Postgraduate and undergraduate medical students may need to be taught differently

Postgraduate and undergraduate medical students may benefit from different teaching styles, researchers in Australia have found.

A team from Monash University in Melbourne wanted to find out whether graduate entry trainees did better—because of their “greater clinical and life experience”—than undergraduates when studying evidence based medicine.1 The researchers collected data over a five year period (from 2010 to 2014) from 885 trainees. The results were published in the Postgraduate Medical Journal.

From 2010 to 2012, the trainees studied a programme in evidence based medicine. It was delivered as a series of 10 two hour sessions, usually in a didactic format. From 2013 to 2014 the curriculum was redeveloped and became a blended learning model. Researchers used a validated measurement of competency and tests to differentiate between undergraduate and graduate entry trainees’ performance. They also analysed trainee group discussions.

They found that undergraduate trainees did “significantly better” than graduates when taught evidence based medicine didactically. In the blended model, graduate trainees’ competency scores increased but were similar to those of undergraduate medical trainees. The researchers said, “Our findings confirm previous evidence that medical trainees value the importance of evidence based medicine in clinical practice, yet have different drivers for learning.”

They said that at the postgraduate level learning was driven by “the opportunity for learners to see how evidence based medicine is integrated within the clinical environment,” and that the context in which the subject was taught was a “major determinant” in how graduate entry students learnt.

Not much was known about how medical trainees’ competency changed as they moved from first to final year and beyond, the researchers said. More longitudinal data could identify changes as trainees gathered clinical experience, and could show how working across different disciplines influenced knowledge, skills, and attitudes towards evidence based medicine.

“Given the trend of medical schools moving towards a graduate entry model, more research is needed to understand to what extent the phenomenon of ‘clinical maturity’ exists in students, and how it impacts across clinical and non-clinical training,” they said.