Learning approaches of physician assistant students: Assessing changes over time

Abstract

INTRODUCTION: Physician assistant (PA) students start medical training with different educational and health care backgrounds. This along with the high volume of complex medical content presented during the didactic year (53 credit hours over 14 months) may impact quality of learning. Students utilize either a deep or surface approach to master course content. While there have been studies assessing study approaches of medical, nursing, and dental students, studies have not been conducted in PA students. The Biggs's Revised Two-Factor Study Process Questionnaire (R-SPQ-2F) is a validated, 20-item, self-administered questionnaire assessing two scales of learning approaches, deep and surface, with four subscales: deep motive, deep strategy, surface motive, and surface strategy. PURPOSE: Evaluate the impact of the rigorous PA curriculum on learning approaches. METHODS: This repeated cross-sectional study evaluated learning approaches within a convenience sample of a single cohort of 52 WSU PA students. Learning approaches were measured at three points in time: 1) prior to beginning the PA program, 2) end of the first summer semester, and 3) end of the fall semester. Likert scale data and subscales were analyzed using the Wilcoxon Signed Rank Test for non-parametric, related samples. RESULTS: Comparing the first and second measurements, there was a statistically significant decrease in Surface Approach (p = .036) and Surface Strategy (p = .037), and an increase in Deep Motivation (p = .040). Comparing the second and third measurements there was a statistically significant decrease in Deep Approach (p = .011) and Deep Strategy (p = .002). However, there were no significant changes between the first and third measurements. Marital status did not affect learning approach, but gender differences were noted. At baseline, males were higher than females with regards to Surface Approach (26.9 vs. 21.4, p < .001), Surface Strategy (11.5 vs. 12.0, p = .001), and Surface Motivation (11.5 vs. 9.4, p < .001). Gender differences were not present at the second or third measurements. CONCLUSION: These data indicate that PA students may shift learning approaches to accommodate curriculum. The shift from surface to deep learning approaches following the first semester of advanced anatomy likely indicates an understanding that deep learning is necessary to master this level of rigorous applied basic science content. The decrease in deep learning approaches seen in the conclusion of the fall semester may be a function of the sheer volume of content (22 credit hours) which may be incompatible with deep learning approaches. Having a greater understanding of changes in student learning approaches over time may help educators improve and adapt teaching strategies and workload throughout the curriculum to promote deep learning approaches.