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      The Analysis of Teaching of Medical Schools ( AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

      research-article
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      BMC Medicine
      BioMed Central
      Medical school differences, Teaching styles, Problem-based learning, Timetables, Lectures, Tutorials, Clinical teaching, Self-regulated learning

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          Abstract

          Background

          What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL).

          Method

          The Analysis of Teaching of Medical Schools ( AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times.

          Results

          A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content.

          Discussion

          UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study ( MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.

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          Most cited references39

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          Problem-based learning

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            The effects of problem-based learning during medical school on physician competency: a systematic review.

            Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.
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              The psychological basis of problem-based learning: a review of the evidence.

              Several potential advantages for students' learning are claimed for problem-based learning (PBL). Students in PBL curricula may be more highly motivated; they may be better problem solvers and self-directed learners; they may be better able to learn and recall information; and they may be better able to integrate basic science knowledge into the solutions of clinical problems. Although some of these claims find theoretical support from the literature on the psychology of learning, to date there has been no review of the experimental evidence supporting the possible differences in students' learning that can be attributed to PBL. In this review article, the authors examine each claim critically in light of that evidence. They conclude that (1) there is no evidence that PBL curricula result in any improvement in general, content-free problem-solving skills; (2) learning in a PBL format may initially reduce levels of learning but may foster, over periods up to several years, increased retention of knowledge; (3) some preliminary evidence suggests that PBL curricula may enhance both transfer of concepts to new problems and integration of basic science concepts into clinical problems; (4) PBL enhances intrinsic interest in the subject matter; and (5) PBL appears to enhance self-directed learning skills, and this enhancement may be maintained.
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                Author and article information

                Contributors
                oliver.devine@gmail.com
                andyharborne@outlook.com
                hugolh@live.com
                tobin.joseph.13@ucl.ac.uk
                tess.marshall-andon@wsh.nhs.uk
                ryuasamuels@gmail.com
                joshua.kearsley@hey.nhs.uk
                i.mcmanus@ucl.ac.uk
                Journal
                BMC Med
                BMC Med
                BMC Medicine
                BioMed Central (London )
                1741-7015
                14 May 2020
                14 May 2020
                2020
                : 18
                : 126
                Affiliations
                [1 ]GRID grid.83440.3b, ISNI 0000000121901201, UCL Medical School, ; 74 Huntley Street, London, WC1E 6BT UK
                [2 ]GRID grid.412926.a, ISNI 0000 0004 0399 7467, Good Hope Hospital, ; Rectory Rd, Sutton Coldfield, B75 7RR UK
                [3 ]GRID grid.264200.2, ISNI 0000 0000 8546 682X, St George’s, University of London, ; Cranmer Terrace, London, SW17 0RE UK
                [4 ]GRID grid.5335.0, ISNI 0000000121885934, School of Clinical Medicine, , University of Cambridge, Addenbrooke’s Hospital, ; Hills Rd, Cambridge, CB2 0SP UK
                [5 ]GRID grid.1006.7, ISNI 0000 0001 0462 7212, Medical Student Office, , Newcastle University, ; Framlington Place, Newcastle upon Tyne, NE2 4HH UK
                [6 ]GRID grid.417704.1, ISNI 0000 0004 0400 5212, Hull University Teaching Hospitals, , Hull Royal Infirmary, ; Anlaby Road, Hull, HU3 2JZ UK
                [7 ]GRID grid.5491.9, ISNI 0000 0004 1936 9297, Faculty of Medicine, , University of Southampton, ; Building 85, Life Sciences Building, Highfield Campus, Southampton, SO17 1BJ UK
                [8 ]GRID grid.7107.1, ISNI 0000 0004 1936 7291, University of Aberdeen, ; Suttie Centre, Foresterhill, Aberdeen, AB25 2ZD UK
                [9 ]GRID grid.8273.e, ISNI 0000 0001 1092 7967, Norwich Medical School, Faculty of Medicine and Health Sciences, , University of East Anglia, ; Norwich, NR4 7TJ UK
                [10 ]GRID grid.5337.2, ISNI 0000 0004 1936 7603, Faculty of Health Sciences, , University of Bristol Medical School, ; First Floor South, Senate House, Tyndall Avenue, Bristol, BS8 1TH UK
                [11 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Imperial College School of Medicine, ; South Kensington Campus, London, SW7 2AZ UK
                [12 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, School of Medicine, Dentistry and Nursing, , University of Glasgow, ; Glasgow, G12 8QQ UK
                [13 ]GRID grid.5685.e, ISNI 0000 0004 1936 9668, John Hughlings Jackson Building, , University of York, ; Heslington, York, YO10 5DD UK
                [14 ]GRID grid.9757.c, ISNI 0000 0004 0415 6205, School of Medicine, , Keele University, ; David Weatherall Building, Keele University Campus, Staffordshire, ST5 5BG UK
                [15 ]GRID grid.6572.6, ISNI 0000 0004 1936 7486, Birmingham Medical School, ; Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2TT UK
                [16 ]GRID grid.4305.2, ISNI 0000 0004 1936 7988, University of Edinburgh Medical School, ; 47 Little France Cres, Edinburgh, EH16 4TJ UK
                [17 ]GRID grid.12082.39, ISNI 0000 0004 1936 7590, Brighton and Sussex Medical School, BSMS Teaching Building, , University of Sussex, ; Brighton, BN1 9PX UK
                [18 ]GRID grid.11835.3e, ISNI 0000 0004 1936 9262, The Medical School, , The University of Sheffield, ; Beech Hill Road, Sheffield, S10 2RX UK
                [19 ]Barts and The London Medical School, 4 Newark St, Whitechapel, London, E1 2AT UK
                [20 ]GRID grid.24029.3d, ISNI 0000 0004 0383 8386, Cambridge University Hospitals NHS Foundation Trust, ; Hills Road, Cambridge, CB2 0QQ UK
                [21 ]GRID grid.8241.f, ISNI 0000 0004 0397 2876, University of Dundee School of Medicine, ; 4 Kirsty Semple Way, Dundee, DD2 4BF UK
                [22 ]GRID grid.415598.4, ISNI 0000 0004 0641 4263, The University of Nottingham, , Queen’s Medical Centre, ; Nottingham, NG7 2UH UK
                [23 ]GRID grid.417083.9, ISNI 0000 0004 0417 1894, Whiston Hospital, ; Warrington Road, Prescot, L35 5DR UK
                [24 ]Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU UK
                [25 ]Guy’s, King’s and St Thomas’ School of Medical Education, Henriette Raphael Building, Guy’s Campus, London, SE1 1UL UK
                [26 ]GRID grid.4777.3, ISNI 0000 0004 0374 7521, Queen’s University Belfast, ; University Road, Belfast, BT7 1NN UK
                [27 ]Manchester Medical School, Stopford Building, Oxford Rd, Manchester, M13 9PT UK
                [28 ]GRID grid.5600.3, ISNI 0000 0001 0807 5670, Cardiff University School of Medicine, ; Cochrane Building, Heath Park Way, Cardiff, CF14 4YU UK
                [29 ]GRID grid.9909.9, ISNI 0000 0004 1936 8403, School of Medicine, Worsley Building, , University of Leeds, ; Leeds, LS2 9NL UK
                [30 ]GRID grid.10025.36, ISNI 0000 0004 1936 8470, University of Liverpool Medical School, ; Cedar House, Ashton St, Liverpool, L69 3GE UK
                [31 ]GRID grid.9918.9, ISNI 0000 0004 1936 8411, George Davies Centre, , University of Leicester School of Medicine, ; Lancaster Road, Leicester, LE1 7HA UK
                [32 ]GRID grid.443984.6, St James’s University Hospital, ; Beckett Street, Leeds, West Yorkshire LS9 7TF UK
                [33 ]GRID grid.439591.3, ISNI 0000 0004 0399 2770, Homerton University Hospital, ; Homerton Row, London, E9 6SR UK
                [34 ]GRID grid.269014.8, ISNI 0000 0001 0435 9078, University Hospitals of Leicester NHS Trust, ; Infirmary Square, Leicester, LE1 5WW UK
                [35 ]GRID grid.240404.6, ISNI 0000 0001 0440 1889, Nottingham University Hospitals NHS Trust, ; Hucknall Rd, Nottingham, NG5 1PB UK
                [36 ]GRID grid.417581.e, ISNI 0000 0000 8678 4766, Aberdeen Royal Infirmary, ; Foresterhill, Aberdeen, AB25 2ZN UK
                [37 ]GRID grid.83440.3b, ISNI 0000000121901201, Research Department of Medical Education, , UCL Medical School, ; Gower Street, London, WC1E 6BT UK
                Author information
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                Article
                1571
                10.1186/s12916-020-01571-4
                7222546
                32404194
                87f06384-b570-4ef5-aa9c-3ec30d14f0ac
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 6 June 2019
                : 24 March 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Medicine
                medical school differences,teaching styles,problem-based learning,timetables,lectures,tutorials,clinical teaching,self-regulated learning

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