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Effect of an Undergraduate Medical Curriculum on Students' Self-directed Learning" BJ Harvey, AI Rothman, RC Frecker, Academic Medicine 78:1259-1265, 2003. Reviewed by William G. Wilson, University of Virginia


Effect of an Undergraduate Medical Curriculum on Students' Self-directed Learning"

BJ Harvey, AI Rothman, RC Frecker, Academic Medicine 78:1259-1265, 2003.

Reviewed by William G. Wilson, University of Virginia

These authors describe the effect of a curriculum modification at the University of Toronto on self-directed learning (SDL) by medical students, as defined by responses to 3 questionnaires designed to assess SDL. Students in each of the 4 years of medical school were randomly surveyed, and the responses between the class years were compared to determine if there were differences that might reflect effectiveness in the curriculum in developing SDL skills. Overall, there were no significant differences in the responses to the questionnaires among the 4 classes. This suggested that SDL was not impacted by the revised curriculum. There were differences between students with Ph.D. degrees and those with either undergraduate or Master's degrees; those with Ph.D. degrees scored higher on the SDL questionnaires than the other groups. There was also a trend toward a diminishing view of the importance of SDL as students progressed through medical school.

I found this study both refreshing and disheartening-"refreshing" because the authors published a negative study, one whose results did not validate a curriculum change. (I sometimes wonder how many "negative studies" go unreported or unpublished, therefore shedding light and perhaps unwarranted attention on those published studies that yield positive results). But I also found it disheartening that a curriculum designed to improve these skills in the medical students was ineffective. The authors offer several alternative explanations for their observations, but felt that the results were accurate and reflected a lack of effectiveness of their curriculum on developing these skills.

(This is an interesting article, the background includes a statement that medical students have scored more highly than other professions in this area - Do you think that your curriculum fosters self directed learning? Steve Miller)

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