What do students want? The types of learning activities preferred by final year medical students

Context A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment. Objectives To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship. Subjects Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors. Methods A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations. Results The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care. Conclusion Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment.