Learning journeys - student learning development in the first years of a medical degree: an analysis of student conversations

Introduction

Students starting medical school generally come from a learning background that expects them to learn content, which is reproduced to pass an exam. As a part of their learning development, they must adapt and become self-motivated learners who can determine the underlying principles or concepts and use these to problem solve in the uncertainty of real-life clinical practice. Whilst much has been written about designing curricula to promote learning development, there is no one-size fits all approach to facilitating this type of learning, thus an analysis of what helps and hinders learning development is indicated.

Methods

Student pairs in Y2 and Y3 of an undergraduate Bachelor of Medicine, Bachelor of Surgery (BMBS) programme of a South-West UK medical school, were asked to audio record a conversation about their learning through a facilitated problem-based learning approach during the BMBS course so far. They were provided with a brief to aid them in their discussion in the style of the outside broadcast method of BBC Radio 4s listening project. Using this method, the conversation was unfacilitated and allowed to take its natural course. Conversations were transcribed and coded to determine emerging themes with respect to the developing understanding of the students about what and how they were learning.

Results

Four student pairs volunteered for the project one from Y2 and three from Y3. Five key themes were identified including: from 'learning it all, to structured learning'; 'developing understanding and the spiral curriculum'; 'working alone versus working with others'; 'integrated learning and understanding context' and 'assessment and resources.' Narrative analysis within these themes suggested that over the course of the first two to three years of study, participants developed a better understanding of how best to learn, although there were differences in both time and order that participants reached a point where learning felt more natural to them.

Discussion

Analysis of the data suggested that students develop independently towards being self-motivated lifelong learners. There were several key aspects of curriculum design that could be used to facilitate this development, which could easily be incorporated into developing or creating problem- / enquiry-based curricula.

Learning journey: Conceptualising "change over time" as a dimension of workplace learning

Understanding how individuals learn at work throughout their lives is significant for discussions of lifelong learning in the current era where changes can be unpredictable and frequent, as illustrated by the COVID-19 pandemic. Despite a corpus of literature on the subject of "learning", there is little research or theoretical understanding of "change over time" as a dimension of individual learning at work. Increasing emphasis has been put on individuals' personal development, since they play key mediating roles in organisations' work practices. This article proposes the concept of the "learning journey" to explore the relational complexity of how individuals learn at different workplace settings across their working lives. In order to illuminate this, the article draws on the learning experiences of two workers with different roles at two points in time across different workplaces. The author argues that individual learning involves a complex interaction of individual positions, identities and agency towards learning. This complexity is relational and interrelated with the workplace learning culture, which is why learning is different for individuals in different workplaces and even for the same person in the same workplace when occupying different roles.