The journey towards understanding : exploring the interplay between teaching and learning

This thesis explores students’ journey towards understanding throughout a nineweek course in their second year of an undergraduate medical programme. Although the investigation was undertaken in the context of a medical curriculum, the overall aim, to investigate the development of students’ experiences of learning and understanding, relates to issues in higher education in general. An exploratory, qualitative research approach was adopted, and data were collected through student interviews and written accounts from medical students taking a compulsory course in pathology. Of all the teaching and learning activities that this course offered the students, three in particular were selected for in-depth analysis with a focus on students’ experiences of learning and understanding in relation to these activities: a case seminar (Study I), formative assessments (Study II) and autopsies (Study III). Study IV broadened the scope of the previous studies and investigated the students’ experiences throughout the course.

Previous research has showed that students are sensitive to their learning environment and tend to adopt either a surface, deep or strategic approach to learning. The findings presented in this thesis suggest a more complex picture of how medical students approach their learning and develop understanding in the course of pathology, and suggest potential pathways students might take towards developing a deep understanding. Initially, students seemed to focus on understanding the basic terminology and getting a brief overview of the course content. Subsequently, the students focused on how to manage the vast amount of information they were supposed to learn. Some students developed a form of catalogue-like understanding of the content, while others developed a more integrated understanding. Furthermore, the design of the course as a whole with its varying teaching and learning activities strongly influenced the ways in which students set about understanding the course content. Activities that explicitly related theoretical knowledge to real life examples, focused on problem-solving and application, and allowed time for reflection and discussion were activities that seemed to facilitate the development of a deeper understanding. Collaborative learning in small groups was also important for students’ learning. When students perceived the activities as being meaningful, relevant and interesting, they seemed more likely to engage in them.

This thesis offers a fine-grained analysis of medical students’ approaches to learning within a particular course, suggesting potential pathways to achieving an academic understanding of course content within a medical curriculum. This research also points up important aspects of the complex relationship between teaching and learning in higher education that have more general implications for the design of courses and individual teaching and learning activities.

List of scientific papers

I. Weurlander, M, Masiello, I., Söderberg, M. & Wernerson, A. (2009) Meaningful learning: students’ perceptions of a new form of case seminar in pathology. Medical Teacher. 31 (6):e248-e253.
https://doi.org/10.1080/01421590802637933

II. Weurlander, M., Söderberg, M, Scheja, M., Hult, H. & Wernerson, A. (2011) Exploring formative assessment as a tool for learning: Students’ experiences of different methods of formative assessment. Assessment and Evaluation in Higher Education, iFirst. 21 juni. 1-14
https://doi.org/10.1080/02602938.2011.572153

III. Weurlander, M., Scheja, M., Hult, H. & Wernerson, A. (2012) Emotionally challenging learning situations: medical students’ experiences of autopsies. International Journal of Medical Education. 3:63-70.
https://doi.org/10.5116/ijme.4f75.fb65

IV. Weurlander, M., Scheja, M., Hult, H. & Wernerson, A. The struggle to understand: Exploring students’ experiences of learning and understanding during a university course. [Manuscript]