Student evaluation of the clinical 'curriculum in action'.
OBJECTIVE
To examine how students' evaluations of the environment, process and outcome of clinical learning interrelated and correlated with assessment results.


METHODS
A post hoc study in the 3rd of 5 years in a student-centred, horizontally integrated, objective-based medical curriculum. In the last week of each module, students evaluated what they had learned and how they had learned it using a previously validated, web-based scale. The interrelationships between scale variables and their relationships with summative assessment results were tested using factor analysis, correlation analysis and stepwise multiple regression analysis.


RESULTS
Student evaluation yielded 4 summary measures: 2 reflected learning outcomes ('real patient learning' and 'curriculum coverage'), 1 reflected process ('quality of instruction') and 1 reflected environment ('conditions for learning'). They fitted a causal model according to which instruction, conditions for learning and curriculum coverage favoured real patient learning. Real patient learning was rated higher in women than men, and the measures were associated more strongly in women. Performance in end-of-year summative assessments was predicted strongly by mid-year performance but by no other measure.


CONCLUSIONS
Students' evaluations of their learning environment and instructional processes correlated with their assessments of 2 outcomes of the curriculum in action: curriculum coverage and real patient learning. There was little shared variance between those measures and students' performance in summative assessments. Given its formative potential, students' evaluation of their curriculum in action could play a useful part in learner-centred clinical education. There is a possibility, which needs further research, that women's evaluations have greater predictive validity than men's. Assessment performance should be regarded not as a solitary gold standard but as just 1 measure of educational outcome.
Dornan
Tim
T
Hope Hospital, University of Manchester School of Medicine, Manchester, UK. tim.dornan@manchester.ac.uk
Arno
Muijtjens
M
Hadfield
Judy
J
Scherpbier
Albert
A
Boshuizen
Henny
H
D001291:Attitude of Health Personnel; D015510:Clinical Medicine / Q000193:education*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004739:England; D006801:Humans; D010549:Personal Satisfaction; D018794:Problem-Based Learning; D015397:Program Evaluation; D013337:Students, Medical / Q000523:psychology*