Dimensions of University Student Learning in Medicine and Pharmacy

Study orientations in higher education consist of various dimensions, such as approaches to learning, conceptions of learning and knowledge (i.e. epistemologies), self-regulation, and motivation. They have also been measured in different ways. The main orientations typically reported are reproducing and meaning orientations. The present study explored dimensions of study orientations, focusing in particular on pharmacy and medicine. New versions of self-report instruments were developed and tested in various contexts and in two countries. Furthermore, the linkages between study orientations and students epistemological development were explored. The context of problem-based (PBL) small groups was investigated in order to better understand how collaboration contributes to the quality of learning. The participants of Study I (n=66) were pharmacy students, who were followed during a three-year professionally oriented program in terms of their study orientations and epistemologies. A reproducing orientation to studying diminished during studying, whereas only a few students maintained their original level of meaning orientation. Dualism was found to be associated with a reproducing orientation. In Study II practices associated with deep and surface approaches to learning were measured in two differing ways, in order to better distinguish between what students believed to be useful in studying, and the extent to which they applied their beliefs to practice when preparing for examinations. Differences between domains were investigated by including a sample of Finnish and Swedish medical students (n=956) and a Finnish non-medical sample of university students (n=865). Memorizing and rote learning appeared as differing components of a surface approach to learning, while understanding, relating, and critical evaluation of knowledge emerged as aspects of a deep approach to learning. A structural model confirmed these results in both student samples. Study III explored a wide variety of dimensions of learning in medical education. Swedish medical students (n=280) answered the questionnaire. The deep approach to learning was strongly related to collaboration and reflective learning, whereas the surface approach was associated with novice-like views of knowledge and the valuing of certain and directly applicable knowledge. PBL students aimed at understanding, but also valued the role of memorization. Study IV investigated 12 PBL tutorial groups of students (n=116) studying microbiology and pharmacology in a medical school. The educational application was expected to support a deep approach to learning: Group members course grades in a final examination were related to the perceived functioning of the PBL tutorial groups. Further, the quality of cases that had been used as triggers for learning, was associated with the quality of small group functioning. New dimensions of study orientations were discovered. In particular, novel, finer distinctions were found within the deep approach component. In medicine, critical evaluation of knowledge appeared to be less valued than understanding and relating. Further, collaboration appeared to be closely related to the deep approach, and it was also important in terms of successful PBL studying. The results of the studies confirmed the previously found associations between approaches to learning and study success, but showed interesting context- and subgroup-related differences in this respect. Students ideas about the nature of knowledge and their approaches to learning were shown to be closely related. The present study expanded our understanding of the dimensions of study orientations, of their development, and their contextual variability in pharmacy and medicine.

Contribution à l'étude de la construction des concepts scientifiques au cours de l'apprentissage par problèmes en médecine

L’approche d’apprentissage par problèmes (APP) a vu le jour, dans sa forme contemporaine, à la Faculté de médecine de l’Université MacMaster en Ontario (Canada) à la fin des années 1960. Très rapidement cette nouvelle approche pédagogique active, centrée sur l’étudiant et basée sur les problèmes biomédicaux, va être adoptée par de nombreuses facultés de médecine de par le monde et gagner d’autres disciplines. Cependant, malgré ce succès apparent, l’APP est aussi une approche controversée, notamment en éducation médicale, où elle a été accusée de favoriser un apprentissage superficiel. Par ailleurs, les étudiants formés par cette approche réussiraient moins bien que les autres aux tests évaluant l’acquisition des concepts scientifiques de base, et il n’a jamais été prouvé que les médecins formés par l’APP seraient meilleurs que les autres. Pour mieux comprendre ces résultats, la présente recherche a voulu explorer l’apprentissage de ces concepts scientifiques, en tant que processus de construction, chez des étudiants formés par l’APP, à la Faculté de médecine de l’Université de Montréal, en nous appuyant sur le cadre théorique socioconstructivisme de Vygotski. Pour cet auteur, la formation des concepts est un processus complexe de construction de sens, en plusieurs étapes, qui ne peut se concevoir que dans le cadre d’une résolution de problèmes. Nous avons réalisé une étude de cas, multicas, intrasite, les cas étant deux groupes de neuf étudiants en médecine avec leur tuteur, que nous avons suivi pendant une session complète de la mi-novembre à la mi-décembre 2007. Deux grands objectifs étaient poursuivis: premièrement, fournir des analyses détaillées et des matériaux réflectifs et théoriques susceptibles de rendre compte du phénomène de construction des concepts scientifiques de base par des étudiants en médecine dans le contexte de l’APP. Deuxièmement, explorer, les approches de travail personnel des étudiants, lors de la phase de travail individuel, afin de répondre à la question de recherche suivante : Comment la dynamique pédagogique de l’APP en médecine permet-elle de rendre compte de l’apprentissage des concepts scientifiques de base? Il s’agissait d’une étude qualitative et les données ont été recueillies par différents moyens : observation non participante et enregistrement vidéo des tutoriaux d’APP, interview semi-structuré des étudiants, discussion avec les tuteurs et consultation de leurs manuels, puis traitées par diverses opérations: transcription des enregistrements, regroupement, classification. L’analyse a porté sur des collections de verbatim issus des transcriptions, sur le suivi de la construction des concepts à travers le temps et les sessions, sur le role du tuteur pour aider au développement de ces concepts Les analyses suggèrent que l’approche d’APP est, en général, bien accueillie, et les débats sont soutenus, avec en moyenne entre trois et quatre échanges par minute. Par rapport au premier objectif, nous avons effectivement fourni des explications détaillées sur la dynamique de construction des concepts qui s'étend lors des trois phases de l'APP, à savoir la phase aller, la phase de recherche individuelle et la phase retour. Pour chaque cas étudié, nous avons mis en évidence les représentations conceptuelles initiales à la phase aller, co-constructions des étudiants, sous la guidance du tuteur et nous avons suivi la transformation de ces concepts spontanés naïfs, lors des discussions de la phase retour. Le choix du cadre théorique socio constructiviste de Vygotski nous a permis de réfléchir sur le rôle de médiation joué par les composantes du système interactif de l'APP, que nous avons considéré comme une zone proximale de développement (ZPD) au sens élargi, qui sont le problème, le tuteur, l'étudiant et ses pairs, les ressources, notamment l'artefact graphique carte conceptuelle utilisée de façon intensive lors des tutoriaux aller et retour, pour arriver à la construction des concepts scientifiques. Notre recherche a montré qu'en revenant de leurs recherches, les étudiants avaient trois genres de représentations conceptuelles: des concepts corrects, des concepts incomplets et des concepts erronés. Il faut donc que les concepts scientifiques théoriques soient à leur tour confrontés au problème concret, dans l'interaction sociale pour une validation des attributs qui les caractérisent. Dans cette interaction, le tuteur joue un rôle clé complexe de facilitateur, de médiateur, essentiellement par le langage. L'analyse thématique de ses interventions a permis d'en distinguer cinq types: la gestion du groupe, l'argumentation, les questions de différents types, le modelling et les conclusions. Nous avons montré le lien entre les questions du tuteur et le type de réponses des étudiants, pour recommander un meilleur équilibre entre les différents types de questions. Les étudiants, également par les échanges verbaux, mais aussi par la construction collective des cartes conceptuelles initiales et définitives, participent à une co-construction de ces concepts. L'analyse de leurs interactions nous a permis de relever différentes fonctions du langage, pour souligner l'intérêt des interactions argumentatives, marqueurs d'un travail collaboratif en profondeur pour la co-construction des concepts Nous avons aussi montré l'intérêt des cartes conceptuelles non seulement pour visualiser les concepts, mais aussi en tant qu'artefact, outil de médiation psychique à double fonction communicative et sémiotique. Concernant le second objectif, l’exploration du travail personnel des étudiants, on constate que les étudiants de première année font un travail plus approfondi de recherche, et utilisent plus souvent des stratégies de lecture plus efficaces que leurs collègues de deuxième année. Ceux-ci se contentent, en général, des ouvrages de référence, font de simples lectures et s’appuient beaucoup sur les résumés faits par leurs prédécesseurs. Le recours aux ouvrages de référence essentiellement comme source d'information apporte une certaine pauvreté au débat à la phase retour avec peu d'échanges de type argumentatif, témoins d'un travail profond. Ainsi donc, par tout ce soutien qu'elle permet d'apporter aux étudiants pour la construction de leurs connaissances, pour le type d'apprentissage qu'elle offre, l’APP reste une approche unique, digne d’intérêt. Cependant, elle nécessite d'être améliorée par des interventions au niveau du tuteur et des étudiants.

Argonauta Video Database: General simulated scenes. Scene 1 (Right camera)

General simulated scenes These scenes followed a pre-defined script (see the Thesis for details), with common movements corresponding to general experiments. People go to or stand still in front of "J9", and/or go to the side of Argonauta reactor and come back again. The first type of movement is common during Irradiation experiments, where a material sample is put within the "J9" channel; and also during neutrongraphy or gammagraphy experiments, where a sample is placed in front of "J9". Here, the detailed movements of putting samples on these places were not reproduced in details, but only the whole bodies' movements were simulated (as crouching or being still in front of "J9"). The second type of movement may occur when operators go to the side of Argonauta to verify some operational condition. - Scene 1 (Obs.: Scene 1 of the "General simulated scenes" class): Comprises one of the scenes with two persons. Both of them use clothes of light colors. Both persons remain still in front of "J9"; one goes to the computer and then come back, and both go out. Video file labels: "20140326145315_IPCAM": recorded by the right camera,

Argonauta Video Database: Spectrography experiment. Scene 1 (Right câmera)

Scenes for Spectrography experiment Scenes were recorded following the tasks involved in spectrography experiments, which are carried out in front of "J9" output radiadion channel, the latter in open condition. These tasks may be executed by one or two persons. One person can do the tasks, but requiring him to crouch in front of "J9" to adjust the angular position the experimental appartus (a crystal to bend the neutron radiation to the spectograph), and then to get up to verify data in a computer aside; these movements are repeated until achieving the right operational conditions. Two people may aid one another in such a way one remais crouched while the other remains still in front of the computer. They may also interchange tasks so as to divide received doses. Up to now, there are available two scenes with one person and one scene with two persons. These scenes are described in the sequel: - Scene 1: Comprises one of the scenes with one person performing spectography experiment. Video file labels: "20140327181335_IPCAM": recorded by the right camera

Argonauta Video Database: General simulated. Scene 2 (Right camera)

General simulated scenes These scenes followed a pre-defined script (see the Thesis for details), with common movements corresponding to general experiments. People go to or stand still in front of "J9", and/or go to the side of Argonauta reactor and come back again. The first type of movement is common during Irradiation experiments, where a material sample is put within the "J9" channel; and also during neutrongraphy or gammagraphy experiments, where a sample is placed in front of "J9". Here, the detailed movements of putting samples on these places were not reproduced in details, but only the whole bodies' movements were simulated (as crouching or being still in front of "J9"). The second type of movement may occur when operators go to the side of Argonauta to verify some operational condition. - Scene 2: Comprises one of the scenes with two persons. Both of them use clothes of dark colors. Both persons go to the side of Argonauta reactor and then come back and go out. Video file labels: "20140326154754_IPCAM": recorded by the right camera.

Argonauta Video Database: Spectography experiment. Scene 2 (Right camera)

Scenes for Spectrography experiment Scenes were recorded following the tasks involved in spectrography experiments, which are carried out in front of "J9" output radiadion channel, the latter in open condition. These tasks may be executed by one or two persons. One person can do the tasks, but requiring him to crouch in front of "J9" to adjust the angular position the experimental appartus (a crystal to bend the neutron radiation to the spectograph), and then to get up to verify data in a computer aside; these movements are repeated until achieving the right operational conditions. Two people may aid one another in such a way one remais crouched while the other remains still in front of the computer. They may also interchange tasks so as to divide received doses. Up to now, there are available two scenes with one person and one scene with two persons. These scenes are described in the sequel: - Scene 2: Another take similat to Scene 1. Video file labels: "20140327180749_IPCAM": recorded by the right camera.

Argonauta Video Database: Spectography experiment. Scene 3 (Right camera)

Scenes for Spectrography experiment Scenes were recorded following the tasks involved in spectrography experiments, which are carried out in front of "J9" output radiadion channel, the latter in open condition. These tasks may be executed by one or two persons. One person can do the tasks, but requiring him to crouch in front of "J9" to adjust the angular position the experimental appartus (a crystal to bend the neutron radiation to the spectograph), and then to get up to verify data in a computer aside; these movements are repeated until achieving the right operational conditions. Two people may aid one another in such a way one remais crouched while the other remains still in front of the computer. They may also interchange tasks so as to divide received doses. Up to now, there are available two scenes with one person and one scene with two persons. These scenes are described in the sequel: - Scene 3: Comprises the scene with two persons performing spectography experiment. Video file labels: "20140327182905_IPCAM": recorded by the right camera.

Argonauta Video Database: Real operation. Scene 1 (Right camera)

Real operation scene This scene was recorded during a real Irradiation operation, more specifically during its final tasks (removing the irradiated sample). This scene was an extra recording to the script and planned ones. - Scene: Involved a number of persons, as: two operators, two personnel belonging to the radiological protection service, and the "client" who asked for the irradiation. Video file labels: "20140402150657_IPCAM": recorded by the right camera.

Argonauta Video Database: Projection and Homography matrices. Projection Right Camera

Description of the Annotation files: Annotation files are supplied for each video, for benchmarking. Annotations correspond to ground truths of peoples' positions in the image plane, and also for their feet positions, when they were visible. Annotations were performed manually, with the aid of a code developed by (Silva et al., 2014; see the Thesis for details). Targets (people or feet) are marked at variable frame intervals and then linearly interpolated.

Argonauta Video Database: Projection and Homography matrices. Homography Right Camera

Description of the Annotation files: Annotation files are supplied for each video, for benchmarking. Annotations correspond to ground truths of peoples' positions in the image plane, and also for their feet positions, when they were visible. Annotations were performed manually, with the aid of a code developed by (Silva et al., 2014; see the Thesis for details). Targets (people or feet) are marked at variable frame intervals and then linearly interpolated.