. Ferguson, E., James, D. and Madeley, L. (2002) Factors associated with success in medical school: a systematic review of the literature. British Medical Journal; 324: 952-957
  3. Cleland, J., Leggett, H., Sandars, J., Costa, M.J., Patel, R. and Moffatt, M. (2013) The remediation challenge: theoretical and methodological insights from a systematic review. Medical Education; 47: 242-251
  4. Winston, K.A., van der Vleuten, C.P.M. and Scherpbier, A.J.J.A. (2010) An investigation into the design and effectiveness of a mandatory cognitive skills programme for at-risk medical students. Medical Teacher; 32: 236-243
  5. Winston, K.A., van der Vleuten, C.P.M. and Scherpbier, A.J.J.A. (2010) At-risk medical students: implications of students’ voice for the theory and practice of remediation. Medical Education; 44: 1038-1047
  6. Hafferty, F.W. (1998) Beyond Curriculum Reform: Confronting Medicine’s Hidden Curriculum. Academic Medicine; 73(4): 403-407
Background
Summary of Work

Outline of the study skills programme:

 


Data analysis

Quantitative analysis - Outcomes were measured in terms of mean change in scores from baseline (Assessment 1), in 3 areas: the 2 individual components of the written assessment (MCQ and SAQ) and change in overall score. These changes were measured in both the short-term and medium-term settings. Student's t-tests were also performed on the data to see whether these changes in scorewere significant. A p-value of <0.05 was considered statistically significant.

 

Qualitative analysis - A thematic approach was undertaken to analyse data from the focus groups and e-mail survey. An initial coding framework was developed using QSR International's NVivo 10 software. Themes were consequently generated from this framework

 

 

Summary of Results

MORE DETAILS ABOUT CHART 1: 'POST-INTERVENTION ASSESSMENT SCORE PROGRESS'

Sample size for evaluation: n=53 (Control Group 1a: n=21. Control Group 1b: n=13. Attended at least 1 session: n=19).


EXPLANATION OF CONTROL GROUPS

Control Group 1a comprised students who did not perform poorly in the first assessment and who attended 0/5 course sessions.

Control Group 1b comprised students who performed poorly in ICA 1 (baseline) and who attended 0/5 course sessions despite being recommended to attend by the medical faculty.


EXPLANATION OF INDIVIDUAL GRAPHS

Overall:
 Short-medium-term changes in overall assessmentscore from baseline (ICA1 overall score), according to number of course sessions attended.

Multiple-choice questions: Short-medium term changes in multiple-choice question scores from baseline (ICA1 MCQ score), according to number of course sessions attended.  

Short-answer questions: Short-medium term changes in short-answer question scores from baseline (ICA1 SAQ score), according to number of course sessions attended.

* indicates significant results from paired-sample t-tests (p<0.05). 


EXPLANATION OF TERMINOLOGY:

In-course assessments (ICAs) are primarily formative assessments used to determine students' progress throughout the year. There are 3 ICAs during the first year at Barts and The London. Assessment 1 takes place in November, Assessment 2 takes place in February and Assessment 3 takes place in April.

Short-term change- indicates the mean change in score from Assessment 1 to Assessment 2 (according to number of course sessions attended)

Medium-term change - indicates the mean change in score from Assessment 1 to Assessment 3 (according to number of course sessions attended)

Conclusion
Take-home Messages
References
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