Clinical experience and performance in final examinations

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7149.1984 (Published 27 June 1998) Cite this as: BMJ 1998;316:1984

Teaching styles need to be reviewed to help students with inappropriate learning styles

  1. Wai-Ching Leung, Senior registrar in public health medicine
  1. Department of Public Health, Sunderland Health Authority, Sunderland SR3 4AF
  2. Medical Education Unit, University of Leeds, Leeds LS2 9NL
  3. University College London Medical School, London N19 5HF
  4. Centre for Health Informatics and Multiprofessional Education, University College, Whittington Hospital, London N19 5NF
  5. Northwick Park and St Mark's NHS Trust, Northwick Park Hospital, Harrow HA1 3UJ

    EDITOR—McManus et al found that their prospective study of two cohorts of medical students at a London medical school showed that the students' learning style, but not their final examination results, was related to the amount of knowledge gained from clinical experience.1

    Their questionnaire measured some aspects of the students' clinical exposure but did not measure the knowledge gained from such experience.2 A proportion of the practical procedures and surgical operations selected in the questionnaire was not of central relevance to undergraduates, even after the time when the study was carried out is taken into account. Students should never have performed procedures such as colonoscopy, abdominal paracentesis, ring block, endotracheal intubation, and intramuscular or subcutaneous injection without supervision, even in the early 1990s.

    Likewise, having seen operations such as laryngectomy, removal of cerebral tumour, or skin grafting more than four times was less relevant than developing a systematic approach to the diagnosis and management of common symptoms. It is this systematic approach that final examinations assess. Furthermore, even if the authors' measurements of clinical experience were valid, the association of learning style with clinical experience was small (for 1986 cohort, deep learning, r=0.26, r2=0.07).

    The authors concluded that medical schools could select students by assessing their learning styles. This …

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